Managing the Change
Posted 9/29/2017 by UHBlog
We often hear change is good – and that can be true of “The Change,” as well. Once women hit menopause, they’re usually more confident and less concerned with pleasing others. And, of course, there’s the bonus of not worrying about an unplanned pregnancy or cramming tampons into a tiny evening bag.
Still, many women find some parts of perimenopause and menopause to be physically and psychologically trying.
“Menopause is 12 months in a row with no period, and the time leading up to menopause is the perimenopausal transition, when you can start experiencing symptoms of menopause several years before menopause,” says certified nurse practitioner Jean Marino, CNP. “Menopause is normal. A lot of women are afraid of it, but all women go through it.”
Reframing the experience is a good way to manage that fear, says psychologist Danette Conklin, PhD.
“Women should try to modify how they’re seeing the transition,” she says. “Not, ‘Oh, my gosh! I’m getting old and I’m useless and people think I’m crazy because I’m having mood swings.’ If they don’t buy into how society looks at women who are aging, that’s helpful.”
The average age for American women to reach menopause is 52, but any time between ages 40 and 60 is considered normal. It’s also normal for some women to have symptoms that temporarily interrupt their usual activity, while others remain unbothered.
“I liken it to women and their menstrual cycles,” Marino says. “Some women will have horrible mood swings and cramps during their periods, and others don’t. We don’t know why.”
Marino and Dr. Conklin outline eight symptoms some women experience during “The Change” and provide advice for mitigating some of them:
- Menstrual changes – Some women begin skipping periods or having a heavier or lighter flow four to eight years before menstruation stops altogether.
- Hot flashes and/or night sweats – About 70 to 80 percent of women experience periodic rises in skin temperature, either throughout the day or just at night.
“Some find it to be severe and say it interferes with their quality of life, and others just have a few hot flashes and skate through menopause,” Marino says.
Women who are African-American, overweight or have a history of PMS are more likely to suffer from hot flashes. Hormone therapy can reduce the frequency and intensity of hot flashes, and is a very safe option, especially for women who are within 10 years of reaching menopause and under age 60.
- Vaginal dryness – This occurs from a drop in estrogen and may cause painful intercourse and irritation. Over-the-counter lubricants may help, but a prescription vaginal estrogen is the best option. Avoid soaps with dyes, perfumes or antibacterial agents.
- Insomnia and interrupted sleep – Hormone-related night sweats, especially those that drench a woman’s pajamas and bed sheets, can disrupt her slumber. So can common stressors of middle-age women, such as juggling adolescent children, aging parents, jobs and relationship changes.
“Anxiety, stress and night sweats affect sleep, and these women are worried about taking care of everybody else,” Dr. Conklin says.
- Skin and hair changes – When estrogen drops, some women develop wrinkles and find the hair on their head thinning – even as chin and face hairs appear. Adult acne may occur from an uptick in androgen production.
- Memory loss – Forgetfulness is temporary, usually disappears upon reaching menopause and has no bearing on developing Alzheimer’s or dementia later.
- Weight gain – Although this often coincides with “The Change,” it is not because of it. Weight gain occurs as metabolism slows, women lose muscle mass and lower estrogen levels send excess weight straight to the abdomen. Wholesome foods, exercise and acceptance are good coping skills.
- Anxiety, mood swings and/or depression – Women with a history of severe PMS, major depression, bipolar disorder or an anxiety disorder are at higher risk of experiencing psychological and/or emotional distress.
“It may be harder to manage this time, and some women may have a relapse of major depression,” Dr. Conklin says.
She recommends talking to other women, learning stress-management skills and pacing tasks instead of trying to do too many things simultaneously. Consult a mental health professional after two weeks of daily mood changes or if struggling with everyday activities, in general. Individuals with a history of bipolar disorder should seek help after four or five days of persistent mood changes.
For help with coping with menopause, University Hospitals offers a menopause discussion (education) group that meets quarterly and a menopause clinic, which runs on the second and fourth Friday of each month. (If there is a fifth Friday, the clinic runs on that day, too.) The clinic and discussion groups are held at University Hospitals Landerbrook Health Center. For more information or to register, please call the Landerbrook office at 440-720-3250.
Jean Marino, CNP, is a certified nurse practitioner in the Department of Obstetrics and Gynecology at University Hospitals Cleveland Medical Center and University Hospitals Landerbrook Health Center. You can request an appointment with Marino or any other health care professional online.
Danette Conklin, PhD, is a psychologist and Director, Midlife Wellness for Women at University Hospitals Cleveland Medical Center. You can request an appointment with Dr. Conklin or any other health care professional online.