By 2025, there will be over 1 billion women experiencing menopause.
Menopause is a word with a simple meaning, but many negative connotations. Menopause literally means the cessation of menstruation, but many women view it as the end of their youth and the beginning of aging into a less valuable person. A woman’s worth should not be measured by her reproductive ability, and the end of her reproductive life does not mean the end of a productive life. But there is so much misinformation and denial about the menopause experience, and the menopause transition, to overcome.
Who wants to be categorized in a group that our society deems are irrelevant? We can do better, and we can shine a new light on what it means to be a woman nearing, or in menopause. Over 1 billion women worldwide will be in or postmenopausal by 2025. But we are living in a culture that has spent centuries dismissing women after their reproductive years - which might explain why we don’t know more about it.1
The combination of a desire to stay youthful in a society obsessed with it, a lack of information, the perpetuation of misinformation to sell artificial products, and the taboos around menopause are overwhelming. For far too long menopause has been stigmatized, and we women allow that perpetuation of shame around women’s aging. As a result, many women don’t feel comfortable talking about the symptoms they’re experiencing with friends, family, or even their own doctors.
Menopause does not have to be the same experience that our mothers endured. We can improve our quality of life, and we should not settle for the status quo. No longer can we listen to doctors telling us that we should just ‘put up with’ menopause symptoms.
As the US population is growing older, over 2 million women per year, or 6,000 women per day, are entering perimenopause.1,2 In this article, we are sharing how to have a better menopause experience, and outlining what you can expect.
As It Was In the Beginning
The word “menopause” is derived from the Greek words for month and cessation, and the final menstrual period. Menopause is similar to puberty, a succession of hormonal changes that leads a woman into a transition from one biological phase of life to another. “Peri” is Greek for “near,” and menopause is the cessation of menstruation. So perimenopause is the beginning of all the symptoms of menopause.
Most of us share a similar puberty awakening. Waking up in the morning, or worse in the restroom at school and our clothes are covered in blood from that first period! What was happening? Many mothers didn’t teach their daughters what to expect, or if they did, it wasn’t enough of an education. Now, menopause is a mirror of that scary experience — but it is a deluge of unexpected symptoms, over a very long period, that can be embarrassing to talk about, and mom didn’t properly prepare us for it either...
Women can experience these changes free of fear, shame, or secrecy. But how? We have to begin with scientific facts and honest education. We should provide women with more information about:
How their hormones change in mid-life,
Reasonable expectations of menopause, and
The various medical treatments available.
The reality is that the majority of doctors are not trained specifically in post-reproductive health for women, and if they are, their training is often out of date.3
Puberty for the Middle-Aged
Forty-year-old women need an updated version of “the talk.” The new “talk” could explain how our bodies are changing in surprising ways, and those changes can be really uncomfortable, but nobody seems to want to have that kind of talk.
Wouldn’t it be amazing if on your 40th birthday a friend would sit you down, look you in the eyes and tell you about the changes that could lie ahead and how to prepare for them? The script might go something like, “Here’s what’s going to happen in this next decade or so… Eventually, you will stop having a period altogether. Yay! But before it disappears entirely your periods may be crazy heavy, or light, non-existent, or constant, and maybe even spotty. Oh, and the fat on your body will likely redistribute so that you start to develop a belly and lose your waistline, and your face and neck can drop and become jowly. Mood changes, even depression, should be expected and a solid night's sleep may become a distant memory. All of it, some of it, and for the lucky few - none of it - will happen. But there are things you can do to lessen the symptoms.”
Menopause Transition
Menopause occurs because of changes in the production of estrogen, progesterone, and testosterone. Medically, this time is known as the “menopause transition” or “perimenopause.” The menopause transition time frames create hormonal changes that often begin in a woman’s 40s, and can last from 7-10 years.3,4
Most women will notice symptoms of these changes like weight gain, night sweats, hot flashes, vaginal dryness, depression, difficulty sleeping, and brain fog. Menstrual periods during perimenopause are often less predictable in frequency and timing and can be very heavy to light interchangeably.
When a woman finally has her last menstrual period it will take 12 months of no periods to officially be in menopause, and even that is not the end of the menopause journey. The hormonal changes that occur in perimenopause and menopause can increase women’s risk of conditions such as heart disease, stroke, dementia, diabetes, and osteoporosis if not treated.
The Enlightenment
Just like puberty, menopause is unpredictable. And like when we entered puberty, many women are unaware of the biology of menopause and don’t know what to expect nor do they feel there are good, safe solutions.
Women may not know that the hot flashes and sweating that left them dripping at work and looking for a change of clothes, can be easily and effectively treated. Or how about the dread of having to talk to your intimate partner about vaginal dryness and pain during sex? No matter how great your relationship may be, that’s a tough one.
This lack of information, the perpetuation of misinformation to sell artificial products, and the taboos around menopause are overwhelming. At Winona, we have heard from hundreds and hundreds of women who share that they didn’t bother to discuss their symptoms with a medical provider because they erroneously assumed there were no safe, effective therapies to treat the symptoms that they were suffering from.
Far too many women have described being dismissed by their health care professional with blank stares, or an eye roll, and a statement like, “You just have to put up with it, it isn’t that bad” or “That’s just part of getting older,” or told to come back if it gets worse.
Inaccurate Marketing Information
Many companies are trying to sell bogus over-the-counter products and scare women away from getting effective treatments. Women seeking symptom relief may turn to sources that have great marketing that focuses on scaring them away from valid science by dredging up old science that used hormones that aren’t used by Winona. Instead, these companies offer products that are ‘natural’, likely untested, and even harmful while some are actually very dangerous.
There is usually no oversight for these ‘natural’ products. So, not only are women wasting their money, but they are losing an opportunity to feel better, improve their quality of life, and prevent long-term chronic diseases.
Additionally, there are many companies that try to sell testing kits to help women diagnose where a woman is in her menopause journey. Single blood, saliva, or urine test cannot accurately determine whether or not a woman is close to her final menstrual period, nor can it identify the hormonal chaos of a woman's menopause transition.
Hormone levels can change significantly from day to day and month to month. These one-time tests are a waste of money - they are meaningless because they provide only a snapshot of hormones that change constantly. Therapy for menopause symptoms does not depend on hormone levels but rather it is dependent on the individual patient's symptoms.
The Most Effective Treatment
The most effective treatment for menopause symptoms is hormone replacement therapy (HRT). HRT for menopause includes estrogen, and if a woman has a uterus, progesterone will be included to protect the uterus. Scientific data shows that HRT is safe and effective for most women who start before the age of 60, but there remains a stigma among women and medical providers due to outdated, poorly conducted research. Specifically the Women’s Health Initiative (WHI).
Scientists and doctors recognize that for women, “We are in an era of a medical menopause renaissance,” and yet many women are not benefiting from it.1 In the two decades that have passed since the WHI was released, there has been a plethora of new menopause research and the development of new types of hormones that can be used for HRT naturally, safely, and effectively.
Not only has new research shown that HRT is safe and effective but it also is showing that there is a correlation between untreated estrogen deficiencies and brain fog (and possibly Alzheimer’s) which can be corrected by using HRT5,6. Hormonal treatments have been shown to relieve vaginal dryness and pain during sex too!
Because every woman is unique - their hormonal variations are too - Winona offers pills, patches, or compounded bioidentical hormones that can be applied via easy to dispense creams. These Winona compounded products are created using FDA-approved ingredients and mixed in our licensed pharmacy to our physician’s specifications.
And those supplements and teas that people are pushing? Supplements are not tested for safety, there is no FDA oversight, and anyone can sell anything and call it a “natural menopause supplement.” Winona’s natural products are prescription, using FDA-approved bioidentical hormones, distributed from our licensed pharmacies.
Conclusion
Sadly, in the United States, women’s menopause experience doesn’t always get the attention it deserves. In the past 20 years, there has been a wealth of new medical research and treatments to help ease the menopause transition. HRT helps restore our bodies’ estrogen and progesterone, which are key hormones that can aid in our bone, heart, skin, and vaginal health. HRT can also help reduce hot flashes, ease vaginal dryness, painful sex, and prevent bone fractures caused by osteoporosis.
While there has been much discussion about the safety of this treatment, experts now agree that if started before the age of 60, this treatment carries a low risk for side effects. As women, we need to be more open about menopause and identify that if ignored we could suffer larger health concerns and can significantly alter our quality of life. Often menopause symptoms and the long-term consequences of not treating them are serious, and not a laughing matter. Let Winona help guide you through a healthy, smooth menopause journey.
