Reprinted from the Health District's quarterly publication mailed to district residents (Spring 2001)
TOPIC: Managing Menopause
Awareness and a "take-charge" attitude can transform women's midlife transition into a time of blossoming 
by kathy hayes

Going into my mid-40s was like entering the twilight zone. Nine extra pounds jumped onto my waist practically overnight. I collapsed into bed each evening, then couldn't sleep. My short-term memory had taken a hike, and all my energy seemed to be fueling some demon that suddenly controlled my emotions. 
My "twilight zone" turned out to be perimenopause: the transition between a woman's childbearing years and menopause, when periods cease altogether. The average age for the onset of perimenopause is 47.5 and for menopause, 51. But some women may reach menopause in their 30s or their 60s. The transition itself may last 20-30 years, or nearly a third of our lives. By learning about the changes and risks associated with perimenopause and menopause and adopting a new healthy living plan, women can enjoy this stage of life with renewed vigor.

Let's take care of the symptoms. Irregular periods, weight gain, hot flashes, vaginal dryness, sleep disturbances, sexual disinterest and low energy often accompany perimenopause. We're all different, though, so the symptoms we experience—and the severity of those symptoms—will vary.

Although these symptoms can make life miserable, it's more important to consider the major health risks that arise during perimenopause as the result of estrogen levels decreasing. These include osteoporosis, heart disease and Alzheimer's.

"I think the best screening test for a perimenopausal woman is to have her physician take a medical history and identify any risk factors she may have," advises Bruce Cooper, MD, medical director at the Health District. A thin woman who smokes, for example, may be at greater risk for osteoporosis than a larger woman who doesn't smoke. The risk for heart disease and breast cancer should also be discussed when considering estrogen therapy.

"The more you know dealing with menopause," says Bruce Cooper, MD, "the better off—and healthier—you'll be."

resources

North American Menopause Society
Extensive information about menopause, health risks and treatments. Call (800) 774-5342 or visit www.menopause.org

Health District of Northern Larimer County 
Information and classes on nutrition, weight management, heart disease screenings and quitting smoking. Call 224-5209. www.healthdistrict.org

Poudre Valley Hospital
Classes on nutrition, self care and other health topics. Call 495-7320 for information. www.pvhs.org

U.S. Soyfoods Directory
Free booklet describing soy nutrition facts, health benefits and recipes. 
(800) 825-5769 or www.soyfoods.com 

Web Sites
Melpomene Institute 
National Institute on Aging
Planned Parenthood 

Balancing estrogen levels is critical to minimizing risks and symptoms to maintain peak health as women get older. Lots of estrogen-replacement options, including natural estrogens, exist. The trick is discovering what works best for you. Consult with your physician about what's available and what might be appropriate for you. Then complement that with a new and improved lifestyle.

"Perimenopause is a great time to step aside, evaluate things, and make those changes you perhaps meant to make awhile ago," says Kathleen Molloy, a former health educator at the Health District. It's also a time, Molloy adds, when women can redirect their attention more toward their own self care, and that new focus can be empowering. 

A healthy lifestyle that emphasizes increased activity and a balanced diet may be the best solution. Here are some ways to achieve that:

  • Get enough calcium — 1200-1500 mgs. every day through low-fat milk or soy milk, tofu, leafy green vegeta bles and calcium supplements.

  • Eat when hungry — five to six small 
    nutritious meals will stabilize blood- sugar levels and give you the energy you need.

  • Make fruits, vegetables, whole grains and soy products a large part of your diet. They're high in fiber, vitamins, and minerals, and soy can provide natural estrogens. 

  • Limit fats to no more than 30 percent of your total caloric intake.

  • Commit to an activity program that includes regular weight-bearing 
    activity, such as walking or weightlifting, to improve heart and bone health. Regular exercise will help lower stress, elevate mood, lessen food cravings and increase a sense of well-being.

  • If you smoke, quit. If you drink, limit alcohol to 1-2 drinks per day or less.

  • Breathe deeply and relax. Look into taking a yoga class. Studies show that women who practice deep breathing have 50 percent fewer hot flashes than women who don't.

With a relaxed attitude, a balanced approach, and a new focus on healthy living, women approaching menopause can enjoy this transition and the "symptoms" that accompany it: greater confidence, self-esteem, energy and joy of living.
Selected estrogen replacement treatments

Hormone replacement therapy (HRT) and estrogen replacement therapy (ERT)—is an effective treatment for menopausal symptoms, but may increase risk of breast and ovarian cancer and blood clots. Has side effects.

Selective estrogen receptor modulator (SERM)—is a hormone-like drug that increases bone density and reduces cholesterol. Doesn't curtail hot flashes.

Fosamax (alendronate) and Miacalcin (calcitonin)—help maintain and even improve bone density. Both have side effects. 

Plant-derived estrogen creams—release estrogen into the body topically to help with menopausal symptoms and osteoporosis prevention. 

Vaginal estrogen creams and estrogen rings—are designed to relieve vaginal atrophy by slowly releasing a low dose of estrogen in the vaginal area. These treatments don't address hot flashes or protect against heart disease or osteoporosis.

Questions about mammograms?