The menopause transition: Understanding the 'stage of chaos' and how to manage it
There’s a lot of support and education that goes into preparing a young adolescent for their first menstrual period. But when it comes to the last period, the process is not discussed as openly.
Jennifer Ramsey, CNM, a nurse midwife at M Health Fairview Clinic - Riverside is on a mission to change that.
“The physiological changes that are occurring as our ovaries are gearing down are as dramatic as puberty,” Ramsey said. “Women get used to being able to function and depend on our bodies to behave in a certain way, and all of a sudden they're not.”
Menopause is defined as going 12 months without a period, but the transition can take 10 to 15 years. There’s no reliable test to determine if a person has entered the menopause transition – or perimenopause. But there are signs. The most talked about are hot flashes and night sweats, Ramsey said. Vaginal complaints, irritation, pain with sex, frequent infections, urinary tract infections, and feeling a frequent urge to pee are also common.
The menopause transition generally begins in a person’s 40s. The hormone estrogen starts to fluctuate unevenly. Since there are estrogen receptors in every organ system in the body, the menopause transition can affect the entire body, including skin, joints, mental health, mental clarity, and body weight.
“I’ve heard it coined as the stage of chaos,” Ramsey said.
There are ways to minimize the chaos. Some lifestyle changes can help. Medical care is also available. But to get help, we have to talk about it.
“If you live long enough and you were born identified as female, you will go through menopause at some point,” Ramsey said. “Some people are able to go through it with very minimal symptoms or disruption to their lives. And then for other people, it can really be catastrophic.”
Find a healthcare provider who you feel comfortable talking to, Ramsey suggested. If you are looking for a new women’s health provider, you can request someone who specializes in menopause care.
“If you ever feel like your symptoms are getting brushed aside or you’re not getting listened to or getting the help you need, then definitely keep looking for a different healthcare provider,” Ramsey said. “Because there is help and you and everybody deserves to have somebody who will listen to them, help address what's going on, and help them try to find a solution. But it’s not always an immediate solution. It’s a process.”
Ramsey said two common concerns are especially tricky: Unwanted weight gain and decreased desire for sex. Both can be complex since there’s no single cause or solution. Having a trusted healthcare provider who is committed to partnering with you on solutions can be helpful.
Ramsey shares some tips for weathering your perimenopause era.
Start with sleep.
If you don’t get enough sleep, it’s going to be that much more difficult to make other healthy choices, so try to make sleep a priority.
“If your sleep is getting disrupted, that is so disruptive to everything in your life,” Ramsey said. “That's going make you more prone to depression, anxiety, weight gain, and brain fog."
Eat well.
Eating foods like fruits and vegetables, and lean protein gives the body the nutrition it needs. Prioritizing those foods over foods high in sugar, calories, or saturated fats can also help keep unwanted weight gain to a minimum.
Exercise.
Aim for at least 20 minutes of activity that raises your heart rate five times a week. It doesn’t have to be high-intensity activity, but it should be challenging enough that you couldn’t sing a song while you do it.
Strength training is important for women to avoid injury. Try to add two strength training sessions to your workout routine each week. The goal is to hit all major muscle groups, so consider some squats and lunges for your legs, a plank for your core, and lift some hand weights to work your arms. M Health Fairview has a team of physical therapists who can help you get started.
Be wary of promoted solutions.
The internet is ripe with influencers sharing what worked for them and manufacturers selling products. But bodies are complex and what worked for one person might not work for another. Ramsey suggests talking to your own healthcare provider about any concerns, so you can work on solutions together. She also recommends The Menopause Society as a reliable source of information.
Consider supplements.
Some vitamin and mineral supplements can help ease symptoms. For most women, Ramsey recommends 400 to 500 milligrams of magnesium, which helps tame hot flashes and promotes sleep. Vitamin D can help with bone health and fish oil can help with heart health.
Talk to your healthcare provider.
Each person’s menopause experience will be unique to them. Your healthcare provider can listen to your symptoms and help find solutions that will work for you.
Risk for health conditions like heart disease and osteoporosis increase with the decrease in estrogen. So having regular check-ups can help find changes early. People assigned female at birth should get regular mammograms starting at age 40. Colon cancer screenings are recommended at age 45.
