Dealing with menopause

Menopause is a dirty word for Karen D'Eon.

After a partial hysterectomy, the Eastern Passage woman went into surgical menopause. She's suffered from hot flashes, dryness in areas that were never dry and hair loss.

There appeared to be no relief.

D'Eon can't take hormone replacement therapy (HRT) because of her mother's breast cancer history. She's tried what she calls some "crazy anti-anxiety medicine" that caused her to see auras and "become loopy."

She tried evening primrose oil to alleviate pain and discomfort but started gaining weight.

Once she stopped, the weight gain stopped, but she's back to suffering from hot flashes. She doesn't want to try the drug black cohosh, because she says it's linked to liver damage.

“So, I suffer along with my menopausal sisters,” says D'Eon. “Other than sitting in a bubble, I carry on with my own personal summer.”

Although this is her experience, D'Eon recognizes everyone's body and reactions are different.

She believes, however, that many women do suffer with menopausal symptoms and feels there are limited safe options for treatment.

TIME FOR TREATMENT? Beverly McKee – a former nurse practitioner who is currently working as a health consultant with an extensive background in women's health, primary care, and population health – is clear: every woman's experience is unique.

There are many factors on whether a woman seeks treatment for menopausal symptoms, says the Port Williams woman. This includes how severe symptoms are, how long the woman has been dealing with them, her personal health history, current health status, current medications taken and the impact the symptoms have on day-to-day quality of life, she says.

Sometimes, there is a need for treatment, says McKee. Other times, women simply prefer to navigate symptoms without seeking assistance.

HOW TO DEAL?

Some women suggested sleeping with the air conditioning on, while others might visualize the hot flashes are instead the result of "tropical moments" of being on a beach in Cuba on a hot day in an effort to change their mindset.

McKee says it's important that women are informed about the stages of menopause as it helps navigate this natural and normal stage of their lives.

For almost every symptom that is thrown at women by their bodies, there are solutions that can assist in lessening the effects felt, she says.

EXERCISE, DIET AND MENOPAUSE

Although many women live healthy lifestyles, eat well and exercise, they still have issues throughout menopause, says McKee.

Science has noted a relationship between decreased animal-based diets and increased physical activity with a decline in hot flashes, says McKee.

The change in hormones during menopause increases body fat and can lead to increased risk of heart disease, osteoporosis and other conditions, says Felicia Newell, a registered dietitian and nutritionist with FN Health located in St. John's, N.L.

"The best approach is to focus on eating more nutrient-dense foods and to find enjoyable ways to make physical activity a regular part of life," says Newell.

Women in menopause should pay attention to their bone health to prevent osteoporosis, says Newell, who points out a woman can lose as much as 20 per cent of her bone density five to seven years after menopause. So, it is important to build enough bone mineral density as possible in the years leading up to menopause, she says.

“Calcium, vitamin D, adequate protein, not smoking, and exercise are key components to decreasing the amount of bone loss,” she says.

HORMONE REPLACEMENT THERAPY

McKee says that there are more than 50 different types of hormone replacement therapy (HRT) available to provide symptom relief in many forms: pill, absorbed through the skin, implants or vaginal insertion.

For many women, HRT makes a significant difference in dealing with what they feel are debilitative symptoms interfering with their quality of life, she says. HRT has the added benefit of protecting women from osteoporosis, she says.

Leann Edwards, a Boutiliers Point resident, had great success with HRT.

Her menopausal symptoms hit her hard, causing her to suffer from terrible panic attacks, hot flashes and bloating. Once, she ended up going to the emergency department as she felt she couldn't breathe.

Soon afterward, she was put on an estrogen patch and prescribed progesterone cream.

“My panic attacks stopped about two hours later,” says Edwards.

Andrea Buchholz, a Nova Scotian now living in Alberta, says she recently started bioidentical hormone therapy (BHRT), which she says is a lesser-known option.

"It's been a lifesaver," she says.

BHRT is a combination of pills, suppositories, and creams, but there are different delivery methods like patches and injections, too.

Not everyone is willing to try HRT though. Justine Langseth, of Boutiliers Point, fears the risk of getting cancer.

HRT is not without controversy, acknowledges McKee, who says there have been links between the estrogen and progesterone in HRT increasing the risk of breast cancer, though not a significant mortality rate; increased risk of endometrial cancer in women who have their uterus; and heart disease.

It's difficult to know which women will be at greater risk, says McKee, as it depends on existing health history and conditions.

“The health risk/benefit must truly be determined on an individual basis with one's health care provider and if HRT is to be utilized, it is best to ensure a short-term usage with the lowest possible dosage,” says McKee.

As for BHRT, McKee says these are person-made hormones and people's bodies use them the same way they do natural ones. They also come with their own potential risk-to-benefit ratio: blood clots, gallbladder disease and an increased risk of stroke and breast cancer have been documented.

Some women find that having an IUD (implanted intrauterine contraceptive device) helps stave off menopausal symptoms. McKee, however, says there is limited scientific evidence for this beyond decreasing bleeding.

A progesterone IUD can help with irregular bleeding that occurs in perimenopause and early menopause, but does not alter hot flashes and night sweats, she says.

NATURAL TREATMENT

At her wit's end with suffering, Langseth discovered her acupuncturist listed menopause as a treatable condition, so she booked an appointment. She noticed a difference after the first session, and after a couple of months of treatments, she felt like she had never gone through perimenopause.

“Who'd have thought some needles could change your life that drastically?” she says.

Lucy Griffiths, a traditional Chinese medicine (TCM) practitioner with the Canadian College of Acupuncture and Traditional Chinese Medicine in Bedford, says menopause is an imbalance in the body's yin and yang.

“The sooner women get into treatment, the quicker their body will respond and rebalance,” says Griffiths.

Menopause will still happen, she says, but it will be a smoother transition.

Part of this treatment is acupuncture, which she says stimulates the natural healing response of the body, hormone release, white blood cell production for the immune system, and red blood cell production for repair and regeneration.

Ouma Cuniah, an instructor with Charlottetown Yoga Space, agrees that menopause can be taxing physically, mentally, and emotionally. She recommends practising hatha yoga, focusing on the breath and slowing body movements, coupled with short periods of immobility. It tones and adds flexibility to the body while bringing stillness to the mind, she says.

“Regulating the breath is a fundamental element in hatha yoga which brings a sense of calmness and may help in alleviating mood swings and headaches,” says Cuniah.

GET SUPPORT

Ruth Downie, a certified counsellor with the Canadian Counselling and Psychotherapy Association, leads a support group in Halifax called Managing Menopause.

The group, which aims to address the associated challenges with menopause, focuses on three aspects that seem to be most distressing: social isolation, psychoeducation and symptomatic management.

Joining a support group seems the best way to realize that this is a normal transition and that all women will experience, says Downie. It provides a sense of camaraderie as well as solidarity.

Talking about menopause and sharing experiences does help, Langseth says. People need to talk about this, she adds, because many women feel their lives are over when it comes to menopause.

“I had to find out what was happening to me by Googling,” she says. “Not enough people know what's going on and that it doesn't have to feel like life is over.”

It's important to feel at ease in sharing and getting support from other women, says McKee.

"Menopause should not be a taboo subject, nor should it necessarily be a negative time in a woman's life," she says.

"Talk to other women about how they deal with symptoms of menopause and do not hesitate to discuss this subject with your health-care providers."

Aging is natural, changes in women's bodies are natural and dealing with the symptoms of menopause is natural too.