Menopause
Menopause
21 Ways to Stay Symptom-Free
Do you have PMZ?
No, not PMS—that's premenstrual syndrome. When you say PMZ, think liberation, not liability.
PMZ stands for postmenopausal zest, a phrase coined by anthropologist Margaret Mead. And what she meant was that women should seize this stage of life and live it to the fullest. You are now unencumbered by contraception and pregnancy and that once-a-month cycle that used to slow you down. This,she says, is freedom.
"It's a time for exploring what it feels like to be a woman in the human sense, not just as someone who raises children," says Irene Simpson, a naturopathic practitioner in Arlington, Washington. "My friends and I are on the verge of menopause and we are finding it very empowering. We are finding personal growth at a time when women used to decline."
Menopause begins when your ovaries no longer function, when estrogen secretion slows, then stops, and monthly menstruation becomes irregular, then ceases. Normally, women reach menopause by age 51.
During the six months to three years of this cycle of your life, you may feel some of the traditional symptoms of menopause, including hot flashes and sudden chills, lowered sexual desire, vaginal dryness, emotional upset, and sleeping problems. Your doctor can advise you on medical help for these problems.
GETTING A BETTER OUTLOOK ON LIFE
The architecture of this cycle of life can be your design. Menopause can be bittersweet. Or, it can be a time of PMZ, with an emphasis on the Zest. Here's how.
Design your own zest! Education about physiological changes and an adventurous outlook can make a big difference in handling the stresses that come with menopause, as well as the life changes (children moving out, parents moving in, for example) that many women are faced with in their late forties and early fifties, says Simpson.
Research shows that today's woman spends a third of her life postmenopausal. So consider menopause a step forward in life and make a change for the better, Simpson says. Go back to school. Find a new hobby. Change careers. Take charge of your own health. Make life an adventure.
Find support. Support groups offer reassurance that menopause is a natural cycle, says Sadja Greenwood, M.D., a family physician in San Francisco, California, and author of Menopause, Naturally. Members can offer practical coping techniques that they've discovered, as well as sisterly support for new endeavors. To find a support group, call your local women's center. To start one, place an ad in the newspaper or tack a notice on a bulletin board where women congregate, such as the YWCA.
Exercise daily. Walking, jogging, bicycling, jumping rope, dancing, swimming, or any other daily exercise can relieve a lot of the symptoms of menopause, according to a study at the University of Medicine and Dentistry of New Jersey Robert Wood Johnson Medical School. Exercise can help prevent or lessen symptoms such as hot flashes and night sweats, depression, and other emotional problems, as well as vaginal problems.
Improved physical fitness, of course, is the most obvious result of exercise. But exercise also improves psychological health by boosting brain concentrations of the neurotransmitters norepinephrine and serotonin, according to Gloria A. Bachmann, M.D., an associate professor of medicine in the Department of Obstetrics and Gynecology at University of Medicine and Dentistry of New Jersey Robert Wood Johnson Medical School.
She recommends aerobics and stretching exercises for flexibility, muscle strengthening, and relaxation. Yoga, she reports, also aids flexibility and has an added benefit—it improves diaphragmatic breathing, which induces relaxation and reduces stress.
AWAY WITH HOT FLASHES
Hot flashes are the body's response to lowered estrogen levels, says Dr. Greenwood. "There's dysfunction in the temperature-regulating portion of the brain until the body gets used to the missed estrogen," she says.
About 80 percent of all women have hot flashes. A typical hot flash lasts about 2.7 minutes. During a hot flash, your face and upper body feels as if it's been shoved into an oven, Your face reddens and you sweat heavily as your skin temperature suddenly rises 7 or 8 degrees. It usually returns to normal in about 30 minutes.
The good news is, many women feel the flash coming just before they actually break into a sweat, so they can prepare for it. Here's how.
Look cool. A positive outlook can be an effective daily tool in combating hot flashes, says Marilyn Poland, R.N., Ph.D., an associate professor of gynecology and obstetrics at Wayne State University School of Medicine.
When you feel a hot flash coming on, remind yourself of a couple of things: that hot flashes are normal, that they don't last long, and that you are able to do something about them. Most times that positive mind-set can make the flash more bearable.
Learn to relax. Women who can relax, Dr. Poland says, will be in better control. Learn meditation or yoga or just sit quietly, eyes closed for a while every day to relax.
Control the triggers. Determine what triggers hot flashes for you, then avoid the triggers. For some women, emotional upset is a trigger. Others may find a hot meal, spicy food, a warm room, or a warm bed will trigger a flush.
Go for the layered look. Wear sweaters and vests, then peel a layer off when a hot flash threatens, suggests Dr. Poland. Add a layer when the hot flash passes because your body temperature actually falls a little below normal and can leave you feeling chilled.
Wear natural fibers. Synthetic fibers trap heat and perspiration during a hot flash, making this symptom even more uncomfortable. Natural fibers, such as cotton or wool, will give your body more ventilation and keep it cooler by wicking moisture away from your body and cooling you naturally.
Carry a fan. Buy something pretty and keep in it your purse, says Dr. Poland. Or buy a small, battery-powered electric fan and keep it on your desk. Flip it on as the hot flash begins.
Eat small meals. Rather than load your system three times a day, five or six small meals will help your body regulate temperature more easily, says Dr. Greenwood.
Drink lots of water. Don't forget to refresh yourself with cool water or juice, especially after exercising, Dr. Greenwood says. This, too, keeps body temperature in check.
Cut the caffeine. Caffeine-containing beverages stimulate production of the stress hormones that trigger hot flashes, says Dr. Greenwood.
Limit your alcohol. Some women find alcohol is another hot flash trigger, says Dr. Greenwood.
Towel off. Buy a purse-size package of moist towels and carry them with you. They'll take the edge off a hot flash, says Dr. Poland. You may want to mop your brow when the heat is most intense or you may want to remove the perspiration after the flash is over.
Turn down the heat. Heat in any form may trigger hot flashes. Turn your thermostat down, leave a window open, and avoid hot foods and beverages.
Stay sexy. Women going through menopause who continue to have intercourse on a regular basis (once a week or more) have fewer or no hot flashes compared to women who have sporadic sex, research shows. Norma McCoy, Ph.D., a professor of psychology at San Francisco State University, and Julian M. Davidson, Ph.D., professor of physiology at Stanford University, studied 43 women who were just beginning to enter menopause. They found that frequent sex helps moderate dropping estrogen levels, which reduces the occurrence of hot flashes.
Dr. McCoy believes that the high estrogen levels help maintain a healthy interest in sex and that regular sexual activity indirectly stimulates failing ovaries, which helps moderate the hormonal system and prevents extreme swings in the estrogen level.
Don't share the sheets. You don't have to have a separate bed to keep from disturbing your husband with on-again, off-again nighttime sweats, says Dr. Polans. Use separate blankets on the bed or get an electric blanket with dual controls, then you can feel free to kick off the sheets when you need to cool down.
OVERCOMING SEXUAL PROBLEMS
Our experts gave the following advice for continuing a fulfilling love life through menopause.
Lubricate your love. Vaginal dryness from a lack of estrogen decreases interest in intercourse during menopause, says Dr. Poland. A water-soluble lubricant, such as Lubifax or K-Y Jelly, vegetable oils, and unscented cream of oil, are all good choices for lubrication, says Dr. Greenwood.
Or break open a couple of capsules of vitamin E and massage them on as a lubricant, says Simpson.
Make talk. Talk to your partner, advises Simpson, Some libido-boosting comes with heart-to-heart talks about needs and feelings.
Take high adventure to the bedroom. Couples may want to try new positions in intercourse to find the most comfortable, says Dr. Greenwood. Touching can be especially important at this time. She suggests more hugs and mutual massages for closeness and sensual pleasure.
Do the Kegel. You can strengthen your anal, vaginal, and urinary muscles with a special exercise called a Kegel, says Simpson. Stronger muscles can help you relax and use these muscles with less pain and more pleasure during intercourse. They are also good for preventing urinary incontinence, a problem for some menopausal women. Here's how to do it.
Imagine you want to stop urine in midstream. Squeeze the muscles in your vaginal area firmly. Hold to the count of three, then relax. Practice with a rapid alternation between tightening and letting go. You can practice this exercise anywhere, anytime.
PANEL OF ADVISERS
Gloria A. Bachmann, M.D., is an associate professor of medicine in the Department of Obstetrics and Gynecology at the University of Medicine and Dentistry of New Jersey Robert Wood Johnson Medical School in Piscataway.
Sadja Greenwood, M.D., is a family practice physician in San Francisco, California. She is on the faculty at the University of California Medical Center in San Francisco. She is author of Menopause, Naturally.
Norma McCoy, Ph.D., is a professor of psychology at San Francisco State University in California.
Marilyn Poland, R.N., Ph.D., is an associate professor of gynecology and obstetrics at Wayne State University School of Medicine in Detroit, Michigan. She is coauthor of Surviving the Change: A Practical Guide to Menopause.
Irene Simpson is a naturopathic practitioner in Arlington, Washington.