The Menopause List

Issue No. 3: Words from the Wise

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My doctor and I were of the same vintage, and so we moved through our life cycles together; first pregnancy, then teenagers, and then menopause.

When she retired, and her practice was picked up by a young doctor, I was happy knowing this doctor would, in all likelihood, see me through to the end. But when this young doctor sent out a notice that she was going on maternity leave (congratulations!) and leaving her practice in the hands of an even younger doctor, I realized that there were probably some life issues these new doctors would encounter in their patients that they had yet to experience in their own lives. The following is a guide for young doctors and others who do not know the inconsistencies of menopause from the perspective of one who has been there.

Hot flashes and night sweats don’t stop when your period stops. They might never stop altogether, but they do become less frequent and less intense.

Sleeping through the night becomes almost impossible (see point 1) but at some point you may find that you sleep better than ever. It might take years to reach this point but it can happen—perhaps because you are no longer worrying about your teenagers being out all night.

Your skin will get DRY all over your body… and inside your body as well. Moisturizers may alleviate dryness but will not come close to returning your skin to a dewy glow. Vaseline™ is not a politically correct product for some, but it really keeps skin from cracking. Internal lubricants may work for some women but will not work for all women.

Dryness leads to wrinkles so be aware that this will happen to you. Some skin care products may “reduce the appearance of wrinkles” but there are no miracle products.

Your skin will lose elasticity and will droop where you least expect it, like your forearms and your knees. Where did that extra skin come from???

Your skin may become more fragile and bruise more easily. It is important to wear sunscreen on your face all year round. Those “age spots” are also known as “sun spots”.

Your hands will look old, unless you paid attention to your mother-in-law’s advice to wear rubber gloves every time you put your hands in water to do dishes or wash out dainty underwear.

Your hair will get brittle and dull (your hairdresser or off the shelf colour can fix that), and it may become much thinner.

You may gain weight—from a few pounds to quite a few pounds. Women are often genetically predisposed to this, so check out how your mother and her family shaped up after menopause. No matter what, you will find that your waist becomes less defined and rounds out. Your belly will soften. Elasticized waistbands are your friend.

You may begin to experience severe pain during intercourse. This condition (called dyspareunia) is thought to be from a lack of estrogen and vagina atrophy but even women who take hormone replacement therapy can experience this. It is a legitimate condition and not just in your head. Talk to your doctor or health care provider. Early awareness may lead to some treatment, although not necessarily. To date, little research has been done to focus on the pain of this condition and most women do not talk about it. In fact, more newsworthy are reports from women who have increased sex drive after menopause, and feel free from concern of pregnancy. This indeed may be true for some, but be aware that many women do not share that experience. Luckily there are many ways to enjoy sexual activity that do not include penetration. Lubricants do not really help.

Even without pain you may not feel particularly sexy—cuddling while watching tv may be the extent of your libido. That one circulating hormone may just not be “in the mood.” It’s important to let your partner know it’s not because you don’t love them anymore, it’s just a downshift in that sexual engine of yours. There may be “boosts” to get back that lovin’ feeling and this would be a good area to talk about with your doctor or health care provider.

Although it may not be obvious, your bones are also becoming more fragile. Exercise is important to keep your body strong. The easiest way to maintain strength and suppleness is a regular walking routine. Find a walking companion to keep you motivated (a spouse can be surprisingly entertaining), or use these walks as a way to spend some quiet time with yourself.

A small bonus: If you have suffered from migraines, you may find that they diminish after menopause.

You may find you are increasingly cantankerous and that you react intensely to what you might previously have considered minor irritations. Do not panic. This is probably the result of having maintained a highly regulated social filter throughout your life which is now thinning (along with your skin and hair).  As you become more aware of this tendency you will find that you are less perturbed by it and can even put it to good use—writing letters to the editor, joining advocacy groups, etc. This is just another hallmark of your transition to the Wise Woman stage of your life.