By Lisa Schmelz | Sponsored by SSM Health
We’re talking and reading about it more than ever, but are women getting the facts they truly need about perimenopause and menopause? Well, that depends on the information’s source.
Sarah Block, APNP-CNP, an SSM Health women’s health provider certified by The Menopause Society, wants to see more dialogue between women and their medical providers — not more glib reels from social media influencers with click-bait promises of symptom relief that aren’t supported by science.
“We used to think menopause was hot flashes and it is way more than that,” says Block. “We have estrogen receptors from head to toe, (so) symptoms can run the gamut.”
WHAT EXACTLY IS PERIMENOPAUSE AND MENOPAUSE?
Both are a natural part of a woman’s aging process.
Perimenopause begins before menopause when estrogen, the main female hormone, levels rise and fall. Menstrual periods can become longer, heavier or irregular. Hot flashes, sleep disturbances and vaginal dryness are also common symptoms. Perimenopause can last for one or several years.
Menopause is defined as a complete year without a menstrual period not caused by surgery, a medical condition or medical intervention. Once a woman has entered menopause, she can no longer get pregnant.
IT’S A WHOLE-BODY SHIFT, NOT JUST HOT FLASHES
Perimenopause and menopause are whole-body processes, affecting nearly every system — from the brain to the skin to metabolism. This is why women see a multitude of symptoms. Beyond hot flashes, there can be weight gain, joint pain, fatigue, brain fog, urinary urgency, low libido and mood changes. Hidden, but also occurring, is the beginning of bone loss.
“These body composition changes are driven by hormonal shifts, specifically the drop in estrogen,” explains Roopa Shah, MD, an SSM Health family medicine provider. “You’re not doing anything wrong. It is a time of hormonal and physiological upheaval.”
Weight gain can be especially frustrating, especially when diet or activity hasn’t changed. But again, the physiological upheaval has a woman’s body storing fat differently and losing muscle mass, which can translate to slower metabolism and greater insulin resistance.
SO WHAT IS A WOMAN TO DO?
Medical providers like Block and Shah encourage women to take a different approach to this time of life. Both suggest a mindset and action plan that supports a woman’s body and works with the changing hormones.
Talking with a women’s health provider is a great first step. A pre-written list of specific concerns can guide the discussion. Avoid delays if you have symptoms that are impacting your physical or mental health. In some cases, hormone therapy may be advised in an appropriate dose and for an appropriate amount of time.
“One of the most common misconceptions is that hormone therapy causes cancer,” says Block. “For many women, hormone therapy is a safe and effective treatment option, and fear of cancer should not prevent a conversation with a qualified healthcare provider.”
In daily life, nutrition, physical activity and other healthy habits can help support metabolism, bone health and emotional well-being. These changes in a woman’s 40s and 50s can also aid in greater long-term independence, too.
(Think avoiding falls and fractures.)
“If I had to prioritize one thing,” says Shah, “it would be focusing on strength training.” Shah’s not the only one telling ladies to lift. Sara Galli, MD, an SSM orthopedic surgeon, is even more direct: “If you don’t use it, you lose it and we see that more acutely during and after menopause.”
Strength training two to three times per week, with a focus on progressive resistance with weights, bands or your own bodyweight, is science-backed. It can bolster balance, improve insulin sensitivity, help manage moods and enhance resting metabolic rate by increasing lean muscle mass. Maintaining muscle health is just as important as protecting bone health during menopause. Upgrading your nutrition is also advised.
“We need more protein to help maintain lean body mass,” says Janeah Schwarz, RD, a registered dietician with SSM Health, adding that protein should be spread throughout the day.
Emerging research also suggests that a low-dose daily supplement of creatine, paired with strength training, can boost muscle strength, energy production and cognitive function. Because collagen production declines with age, supplementing with collagen — and vitamin C for absorption — can assist with joint support, hair and skin health, and exercise recovery. (Check with your medical provider before starting any supplements.)
WHAT ABOUT MENTAL HEALTH?
Psychiatrist Bhawani Ballamudi, MD with SSM Health, points out the demands of life don’t stop for women in perimenopause or menopause, and that mental and emotional health symptoms often catch women off guard.
“Estrogen works with neurotransmitters like serotonin, dopamine and norepinephrine,” explains Ballamudi. “Women start experiencing mood swings, anxiety, brain fog and low self-esteem. This is happening at a time when there’s also stress from careers, parenting, aging parents and everything comes together.”
A key first step is not to dismiss or misattribute emotional or mental symptoms. Seek help. For some women, hormone therapy can prove beneficial. Seeing a licensed counselor; making nutrition and fitness a priority; talking with others who’ve been down this road; and good sleep hygiene and mindfulness practices can also make this phase of life less about loss and more about reinvention.
Evelyn Schaefer, PsyD, is a licensed clinical and sport performance psychologist with SSM Health in Fond du Lac. She strives to help women understand, prepare for and navigate the process we call the change of life. It is not a time that women simply have to endure, she emphasizes.
“One of my favorite things to do,” says Schaefer, “is to work with people during life transitions and I think that menopause is one of the major life transitions that individuals go through… It’s always a privilege to walk on that journey with people and help them come up with new concepts of who they are and what life looks like in this new realm.”
5 Ways to Feel Better as your Body Changes
Perimenopause and menopause are not about decline; they signal a new beginning.
Here are five tips to make this chapter a strong one:
- Actively engage in strength training to preserve muscle and metabolism.
- Nourish with a lean protein-focused diet throughout the day.
- Get quality sleep and help reducing stress, if needed.
- Inquire about whether hormone therapy and/or certain supplements are right for you.
- Develop a personalized care plan with an SSM Health provider.
Test Your Knowledge
How menopause savvy are you? Take this quiz to find out.
- True or False: There are three phases of the menopause transition: perimenopause, menopause and postmenopause.
- True or False: Over time, decreasing estrogen can raise your blood sugar.
- True or False: Hormone therapy should be a last resort for most women.
- True or False: Lower estrogen levels decrease cardiovascular risks.
- True or FalseLower estrogen can affect blood cholesterol levels.
- True or False: You cannot get pregnant during perimenopause.
- True or False: Hot flashes can occur in perimenopause, menopause and postmenopause.
- True or False: As estrogen levels lower, bone loss happens more quickly than the rate of natural replacement.
- True or False: Perimenopause can last as long as a decade, but averages three to four years for most women.
- True or False: There is very little the medical community can do or suggest for the symptoms of perimenopause or menopause; you just have to endure it.
ANSWERS: 1. TRUE 2. TRUE 3. FALSE 4. FALSE 5. TRUE 6. FALSE 7. TRUE 8. TRUE 9. TRUE 10. FALSE
