Women's Health

A Primer on Menopause What Every Woman Should Know. Part 1

Like many girls growing up in the ’50s, I first learned about menopause by gleaning information from whispered conversations. If women of a certain age were acting out of sorts, it was said, they were going through “the change.”

With scant details to work with, the image of this “change of life” loomed large — and ominous. What did it mean? What happened next? Would I change too?

Fast forward to today, where little is left to the imagination. Menopause has come out of its quiet place and into the public consciousness.

The numbers and the nature of the baby boomer women now in or entering menopause make it hard to hide. Roughly 4,000 women a day are reaching menopause, an unprecedented number, said Pam Boggs, education director of the North American Menopause Society, a nonprofit organization based in Cleveland, Ohio.

Further, “Baby boomers talk more about everything,” said Dr. Susan Love, author of “Dr. Susan Love’s Hormone Book: Making Informed Choices About Menopause,” (Times Books, 1997, $15). And menopause provides plenty of fodder for discussion, including lifestyle issues, stories of females who went through menopause in different times or cultures, and medical management through adding hormones.

The key questions for women today include: What do women really need to do to maintain a healthy mind and body as their chemistry changes? What should they draw from medical science and what can they take from nature to make this transition and the following years a positive experience? And what are the risk/reward trade-offs of following any given course?

What’s important to keep in mind, said Love, adjunct professor of surgery at UCLA in Los Angeles, Calif., and director of the Susan Love MD Breast Cancer Foundation, is that “Menopause is not a disease. It’s a natural, normal part of life, though not always a perfectly pleasant one.”

When it comes to deciding whether you want to treat symptoms or how you can prepare for healthy aging, “It’s a little less scary when you realize it’s your body and you’re not making a life-and-death decision,” she said. “You’re making a choice for prevention, and women are capable of making those kinds of decisions.”

There are no unequivocal answers that suit everyone. The issues of menopause are highly individual — timing of the changes, severity of symptoms, and pros and cons of treatment options.

The good news is you don’t have to wade through this alone. There’s plenty of information available, said Dr. Saralyn Mark, advisor at the Office on Women’s Health, senior advisor to NASA on women’s health issues.

“It’s a two-pronged approach,” said Mark. “First, you do need to establish a relationship with your health providers — nurse, nurse practitioner or physician — so that you can feel comfortable asking questions. I really believe it is a partnership, and there is no better place where you see that partnership at work than in the discussion of menopause.”

Next, Mark said, “Take active control of your educational process. Obtain knowledge in your own right — through books, research guides, the Internet, television. Do your own reading, at your own level and in the comfort of your home. You can gradually take in information and continue your active discussion with your provider.”

There is a challenge in the amount of information out there, with new data coming in every day. Make sure you know who the source of your information is, she said. If you get information from the Web, for example, question who has reviewed it and whether it is accurate. If information is from a company that may have a vested interest, keep in mind there might be a bias.

And as you get informed, stay positive. “Think of women in menopause as healthy women in their prime, with at least 25 years ahead of them that may be the most vigorous and energetic they’ve had,” said Barbara Seaman, co-author of “For Women Only!” (Seven Stories Press, 1999, $75), a guide to women’s health. In many cultures, she writes, “Menopause is anticipated as a rite of passage into a stronger, wiser time of life.”

Rather than just being an end of the ability to bear children, it’s the beginning of the rest of your life. Quoting anthropologist Margaret Mead, Seaman said to view these years as “the time of PMZ — post-menopausal zest.”

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