Health & Wellness

Menopause: Preparing for the Second Act

By MSF Staff and reviewed by the MSF Medical Advisory Board
As with so many challenges in life, attitude is critical. Menopause is no exception. We can dread menopause as the beginning of the end, the fading of our youth, the loss of our beauty and vitality. Or, we can embrace it as a gateway to the second act of our lives, a time of freedom, self-expression and self-discovery. We’ve spent our lives nurturing others. Could it now be time to nurture ourselves?
What Is Menopause?
Menopause is a natural part of aging that occurs when the ovaries stop producing hormones called estrogens. As estrogen levels drop, monthly menstrual periods cease. A woman is said to be menopausal when she has ceased to menstruate for 12 consecutive months. Menopause, which typically occurs between the ages of 45 and 60, marks the end of a woman’s reproductive years. Menopause can occur earlier, due to surgical removal of the ovaries or other medical reasons.
What Causes Menopause?
We are born with a limited number of eggs stored in our ovaries. Our ovaries also produce estrogen and progesterone, the hormones that regulate menstruation and ovulation. When the ovaries no longer produce an egg every month and menstruation stops menopause occurs. This is a gradual process that occurs in three stages.
Perimenopause, which begins several years before menopause, involves a gradual reduction in the production of estrogen. In the last few years of perimenopause, this estrogen reduction accelerates, at which point menopausal symptoms often begin. Post-menopause refers to the years after menopause, a time when menopausal symptoms ease for most women. However, health risks related to estrogen loss – most notably osteoporosis and heart disease – increase.
Don’t Let Symptoms Take Center Stage!
Most women will experience hot flashes, a sudden feeling of warmth that spreads over the upper body. The severity and duration of hot flashes varies. Excessive sweating and night sweats are also common. If heat exacerbates your MS, be proactive. Buy a small portable fan. Get a cooling vest or cooling pillow. Drink plenty of cool water and monitor your caffeine intake. Too much caffeine can exacerbate stress, irritability, fatigue, and hot flashes.
Other common symptoms include insomnia, mood swings, depression, fatigue, irritability, heart palpitations, headaches, joint and muscle aches, change in sex drive, vaginal dryness, and bladder control issues. As with MS, not all women will experience all symptoms. If you are taking any sedating medications, ask your doctor if they can be changed. For depression, ask about the selective serotonin reuptake inhibitors (SSRIs), such as Prozac, Paxil, Zoloft or Effexor. These drugs treat depression and offer a stimulating effect to fight fatigue.
Eating a diet rich in fiber and lots of green vegetables can make a big difference. Consume at least 1,000 to 1,500 milligrams of calcium a day. Watch portion sizes and add soy and flax to your diet – both are natural estrogen replacements and packed with nutrition. Avoid hot and spicy foods as well as caffeine.
Exercise increases energy, burns calories, and reduces stress, depression and anxiety. Regardless of your level of physical ability, there is an exercise program for you. Call us and request a copy of our booklet, The Fitness Prescription. Don’t forget to add a healthy dose of fresh air and sunshine. Crossword puzzles, word jumbles, and TV game shows all keep your mind working and they’re fun! Listen to music or books on tape. Remember, your brain is a muscle too – work it out!
Many women use St. John’s wort, black cohosh, ginkgo biloba, evening primrose oil, and other nutritional supplements. These must be used with caution in women with MS. Always speak to your doctor to learn of any potential harmful effects or interactions with other medications.
If you need support, seek counseling or join an online support group. Talk on the phone or have lunch with your women friends.
“To date, there has been scant research into the menopause and MS, and even less research into the menopause and immunomodulatory drugs specifically,” said Helen Tremlett, Ph.D., University of British Columbia, Vancouver, Canada. “As many of you know, female hormones and MS has been an area of much focus, specifically how MS tends to remit or stabilize during pregnancy. If higher rates of circulating female hormones are 'protective' with respect to relapses, then you might expect menopause to be associated with a worse disease course or more relapses. Conversely, we also know that the older you get and the longer you have MS, the less 'inflammatory' MS becomes, with typically fewer relapses. So, theoretically, the menopause might make no difference at all in terms of disease course and relapses.”
“During menopause, women with MS may have to cope with a new set of symptoms, which is a challenge,” adds Roger Williams, M.D. My nurse practitioner, who is an expert in women's health, and I treat these conditions in parallel and without a feeling of restraint, one for the other. Menopause, like menarche, is just another stage in life that must be taken in stride.”
Hormone replacement therapy (HRT) is a treatment program in which a woman takes small doses of one or two female hormones, estrogen and progesterone, to relieve menopausal symptoms. HRT reduces the risk of osteoporosis and other conditions that become more common after menopause. However, HRT can have serious side effects and has been shown to increase a post-menopausal woman's risk of developing breast cancer. It is very important to weigh the benefits and the risks when considering HRT.
(Last reviewed 8/2009)