October is Menopause Month
By: Paula Burchat, BA, RMT, CSMTA(SF) • October 14, 2024
| Guys do not tune out. If you have a girlfriend, wife, mother, sister, or female employee, you need to understand this information too. Forever, menopause was not spoken about. Even among women. In my lifetime it has been little understood and talked about even less. Thankfully, that is now changing. According to the Menopause Foundation of Canada (MFC), “the unmanaged symptoms of menopause cost Canadian women $3.3 billion in lost income due to a reduction in hours and/or pay, or leaving the workforce altogether, and employers 540,000 in lost workdays. Organizations that support menopausal women and normalize conversation about this very normal part of life are making a smart business move.” This is not just a “woman’s health issue”. It not only affects a woman’s daily life significantly, but it also affects her relationships, her family, her ability to work, her health and her quality of life for 1/3 to 1/2 of her life. Up until now, women have been dealing with this process in silence without much effective support. While living in Sweden, I was lucky enough to have an amazing doctor who listened to me and helped me tremendously. I also got to work with a doctor who is a menopause specialist. It is not overstating my case to say that being validated in my healthcare struggles over the previous 10 years and starting hormone replacement therapy (HRT) changed my life. I am a strong advocate for HRT use. Its effect on me has been drastic. The Menopause Process The traditional definition of menopause is simply the one day of a woman’s life when she stops getting her period for a continuous period of 12 months. This was a term coined by a man in a male-dominated healthcare system. It only speaks to a limited aspect of the entire process. Menopause is not just one day. When I refer to menopause, I will speak about everything from peri- or pre-menopause to post menopause. It is actually a process over time that starts about 7-10 years before that day and goes on for the rest of a women’s life. Every woman will experience this process differently. The average woman hits that one day of “menopause” at 51 years old. Woman can start perimenopause as early as 35 years or as late as their late 50’s. There is no set of blood tests that will tell you when you start perimenopause. It is usually indicated by symptoms that again vary from woman to woman. During this period women may experience wide swings in estrogen leading to a wide range of symptoms (listed below). For woman’s bodies a hormone called estrogen is the main fuel for all our cells just as testosterone is the fuel for men’s. While men see a gradual drop in testosterone around 35 years old and a mild taper off over time, on average woman can see widely fluctuating hormones for 7-10 year in their 40’s and then a continuous reduction over the rest of their lives. This loss of estrogen effects all the organs and systems in the body from the brain to the musculoskeletal system, to digestion and heart function. It can have a significant effect on mental and physical health. I have made it an important pillar of my clinical practise to help educate and advocate for my clients in their menopause journey. What I have noticed in the last few months of talking with my clients is that most women do not know the symptoms of perimenopause or post menopause. Understanding these symptoms is key to taking charge of your conversations with your doctor about menopause, understanding how it is affecting your life and what can be done about it. Male clients have asked for this information to take to their wives. Menopause Symptoms There are many symptoms of menopause that can be experienced at any time during this process. Menopause symptoms, according to the Menopause Foundation of Canada (www.menopausefoundation.ca) include, but are not limited to: Physical: · Hot flashes and/or night sweats (usually closer to the end of perimenopause) · Period changes (increases in duration and frequency until it ceases) · Body and joint aches (aka the Musculoskeletal Syndrome of Menopause) · Fatigue · Headaches and/or migraines · Skin and hair changes · Heart palpatations · High blood pressure · Dry eyes · Dry mouth and dental complications Mood and Mental Health: · Anxiety (nervousness, stress) · Depression · Low mood · Anger · Feeling not yourself, low confidence · Mood swings · Low motivation or energy · Crying spells Genitourinary and Sexual Health: · Vaginal dryness, itching, burning · Painful sex · Urinary incontinence/leaking urine · Urinary urgency (inability to wait to urinate) · Urinary tract infections (UTI’s) · Low libido/sexual desire · Sexual arousal issues Cognition and Sleep: · Brain fog · Sleep disturbances · Forgetfulness · Concentration issues · Short-term memory challenges · Poor Word Finding · Slower processing speed My Personal Experience For me, among the 18 different symptoms I experienced, inflammatory conditions were the worst. They included: Achilles tendinitis, significant and sometimes debilitating back pain, digestive upset, celiac disease, gastritis or stomach lining inflammation, urinary tract issues, heart palpatations and high blood pressure with exercise. I was repeatedly tested with ultrasounds, ECG’s, stress tests, X-rays, endosopy, and countless blood tests. Almost all tests were negative. Despite there being no obvious causes for my symptoms I was regularly prescribed anti-inflammatory medications for the musculoskeletal issues and PPIs (protein pump inhibitors) for my inflamed stomach lining. These had short-term, but no lasting effect. Working with a nutritionist, naturopath and other therapists that included years of diet and exercise changes did not work in the long term either. Significantly, all of my symptoms ceased or reduced when I started HRT. The loss of estrogen caused these inflammatory issues. Other women may experience different inflammatory conditions like arthritis, fibromyalgia, frozen shoulder, rheumatoid arthritis, and other autoimmune diseases. My almost 15-year-old daughter and I are much happier, and we have a much better relationship now that I am on HRT. It was like finding myself again – focused, motivated, energetic, and happy – without pain or discomfort. Being able to sleep 7 to 10 hours a night helps me to recover from daily life and workouts. I can lose weight and gain muscle mass again and I feel stronger. Every woman will go through menopause. By 2027, there will be 1 billion menopausal women worldwide. Understanding the vast array of menopause symptoms and getting up to date information on interventions like hormone replacement therapy is the starting point. After that, nutritional changes like increasing fiber intake and protein, and fitness changes like increasing muscle mass are keys to living a healthy and productive lives. Hormone Replacement Therapy For 25 years, hormone replacement therapy was dirty phrase. Due to an incorrect study in the late 90’s study that said HRT caused an increase in breast cancer women stopped taking this important medical intervention. In the two years after the study was published, HRT use dropped from 90% of menopausal women in the US to less than 30%. For the last 20 years women were told they could not take it. Instead, they were prescribed anti-depressants and sleeping pills and individual symptoms were addressed. Thankfully after 10-20 years of dedicated work by female doctors and researchers we now have accurate and specific data on HRT use. Today, even woman who have had breast cancer can take some forms of estrogen. The gold standard for a woman who still has her uterus is estrogen with progesterone. Canada, and many countries, are lagging in physician education on this issue. For that reason, it is important for women to educate themselves and to be proactive in addressing their issues with their doctors. Perimenopause/Menopause Resources The Menopause Foundation of Canada is a great resource (www.menopausefoundation.ca) Their two-page symptom tracker that was instrumental in helping me understand the totality of my issues. I encourage all women over the age of 35 years to look at the information available on their website. There has been so much change in the research that has come out in the last few years. For women in all stages and ages there are significant changes in how your health can be approached. Below are the most helpful resources I’ve found so far. Dr. Werner, the menopause specialist I worked with in Stockholm, also highly recommended these books: · The New Menopause by Dr. Mary Claire Haver is an informative book. She also has Instagram and Facebook pages as well as website: www.thepauselife.com. · The Menopause Brain by Dr. Lisa Mosconi. She is a neuroscientist who did 10 years of research on menopausal woman. It was a revelation to read. · You Are Not Broken by Dr. Kelly Casperson, a urologist, is an enlightening read on female sexual health and sexual relationships. Paula Burchat is a massage therapist with 20 years experience. She was an active athlete in many sports and travelled with Athletics Canada for 12 years treating national and Olympic athletes. She is proud to have supported Team Canada at the 2018 Commonweath Games in Australia and the 2019 Pan Am Games in Peru. She moved with her family to Sweden for 2 years and has recently returned to operating her in-home clinic near the Civic Hospital in Ottawa. She can be reached by email: paula@balanceandmotion.ca; by phone: 613 301-3131 or you can book an appointment online via her website: www.balanceandmotion.ca |
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