Read an Excerpt
Wait a Minute…What Just Happened?
Your Body During Menopause
Feeling blue, gaining weight, suffering from hot flashes, being cranky, losing interest in sex and forgetting things—this had become my new daily reality. And as if that were not enough, I had to start slathering on gallons of facial moisturizer, hoping my once-radiant complexion would return.
Feeling helpless, frustrated and desperate for a solution, I scheduled an appointment to see my doctor. After the examination and a tearful discussion, including my confession—"I think I am losing my mind"—the doctor gave me an FSH blood test. Praying I didn't have a strange disease causing all this misery, I eagerly awaited the results.
A week later, the doctor phoned and said, "I have good news. You're not losing your mind. You don't have a disease. You're going through menopause."
I said, "What! I'm what? Not me? Wait a minute…what just happened?"
Shocked, standing there with the phone in my hand, I felt as if life as I knew it was over. Menopause had never even occurred to me; I was totally blindsided. Surely this was not happening to me. My favorite blouse was suddenly drenched from an uninvited hot flash. My mind was fuzzy as I tried to focus on the clock pounding over the kitchen sink—tick, tock, tick, tock—or was that my heart? It certainly wasn't my egg count—that was now tocked!
I was scared—something I took for granted had just been taken away without my permission. The sunlight was streaming through the kitchen window, giving me a glimmer of hope that there must be a way to make this go away. I took a deep breath, and said, "Okay, give me something to fix this."
Well, the hard truth is that there is no magic pill that will "fix" menopause. Believe me, I tried to find one. The good news is that you can manage menopause. The first step is to understand your symptoms and your treatment options. If you know your options, you can manage menopause.
You may be feeling miserable and frustrated, wanting to feel "normal" again—and fast. Fortunately, you have a big advantage in your life that you may not be acknowledging—unlike other transitions, now you have a lifetime of experience at hand! You are already equipped with survival tools and coping skills. You managed to make it through puberty, perhaps marriage, divorce, children, financial challenges, family issues, and career ups and downs. If you have gotten this far in life, hot flashes, a few new wrinkles, a declining libido and weight gain are all conditions you can handle. You are armed with a lifetime of knowledge. Once you make up your mind to meet these issues head-on, you are ready to walk through a new door and realize your new powerful potential!
WHAT IS MENOPAUSE?
As I urgently searched for answers to my severe menopause symptoms and cranky moods, it occurred to me that this was a time in my life that demanded attention. The word menopause took on a new meaning for me: ME-NO-PAUSE. I could no longer give all my attention to others. I now had to focus on "ME." I could "NO" longer "PAUSE" on matters regarding "ME."
Menopause is actually derived from the Greek roots meno (month) andpausis (a pause, a cessation). Menopause, the natural stopping of your reproductive cycle, is a completely normal physical transition in a woman's life. The dictionary defines menopause as "the time in a woman's life when menstruation diminishes and ceases, usually between the ages of 45 and 55."
The menopause journey has three stages. Perimenopause (peri is Latin meaning "around" or "near") is the time prior to the cessation of menstruation, when you begin to experience hormonal changes and you are still having intermittent periods. Many doctors now refer to perimenopause as the menopausal transition. I will refer to it this way as well. You have reached menopause once you have gone 12 months without a period. Postmenopause is the time after menopause when the acute symptoms of estrogen absence generally diminish.
Going through the menopausal transition is the reverse of puberty. Puberty was the transition in your life when your hormones were gearing up for the reproductive years. Remember your first period? Emotional outbursts, tender breasts, restless nights and feeling bloated?
YOUR HORMONES DURING MENOPAUSE
During the transition into menopause, you may experience many of the same puberty symptoms, but for different reasons. Instead of turning on your hormones, your body is now turning them off by slowly producing less estrogen and progesterone.
Many women who had severe symptoms during puberty may also have a challenging menopause, while women who slid through adolescence easily often have the same experience with menopause. We are all different, and menopause is no exception. In order to fully understand menopause, we must look at how our bodies have been operating since birth.
We are born with a finite number of eggs, about 1 to 2 million, stored in small follicles in our ovaries. From birth to puberty, the majority of eggs will die. At puberty, about 400,000 remain. Each month in which we have a period, about 1,000 eggs are lost and usually only 1 actually matures into a fertile egg (ovum). A woman will have about 500 ovulations.
The ovaries not only hold these eggs, but also produce the hormones estrogen and progesterone. During days 1 to 14 of your cycle, a hormone called follicle-stimulating hormone (FSH) is produced by the pituitary gland in your brain. It stimulates the growth of immature follicles to maturation and it stimulates the production of estrogen. Once there is a sufficient level of estrogen in your body, usually around day 12 to 16 of your cycle, the pituitary gland sends luteinizing hormone (LH) to signal the follicle to release the egg (ovulation).
Once ovulation has occurred, your estrogen levels drop and progesterone starts to rise. By day 20, progesterone levels are high enough to prepare the uterus for pregnancy. If the egg is fertilized, your progesterone levels will remain high. If the egg is not fertilized, both estrogen and progesterone levels fall and you start your period. This process is called the menstrual cycle. During menopause, your body begins to produce less estrogen and progesterone, causing this cycle to become irregular, and eventually ending.
