Menopause disrupts a woman's life, but there are ways to cope

Hot flashes, night sweats, insomnia. Must be menopause.

When it comes to offering advice on the topic, Mary Ann Fleming knows what she's talking about. She's been through it.

"It's not a disease," said Fleming, a nurse midwife with Health Delivery Inc. OB/GYN & Midwifery Services on Bay Regional Medical Center's West Campus. "It's a transition, and we have to realize how to take care of ourselves to maximize the positive things."

Fleming says women must be patient, adding that menopause itself usually lasts about a year after the last spontaneous period. It's the perimenopause phase, the time before, and the postmenopause phase, the time after, that can make it seem longer.

Perimenopause can last from 35 years of age up to 60, Fleming said.

A bit about herbs

Herbal remedies for menopause are recommended by the National Center for Complementary and Alternative Medicine.

Before starting any natural therapy, check with your pharmacist for interactions with prescribed drugs already being taken.

BLACK COHOSH

A member of the buttercup family. It has been used to treat hot flashes, night sweats and other symptoms of menopause.

Side effects can include headaches, stomach discomfort, heaviness in the legs, weight problems.

ST. JOHN'S WORT

Used to treat moderate depression, anxiety and sleep disorders.

Side effects can include increased sensitivity to sunlight, anxiety, dry mouth, dizziness, gastrointestinal symptoms, fatigue, headache or sexual dysfunction. Can interact with other drugs such as antidepressants, birth control pills, cyclosporine.

RED CLOVER

Contains phytoestrogens, compounds similar to the female hormone estrogen. Is said to help with menopausal symptoms and osteoporosis.

No serious adverse effects have been reported.

SOURCE: National Center for Complementary and Alternative Medicine

"It can span that amount of time," she said. "You may not necessarily be symptomatic. But it's a time when you can expect anything. Periods may become a little irregular or you can have regular periods right up to menopause."

The average age for menopause is 50-52. However, it is not the same for all women. And how a woman goes through menopause differs for each individual.

Dr. Bradley Merrills, an obstetrician-gynecologist with Health Delivery, says a good predictor of when and what will happen lies within your family history.

"The best predictor is when Mom went through it. That's a good guessing point," he said. "Most women start to have hot flashes. It may happen a number of years before they go through it. It's different for different individuals. Some people have very few symptoms and others it's just about intolerable. They can't sleep, can't work."

Maximizing the positive, Fleming says, starts with regular exercise along with a balanced diet of fruits and vegetables and no more than three servings of red meat per week.

Fleming recommends women try to reap as many benefits as possible from a good diet and exercise before resorting to hormone replacement or herbal remedies.

Squash and yams, which are rich in vitamins and minerals, may minimize hot flashes, since yams are said to help with estrogen imbalance, Fleming says.

Fleming also recommends vitamin supplements, including vitamin B for mood balance and calcium with vitamin D to keep bones strong.

A combination of vitamin B6 and magnesium can help replenish the body's levels of serotonin, helping to even out moods as well, Fleming said.

"We're under stress on a daily basis," she said. "Stress causes us to use all available B vitamins. As we age, we decrease the production of neurohormones that make you happy."

Aerobic activity, jogging and weight-bearing exercises release endorphins, natural mood-lifters.

While there are mood swings, menopause may exacerbate other emotional problems, Merrills says.

"The general trend is to say menopause doesn't cause those things, he said." But it might exacerbate something already there."

Getting on the right track of eating balanced meals and exercising should begin when a woman is in her 20s, Fleming said, to help prevent another aspect of menopause - thinning of the bones and osteoporosis.

That's where the calcium and vitamin D come in.

Besides dairy products, other foods are good for building bone mass, including soy products, dark green leafy vegetables, broccoli, asparagus and green pepper.

"There is a rapid decline in bone density after menopause for the first few years before it stabilizes," Fleming said.

"Women need to be thinking about building bone mass so we can offset the decline."

If diet and exercise don't offer enough benefits, there are both pharmaceutical and natural remedies available to help women get through menopause.

Doctors may prescribe estrogen and/or progesterone to help with symptoms. Antidepressants may be prescribed as well.

There are a number of herbal supplements available. One of those is black cohosh, said to help with hot flashes and sleep interruptions.

However, Fleming says it shouldn't be taken longer than six months.

Red clover is another herb recommended for menopause symptoms. Fleming says it may also have cancer-preventive benefits and help with hardening of the arteries.

St. John's wort has been touted for its benefits in relieving mild depression.

Fleming says to make sure herbal remedies come from a reliable company and have a USP symbol on the label, which means the product contains what it says it contains.

Before any treatment begins, however, talk with a doctor about what is right for you.

"It's not as simple as one size fits all," Merrills said.

"We have to look at the risk and benefits for each individual."

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