You may have noticed that, although I’m a gynecologist, I haven’t written much about menopause on Owning Pink. This is intentional. You see, I’m always reluctant to write about something I haven’t experienced firsthand. I know men write with expertise and wisdom about childbirth and menopause, periods and vaginas, without experiencing any of these things. But I’ve always dug deep within when I write, so it’s harder for me to write about what I haven’t yet experienced.

But so many of you have asked for menopausal help that I’m gonna go for it! So if you’re experiencing menopausal symptoms, this post is my gift to you.

Menopausal women are like snowflakes.

Menopause really is different for every woman. Some sail through with few, if any, symptoms. Others feel like they’ve been possessed. It’s normal either way.

How Do You Know If You’re In Menopause?

The average age of menopause in this country is 51, but it’s important to understand that perimenopause may start much sooner and may last anywhere from 5-15 years. While menopause is technically defined as the absence of a period for a year, perimenopausal symptoms may start long before that. And it’s not just hot flashes women suffer through. Many also experience heavy bleeding, headaches, weight gain, hair loss, and decreased libido. What some doctors may gloss over, though, are some of the cognitive factors. For example, you may feel perpetually forgetful, depressed or altogether NUTS! (The unscientific phrase we in the medical community use is “brain fog.”)

In addition to the premenopausal symptoms mentioned earlier, women going through menopause may suffer from:
•    Insomnia
•    Mood swings
•    Fatigue
•    Depression
•    Irritability
•    A racing heart
•    Joint and muscle aches and pains
•    Vaginal dryness
•    Bladder control problems
•    Increased/decreased clitoris sensitivity and responsiveness
•    Fewer orgasms
•    Decreased depth of orgasm
•    Pain or burning during intercourse

So what can you do about it?

Why Not Start With Natural Remedies?

Sure, you can take bioidentical hormones, which can work wonders and which I’ve written about here. But keep in mind that hormones have their risks.

While I totally support those women who choose to take bioidentical hormones, why not consider other options first? Before you jump straight to estrogen therapy, why not check out natural remedies that may relieve your symptoms with fewer risks?

Natural Remedies For Menopause

Nutrition:

• Eat a diet rich in whole natural, unprocessed foods, with an emphasis on fruits, vegetables, whole grains, beans, seeds, nuts and healthy fats, and low in saturated fats, fried foods, white flour, sugar, and salt.
• Increase foods high in phytoestrogens, such as soy products, in moderation -- 1-2 servings/day and flaxseed.
• Increase calcium in your diet to protect your bones. You can load up on calcium by eating spinach, dairy products, clams, sardines, broccoli and legumes.
• Avoid alcohol, which can make hot flashes worse.
• Make sure you’re getting essential fatty acids in your diet, which can be found in pumpkin seeds, walnuts, linseeds, fish, dark green vegetables and oils such as sesame, walnut, soya and sunflower.

Exercise:
Studies show that exercise alone can alleviate hot flashes. In fact, one study of exercising women demonstrated a 55% reduction in hot flashes. Exercise also has the additional bonus of helping to strengthen bones, which can become weak after estrogen’s positive effect on bone density wears off.

Behavioral interventions:
Layer up! That way, if you start sweating, you can strip off a layer and feel cooler. Avoid coffee, alcohol, spicy foods, and stress, which exacerbates menopausal symptoms. Keep an ice pack in the freezer and sip cool drinks. Relaxation and deep, abdominal breathing (6-8 breaths per minute) have been shown to reduce hot flashes by about 40% when practiced as minimally as twice per day. Eliminate hot baths or showers before bedtime.

Yoga:
Although I can’t find data to support it, many women I know SWEAR by yoga (though you might skip Bikram yoga, which is done in a very hot room!). Ask your yoga teacher to recommend poses specifically aimed at relieving your symptoms, or seek out special yoga classes geared towards women in menopause.

Acupuncture:
One Swedish study demonstrated that acupuncture could relieve hot flashes for up to several months.

Coconut Oil:
If you’re experiencing vaginal dryness and sex hurts, try lubing up with coconut oil (as long as you don’t need condoms for STD prevention; coconut oil can degrade condoms). It smells and tastes great, and it’s a wonderful natural, hormone-free lubricant. But don’t blame me if you find yourself jonesing for a post-coital macaroon!

Supplements for Symptom Relief in Menopause:

• Black cohosh 40mg 1-2 caps twice/day -- may help with a variety of menopausal symptoms, including hot flashes and night sweats.
• Natural progesterone cream -- a 1999 study in the journal Obstetrics and Gynecology found that natural progesterone cream significantly reduced hot flashes compared to the placebo group. 2% progesterone skin cream helps relieve symptoms in about 85% of perimenopausal women. (Although progesterone cream is a hormone, estrogen appears to be the risky hormone, and low dose bioidentical progesterone cream appears to be very safe.)
• Bioflavonoids 1000mg/day plus 1000-1500mg Vit C -- may relieve hot flashes.
• Vit B6 50-200mg/day -- deficiency of Vit B6 may cause insomnia and irritability.
• Evening Primrose Oil -- 1500-3000mg/day, for breast pain in perimenopause.
• Ginkgo Biloba 40-80mg standardized extract capsules or 1/2-1 tsp tincture 3 times/day -- may improve memory and attention loss and help with symptoms of depression, may help improve sexual function.
• Ginseng -- Panax Ginseng standardized extract capsules 200mg 5% ginsenosides or 100mg 10% saponin ginsenoside/day, high quality root 4-6g/day; may increase energy, decrease insomnia, reduce depression, help with vaginal atrophy, and improve well-being but does not help hot flashes. Be careful of contaminated sources.
• Saint John’s Wort -- standardized extract 300mg 3 times/day for depression, irritability, and mood swings. Avoid if taking digoxin, oral contraceptives, warfarin, cyclosporine, or indinavir.
• Valerian -- 300-600mg before bedtime for insomnia.

For ease of use, you can try Estroven, which is the leading over-the-counter supplement line that mixes many of these ingredients together and is available in formulations that target hot flashes, insomnia, and decreased energy.

Mindset Makeover
While every woman is different, in my experience, those who expect an easy menopause have fewer symptoms than those who dread it and freak out when they start skipping periods. So give yourself a little pep talk and expect the best. After all, you are what you think.

Own Pink:
Keep in mind that everything that makes up your whole health plays into how you will experience menopause. To truly thrive during your menopausal transition, focus on balancing all the facets of what makes you whole. Bolster your creativity. Connect spiritually. Build authentic relationships. Nurture your body. Care for your mental and emotional health. Let your sexual freak flag fly. Get in touch with your life purpose. Find your calling. Engage in work you love. Own Pink!

When It’s My Turn

I know my day will come. I used to dread menopause, as many of my patients do. Who wants to endure hot flashes, night sweats, mood swings, brain fog, insomnia, vaginal dryness, skin changes, and weight gain? But as this life transition draws closer, I find myself shedding my fear and beginning to embrace it. I would never want to move backwards in my life. Each year is filled with lessons learned and growth experiences. God forbid I should ever have to relive my 20s, full of insecurities, vanity, pride, and selfish choices. And my 30s, while vastly better than my twenties, were largely a time of walking through life like a zombie, asleep to my true calling. On April 24th, I’ll turn 42, and already, I feel different. I’m getting smile lines and grey hair and age spots, but I really don’t give a flip. Sure, the radiance of youth may fade as we age, but we glow with a different kind of light as we step into who we are truly meant to be.

Because of this, I no longer dread menopause. Instead, I see the hot flashes, mood swings, and insomnia as part of the transition. Just as the pains of labor and childbirth allow us to create a whole new life, the discomforts of menopause usher in a rebirth of another sort. Many of the women I most admire have passed through this phase and emerged more fully as confident, gifted, loving, secure, beautiful human beings. Someday, that will be me.

What About You?

Are you in menopause? Getting close? Having symptoms? Tell us what works for you. Tell us what doesn’t. Between us, we have hundreds of thousands of years of experience, so let’s go to the Red Tent together, sisters, and share what we’ve learned!

Honoring menopause,
Lissa

Disclaimer: I am doing a spokesperson gig with Estroven and will be speaking on their behalf to editors of national women’s magazines in the Big Apple this week. So while I do genuinely recommend Estroven, they are paying me, so FCC guidelines require that I disclose this juicy tidbit. Just sayin’…

Lissa Rankin, MD: Founder of OwningPink.com, Pink Medicine Woman coach, motivational speaker, and author of What’s Up Down There? Questions You’d Only Ask Your Gynecologist If She Was Your Best Friend and Encaustic Art: The Complete Guide To Creating Fine Art With Wax.