It’s National Menopause Awareness Month! We’re celebrating with a) a shout out to the only other menopausal mammals we know of ( 🐳) and b) some recent research about bodily changes during perimenopause and menopause. If you believe every internet search result, women’s undeniable destiny appears to be sweaty, sexless crone-dom and eventual combustion into dust. In the interest of assuaging my own fears (and letting you make your own judgments about your menopausal past, present, or future), I chatted with Dr. Taraneh Shirazian, a gynecologist at the Tisch Center for Women at NYU. She explained the up-to-date science and research behind five commonly cited, and commonly feared, ideas about menopause:
1. Your period will disappear overnight.
Actually, most periods make a pretty gradual exit which, depending on your relationship with your cycle, is the best or worst news anyone has ever given you. During a regular menstrual cycle, estrogen and progesterone hormones increase and decrease in a (theoretically consistent) pattern. When you enter perimenopause, your hormones start to fluctuate and dwindle, which means there might be months when your flow is heavy, months when you fully skip a cycle, or months when you just sporadically spot until, eventually, you stop menstruating (and cramping and PMSing and PMDDing🎉) entirely. Dr. Shirazian explains that some periods do just stop cold turkey, but for most of us there’s an ebb and flow until it peters out and, after a full year of no bleeding, menopause officially begins.
2. The rest of your time on earth will be filled with hot flashes.
It turns out that about 40% of women don’t ever experience hot flashes! That’s really cool, but for the 60% of us dripping in sweat right now (including those of us who, menopause aside, have had thermoregulation issues our whole dang lives 🙋), the hot flash forecast is a little bleak. Dr. Shirazian says it’s actually true that about 18% of women experience lifelong hot flashes, and recent research has upped the average timeframe for the rest of us to about 10 years. That’s a far cry from the three to four year window doctors used to tell women they could expect to sweat through. But Dr. Shirazian says there are many accessible, alternative therapies out there to help manage the heat. Many women find that exercise helps regulate their bod’s temperature, and Dr. Shirazian also recommends a supplement called Swedish Flower Pollen that’s been shown to reduce the frequency and intensity of hot flashes by an insane 60% for women who use it long term. What works for one person may not work for someone else, so it’s worth trying a range of supplements and therapies to find the one that’s best for you.
3. You’ll never sleep again.
It’s true that menopause and bouts of insomnia are tightly linked, but the reasons vary. For one, progesterone, a sleep-inducing hormone, drastically decreases during menopause. When you combine that decrease with uncomfortable night sweats and the fact that our sleep cycles naturally shorten as we age, it makes sense that your sleep is out of whack. The good news: it’s totally possible to get back on track if your insomnia gets out of hand. Dr. Shirazian says the first step is to figure out whether night sweats, or even anxiety, which often spikes when hormones are shifting in our bodies, are compounding your sleep problems. She says that “once those two things are managed, a shortened sleep cycle won’t be such a negative thing,” and your body and mind can start to feel a little more rested.
4. Sex is over.
I’m happy to report that this one is patently false! Your bod’s lowering estrogen and testosterone levels *can* make you feel like your sex drive has left you in the dust. But recent research shows that a fluctuating sex drive is also influenced by a ton of other factors during menopause, and that most of those factors are totally treatable: exhaustion from disrupted sleep cycles, anxiety and depression, and uncomfortable conditions like vaginal dryness and vaginal atrophy (aka inflammation from dry and thinning skin). If dryness is holding you back, water-based lubricants and estrogen creams are two simple solutions. It’s easy to decide menopause is a sexual wasteland, but Dr. Shirazian explains that many women navigating menopause actually feel sexually free because birth control is a thing of the past, and sex officially serves no purpose other than being a pleasurable pastime.
5. You can kiss bladder control goodbye.
...you can, but you definitely don’t have to. The natural process of aging combined with dropping estrogen levels during menopause *can* contribute to the weakening of your pelvic floor muscles, which in turn ups your odds of becoming a little leaky. In fact, Dr. Shirazian says this is something she commonly sees in her practice, and that 40% of women over age 50 experience prolapse or leaks. But leaking isn’t necessarily a symptom of menopause or aging that should just be accepted. Why? Like other muscles, the ones that comprise your pelvic floor can be strengthened again through simple, strategic exercises. So, depending on what’s causing your leaks, a visit to your doctor and to a pelvic floor therapist are solid first steps in making menopause a little more comfortable.
No matter where you rate your menopause experience on a scale from island vacation to sweaty, excruciating horror film, understanding the changes happening in your body can empower you to embrace the experience (most of the time.)
-What are your best menopause hacks?-