What's happening with me? - menopause

Mid-life--a time of change in every dimension--mind, body, emotions, and spirit. Sometimes the changes are subtle, a faint stirring that is hard to describe. Sometimes they rock our very foundation and sense of who we are, and we find ourselves asking, "What's happening with me?"

Physical and emotional signals. Often the first signs of menopause are subtle, and the changes we notice may not be physical, but more emotional. We may be irritable, or find our moods swinging unpredictably. These changes at first may be attributed to life's pressures. Certainly, living with a difficult spouse or teenagers, working in a demanding or unchallenging job, ending a relationship, or dealing with aging parents can lead to emotional imbalance.

Seeking professional help may not provide all the answers because our problems might be dismissed as being simply stress-related, or the help may address our emotional state and not the physical changes that are occurring.

Understanding hormonal balance. Two hormones play a part in a woman's reproductive cycle each month: progesterone and estrogen. Sometime between the ages of 35 and 50, ovaries slow production of these hormones. Many women lose progesterone first, which may cause irritability, increased bloating, breast tenderness, or irregular menstrual flow.

During this first stage of menopause, doctors may prescribe progesterone supplements to restore hormonal balance. Later, when the body has also begun to make less estrogen, these same supplements may make a woman feel worse.

Often the first sign of a lack of estrogen is sleep disturbance. Many women wake up feeling agitated, or with heart palpitations. The familiar "hot flashes," or flushes, may begin. Other women notice changes in their skin sensitivity, and dryness or inelasticity in their vagina. Whether these symptoms are slight or severe, what's important to know is that they are signaling an imbalance that can be corrected.

When you are considering hormone replacement therapy, it is also important to know that two of the most dangerous effects of estrogen reduction do not have early symptoms. These are bone loss and cardiovascular disease. lf your family history includes these problems, you should find out about the relationship between them and estrogen reduction.

Choosing hormone replacement therapy is a very individual decision. Some women may not have symptoms that would indicate its use; others may reject the idea of taking hormones regardless of their symptoms. Likewise, the medical community has differing opinions about hormone replacement. When you seek professional advice about hormone replacement or any other mid-life change, take a written list of questions and concerns, and insist on respectful and comprehensive answers. Expect to hear that there are many things not yet proved through research, and insist on learning about all your options. Then make your decision.

The Cooper Feather Institute. In my work with women there are two complaints I hear most often. One is "I hate this feeling of being out of control. I've got to do something; but what?" The second is "l feel so stuck and so alone. Nothing is right and I don't know how to make changes that work." Some women feel angry, perhaps even very angry; others feel sad or resigned and seem to retreat from life. Imbalance at mid-life blocks the possibility of "postmenopausal zest," as Margaret Mead so aptly labeled it.

In conjunction with the Flagstaff Medical Center in Arizona, my partner, Lana Holstein, M.D., and I created Copper Feather Institute as a program of information, research, and seminars for women in mid-life. We know that there is a lot that women can do to balance their lives, provided they have adequate information and support.

Participants in our program complete a thorough blood analysis, including hormonal levels, and a psychological profile of lifestyle, goals, and needs. They receive specific information on such universal topics as achieving vitality, balancing life roles, sexuality at mid-life, and dealing with conflict. They leave knowing the tremendous source of power, insight, energy, vitality, and wisdom that they and other women bring to society.

Reestablishing balance. I believe it's best to read everything you can about mid-life and menopause, As you become informed, remember that menopausal symptoms do not indicate psychological abnormality or physical disease. Even if what you are feeling is uncomfortable and requires professional attention, it is nothing to be apologetic about or ashamed of.

Perhaps more important, talk about what's going on with friends or women who are having similar experiences. Recent research into responses to major life challenges shows that support from others is often the most important factor in successful coping or recovery.

Break the cultural taboo about acknowledging mid-lffe or menopause and tell people what's going on with you. Remember that in the next two decades about 40 million women will pass the age of 40. Finally, think of mid-life and the physical, psychological, emotional, and spiritual changes that occur as renewal rather than crisis or stagnation.

As I notice and respond to the changes in myself and other women at mid-life, I'm encouraged to know that at age 51 we still have half of our adult lives to live on average. By learning more about ourselves, and speaking out about our experiences and needs, we can make these the best years yet!

Alinda C. Page is clinical director of the Copper Feather Institute for Mid-life Enhancement. For more information, contact the institute at 1200 North Beaver Street, Flagstaff, Arizona 86001; or call 602-773-2559.

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