How to Cope with Menopause

Are you currently experiencing menopause or feel nervous about going into menopause? If you answered, “yes” you are not alone. Many women are unsure on how to deal with menopause. To help understand what type of impact menopause can have on a woman’s overall life and how you can cope with menopause, I have interviewed therapist Lenore Pomerance LCSW.

Tell me a little bit about yourself.
I am a clinical social worker with a private practice in psychotherapy in Washington, DC. I became interested in menopause when I myself started to experience it. This was during the era when women were automatically given hormone supplements, which I initially took even though I didn’t have symptoms other than a cessation of periods. Then I joined other women in questioning the safety of hormones and gradually learned how “menopause medicine” was becoming a multi-billion dollar industry. I also became interested in the impact of menopause on women’s sexuality and wrote the sexuality chapter in Our Bodies Ourselves: Menopause published by the Boston Women’s Health Collective. (2006) I highly recommend that book which gives a comprehensive look at menopause from the prospective of many women.”

What type of impact can menopause have on a woman’s overall life?
“First, menopause is not a disease. Second, there are psychological and physiological impacts which every woman experiences differently. It is a normal physiological condition that will happen to every woman if she lives long enough. But her response to menopause depends on what else is happening in her life.

Unless it is surgically induced through a hysterectomy, menopause is a gradual process culminating in cessation of menstruation. The process, called perimenopause, usually lasts about eight years and usually starts in the late 40’s through mid-50’s. It is the book-end of puberty when we began our reproductive lives: it marks the end of our reproductive lives.

This fact can impact a woman in different ways: if she wanted biological children but put that off in the distant future it can be a shock to realize that the option is closed. She may need help grieving this loss. If a woman thought of menstruation and the idea of being able to bear children as a large part of her feminity she may feel she is no longer feminine. Other women may rejoice at the cessation of periods and feel a sexual freedom at no longer needing to use birth control. Some women may have internalized our society’s stigma of “the old” and see menopause as the beginning of the decline into old age.

Menopause occurs at a time in women’s lives when many other life changes may be happening. She may have lost a long-term partner; if she has children they may be in the throes of adolescence and beginning to show signs of leaving the nest. If she has been working outside the home she may find her job eliminated or threatened by younger more technically savvy people. She may also find herself having major responsibilities caring for aging parents. On the other hand she may be in a supportive long-term relationship, feeling energized by her children who are ready to take on the responsibilities of adulthood.”

How can women cope with menopause?
Two major physical symptoms that some women experience are vaginal dryness and hot flashes. Vaginal dryness can result in painful or uncomfortable sexual intercourse. This can be remedied with liberal use of lubricants and low doses of estrogen applied locally in the vagina as a cream, pellet, or a vaginal ring. Estrogen is not the solution for women who are experiencing a decline in sexual desire or sexual response. Fatigue, body image, and relationship issues are just a few of the factors influencing sexual desire and can be experienced by women at any age. Some women can experience debilitating hot flashes, which can be alleviated by life style changes and low doses of estrogen. There is still controversy over the risks of taking estrogen, which came out in the National Institutes of Health Women’s Health Initiative Study in 2002. Since then the official position is to use estrogen supplements at the lowest dose and for the shortest period of time to control these symptoms.

There are also psychological challenges. For many women menopause at mid-life provides a unique opportunity to evaluate their lives and make what I call mid-course corrections in any aspect of their lives. Maybe it means getting out of an unhealthy relationship or seeking help to make it better; healthy life style changes including exercise that’s enjoyable, changes in eating and drinking habits; retraining in some other profession, widening social or intellectual horizons.”

What type of professional help is available for a woman who is having a difficult time coping with menopause?
“First of all there are dozens of books covering all aspects of menopause: physical, psychological, spiritual, etc. In addition to Our Bodies Ourselves: Menopause that I mentioned above I would recommend Christiane Northrop’s The Wisdom of Menopause. Both books have long lists of additional resources. Go to a library or bookstore and find others that appeal to you. Starting or joining a supportive group of women who can share their experiences is a way not to feel alone. Having a comfortable relationship with a healthcare provider, be it a gynocologist, internist, nurse practitioner, acupuncturist, naturopath or holistic practitioner is of primary importance. Finding a psychotherapist / counselor for more in depth psychological work can also be beneficial.”

What last advice would you like to leave for someone coping with menopause?
“Right now there are more resources than ever before in addressing menopause issues. As with any changes and transitions there are losses and gains. We can both mourn some of those losses and celebrate new paths opening up to us. Find yours!”

Thanks Lenore for doing the interview on how to cope with menopause. For more information on Lenore Pomerance or her work you can check out her website on www.menopausecounseling.com.

Recommended Readings:
Alternatives to Hormonal Therapy for Menopause
Coping Strategies for Midlife Challenges
How to Overcome Midlife Parenting Challenges

Reference:

• www.menopausecounseling.com