Tuesday, November 27, 2012

Coping with Peri-Menopause and Menopause

Welcome back to Shrink It Down. I hope everyone had a great Thanksgiving. Today I want to talk about peri-menopause, also known as pre-menopause, and menopause. So many women come to me in a state of confusion. It is not unusual for women to be referred to me to rule out a psychological problem, even though they have no history of psychological problems and no recent history of problems other than physical and psychological symptoms that are new to them. A thorough interview often suggests peri-menopause and a referral to their Gyn. Doc. On average, most women begin their journey into peri-menopause in their late 40’s and menopause in their early to mid 50’s. However, it can start as early as the mid to late 30’s or as late as the early 50’s. A woman is not in menopause until she has missed 12 consecutive menstrual cycles. Typically, your symptoms will tell you that you are in peri-menopause long before blood work validates what you already know. Peri-menopause is a natural transition of changes and loss of hormone levels. How you deal with this journey interacts with your personality, experiences and current life stressors.
Common symptoms may include irregular periods, hot flashes, night sweats, sleep difficulties, fatigue, irritability, depression, weight gain, fuzzy and foggy thinking, anxiety, headaches, poor stress tolerance, thinning hair or loss of hair, vaginal dryness, and even joint stiffness. Decreased sexual desire is also very common. Any combination of these symptoms is a lot to deal with, especially if you have other stressors in your life such as adolescent children at home, maybe taking care of aging parents, stressful job, money problems, relationship issues, or any loss in your life. I refer to peri-menopause as a scenic journey that involves some hazing into the next chapter in our lives. Everyone has their own collection of symptoms that are most challenging to them. I strongly encourage you to focus on acceptance with elegance and a great sense of humor. If you are hot, let yourself be hot without apology and your family will adjust to freezing for awhile. If you have night sweats, keep clean sleep wear by your bed side, along with a large towel you can use to cover the damp part of your bed so you don’t have to get up and remake your bed, somehow doing this around your husband or partner. Biotin is great for thinning hair, black cohash is good for hot flashes, and your Dr. can prescribe hormonal creams for dryness. Work with your Doctor regarding hormone replacement, natural remedies, and symptom relief. Make sure you are working with someone you are comfortable with and who is receptive to both traditional and homeopathic interventions. Many women find therapy to be very helpful as they learn to deal with the physical and emotional changes they are experiencing. Two main issues that women often address in therapy are their mood regulation when their children come home from school and the after school chaos overwhelms them. Often a mild anti-anxiety in the late afternoon on a rough day can be very helpful. The second main issue is what I refer to as swiss cheese brain. This is when you have holes in your memory and the holes keep moving, like in a carnival game. The most important intervention for swiss cheese memory is that sense of humor I mentioned, and good notes. Although this is not actually one of the major problems women bring in to therapy, decreased libido can present a problem for some couples. When women bring their partners in to discuss the situation, some education and suggestions are often all it takes to get partners on the same page. Talking to friends or relatives also on this journey can be helpful, as long as it is not just a litany of complaints. This is a time when you really need to take care of yourself with eating healthy, exercise, relaxation, and socialization. There is life after peri-menopause, I promise!

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