Ask Dr. Pat · Menopause

Menopause: Getting It Right

Patricia Yarberry Allen, M.D. is a Gynecologist, Director of the New York Menopause Center, Clinical Assistant Professor of Obstetrics and Gynecology at Weill Cornell Medical College, and Assistant Attending Obstetrician and Gynecologist at New York-Presbyterian Hospital. She is a board certified fellow of the American College of Obstetrics and Gynecology. Dr. Allen is also a member of the Faculty Advisory Board and the Women’s Health Director of The Weill Cornell Community Clinic (WCCC). Dr. Allen was the recipient of the 2014 American Medical Women’s Association Presidential Award.

Dear Dr. Pat:

I am 46 years old and am terrified of menopause for good reasons. My mother, who was a great beauty when she was young, had terrible symptoms with depression and drinking in her late 40s. She was never easy, but became really bad-tempered during this time. She gained weight, and before she was 50 was a divorced, angry, overweight, stay-at-home woman whose children were happy to be out of the house and away from the mess. She finally got sober and moved back to her hometown in the Midwest after many unhappy years in a big city. My brother and I rarely see her, because she may be sober but she is still self-absorbed and demanding. My brother, unfortunately, has a drinking problem and has work and marriage problems as well.

I want to do everything I can to prevent my life from turning out this way. I have two teenage daughters who are doing well, and both will be in college in two years. I have a really good marriage with a great sex life. I eat in a healthy way and exercise daily but have noticed that I have begun to gain some weight. I do have a drink most nights, and a bit more socially, but don’t have any other bad habits. I have a great job where I have the opportunity for advancement, and, of course, I have the usual overwork that everyone complains about.

I now have some night sweats before each period and my periods are less frequent. In the last six months, the periods occur every eight weeks. I used to sleep a sound seven hours, and now I fall asleep and wake up in the middle of the night. I am not sure why I wake up, but I have a hard time turning my brain off when I do wake up. When I wake up in the night, I generally think about never getting back to sleep, being exhausted the next day, and then begin to worry about MENOPAUSE. The daytime fatigue seems to have caused some kind of brain fog as well, and I certainly don’t need that.

These symptoms have triggered my fear that I will become like my mother as I become menopausal. I saw my GP, who did blood tests and an exam, and I have no health problems. My gynecologist told me that I was too young to have menopause and that these symptoms were nothing to worry about anyway. My girlfriends and I talk all the time about how we will manage menopause. What can I do to prepare for this horrible time so that I don’t ruin my life like my mother did?


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  • Maria Jasmine Freeman March 29, 2017 at 6:57 am

    Dr Pat’s advice is valuable and pertinent; much of it can be practiced indeed. Perimenopause symptoms however can be subduing, especially insomnia. Yoghurt was a great help in my case-worked like a sedative, and often I would ingest 2-3 bowls in a row to calm my crawling nerves and muscle and heart burn( mind you, v recent studies point that it decreases breast cancer risk before menopause). Herbal concoction-like orange blossom and sage ameliorate anxiety and depression, and so does anise drinks. It is great if you persevere with a fiber -rich diet, with soy, sesame, chickpeas, nuts, beans, legumes, and dried fruits, all good sources of plant estrogens, to compensate for ovarian estrogen depletion.
    For weight gain, my experience seems unprecedented in this connection. From a nimble girly figure( 4-6 American size), I was acutely turned into a morbidly obese woman( 14 size), and turned bed ridden, literally, while I was continually vomiting. A little weight gain in your case would thus be a blessing.
    Duration of menopause could exceed a decade, especially the earlier perimenopause starts; so don’t be disappointed at any encounter of its treachery.
    I am not here for discouragement, but for trying to be realistic, as too much optimism backfires; it is essential that a woman knows that her symptoms are only part of the “normal” in menopause.
    Most crucial is mindfulness of menopause and its impact, wherein attempt at adaptation and dealing with each day as feasible should be practiced, without frustration added over its pains!
    Dr Hana Fayyad, pediatrician
    Maria Jasmine Freeman.