Menopause

Menopause is Never Old News

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.

September is Menopause Awareness Month. Last week, Dr. Patricia Allen wrote about Lichen Planus and Menopause: Diagnostic and Treatment Differences. This week she continues answering questions  about menopausal symptoms and relief.

 

Dear Dr. Pat,

My only sister is fifteen years older than me.  At 57, she has just come out of a decade of misery, all of which she blamed on menopause.  She was a great beauty when she was young but did not deal with aging in a positive way. She began to drink heavily in her late 40s.  She was never easy, but became really bad-tempered during this time. She constantly saw doctors to find a hormone fix for her symptoms.  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, went into therapy and turned her life around in the last two years.  She is slowly mending her relationship with her children and all of us who loved her but found her too toxic to tolerate. She still blames everything that went wrong on “a terrible menopause.”

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. I have a really good marriage with a great sex life. I eat in a healthy way but have noticed that I have begun to gain some weight. I do have a drink most nights, and a bit more socially, but I don’t have any other bad habits. I have a job where I have the opportunity for advancement, but it is stressful and time consuming. I don’t have much time for the “self-care” I read 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 four to 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. These symptoms have triggered my fear that I will become like my sister as I become menopausal.  I saw my GP who did blood tests and an exam. I have no health problems. My blood work shows that I am not in menopause, even though I have symptoms that sure do mimic menopausal symptoms.  What can I do to prepare for this time so that I don’t ruin my life like my sister did? Do I take hormones or not?  Hormone therapy certainly didn’t seem to help my sister.

Jean

 

Dear Jean,

The interesting thing about menopause management is that the subject is never old and the information is never final. The recruits to this life stage come in, day after day, year after year. Menopause may be old news to women in their 60s and 70s, but to women in their 40s and 50s, it is news that is always “hot off the presses.” Each woman has a unique experience with menopausal transition, though there are certain constants. Unfortunately, menopause is often the reason given for a great many bad choices.  Your sister’s decision to blame menopause for her alcohol overuse, mood disorder, weight gain, divorce and estrangement from her children may help her explain her decade of misery but I disagree. I do understand however that it can be frightening for women to think about and plan for the menopausal transition when they witness and hear about family members and friends who manage this part of life in negative and often destructive ways.  You chose early in life to follow a different path from the one your sister chose.  You have every reason to be hopeful that you will continue to make choices that will ensure a manageable menopause.

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  • Emily September 17, 2018 at 12:38 pm

    I wonder if Pat might address bioidendical hormones post-menopause. I have been prescribed these by a naturopath and I do think I am sleeping better but I feel uncertain about their safety, mostly because mainstream gynecology doesn’t seem to prescribe them. Thank you.

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