Menopause brings certain anxiety, because change is always scary. But according to Dr. Eileen Manalo, the best way to “survive” menopause is by embracing it. Menopause is not the end of the world, in fact, it brings a new beginning.
When we were young, we looked to the future with great anticipation. From graduating school, landing our first job and working our way up the corporate ladder, to marriage and raising our own family – each phase brought excitement. This cannot easily be said when it comes to menopause. The dreaded “M” word is a heavy dark cloud that hangs over every woman’s head.
Dr. Eileen Manalo, a reproductive endocrinology and fertility specialist of Makati Medical Center, shares that menopause does bring about certain unique challenges, but each one can be hurdled. While challenging in itself, menopause is also a blessing as it provides the opportunity for women to gracefully embrace their body, their new life, and a gentler view of aging.
“I started noticing changes in my body when I was 42, but the ‘full effect’ of menopause hit me at 46 when I was experiencing painful, erratic menstruation and severe hot flashes. And the entire menopause process took 5-6 years,” share mother of 4, Dr. Evelyn Casal Dacumos.
Here, Dr. Manalo sheds light on some of the pressing concerns, and answers the most common questions about menopause.
1. I’m a woman in my early 50s and I’m experiencing so many changes in my body, such as dizziness, hot flashes, and night sweats that are out of the ordinary. Am I going through menopause?
For Filipinas, the average menopausal age is 48 years old, based on the study of 1000 menopausal women in Metro Manila conducted by Dr. Julita Jalbuena, the founding president of the Philippine Society of Climacteric Medicine. While internationally, the average age is 51.
Estrogen is the female hormone that is primarily associated with ovulation and menstruation. However, it’s found in different parts of the body, including the brain and the heart.
During menopause, estrogen levels decrease, and this, in turn, causes many changes in a woman body, including the eventual stop of menstruation in women. This means that a woman can no longer get pregnant, unless through medical intervention.
During menopause, a woman may experience hot flashes, night sweats, mood swings, the thinning and wrinkling of skin, as well as vaginal atrophy. If you are experiencing one or more these symptoms and are around 50 years old, you may be going through menopause.
2. I had just turn 30 and I think that I’m in pretty good health. But I’ve noticed that my periods are not as regular as they used to be. Can I woman go through menopause as early as 30 years old?
There are many factors that may disrupt the normal menstrual cycle such as stress, changes in lifestyle, weight gain and weight loss, among others. As mentioned, the average Filipina experiences menopause at 48 years old, however, there is a possibility one may experience early menopause.
Smoking, bilateral tubal ligation, surgical procedures like removal of ovarian cysts even if ovaries are left behind all can lead to early ovarian failure and menopause. A consultation with your doctor and several tests can confirm if you are, indeed, going through early menopause.
3. I’ve heard that menopause is especially uncomfortable, if not painful. What symptoms should I expect and how severe is the pain? Is it true that not all women experience the symptoms?
Each woman goes through menopause differently. An estimated 17% of women experience severe symptoms, while others go through menopause gracefully, without feeling anything. Those are the lucky ones. In about 10% of cases, menstruation simply stops and women don’t even go through the menopausal transition.
For moderate to severe pain, estrogen therapy is prescribed to relieve vasomotor symptoms, to prevent vaginal atrophy as well as to prevent osteoporosis in women ages 50-59. Discuss your symptoms with a doctor, and he/she can advise what is best to help alleviate the discomfort.
4. When I was in my 20s, I focused on building my career. I’m now in my late 30s but I don’t think I’m ready to have kids just yet. With menopause just around the corner, is there anything I can do to delay it, especially if I still want to have kids in the future?
Women really do have a biological clock, and you cannot delay menopause. Fortunately, if you would still like to have children, at this day and age, there are many available fertility treatments like ovarian tissue preservation, where you can have your eggs extracted, frozen and stored until you are ready to become pregnant. For a more thorough understanding of such treatments, it is best to discuss with a fertility specialist.
5. I’m dating and going through menopause. How will menopause affect my sex life?
One of the effects of menopause is vaginal atrophy or the thinning of tissue around the vagina which may lead to painful intercourse and painful urination. You may want to use lubrication or the doctor may prescribe vaginal estrogen therapy.
6. I’ve read that other women have tried hormone replacement therapy (HRT) to make the symptoms of menopause less uncomfortable. What is HRT and what are the risks?
While you cannot delay menopause, you can make the transition more comfortable for you through hormone replacement therapy, which essentially uses estrogen and progesterone, another important hormone, to treat common symptoms of menopause.
In cases of women who are experiencing moderate to severe symptoms, HRT is prescribed for long-term relief. In addition, HRT helps in the prevention and treatment of osteoporosis, as well as arthritis. In some case, HRT is seen to prevent heart disease and Alzheimer's dementia. In women with an intact uterus, progesterone is prescribed to prevent endometrial hyperplasia and cancer.
While the combination of estrogen and progesterone replacement therapy have been linked to a higher risk of breast cancer, cardiovascular disease and strokes, the absolute risks are small, almost negligible in healthy women ages 50 to 59, the very same age group of women who will benefit the most from HRT.
Not all women can take hormone therapy, however, especially women who have been diagnosed with breast cancer, and those who have suffered a stroke, heart attack or venous thrombosis.
7. I’m a bit hesitant about taking hormonal therapies, are there other natural remedies/ treatments that you can advise for women who are going through menopause like me?
Of course, changing one’s lifestyle is highly recommended. Anything that is toxic to the ovary can bring about menopause. So follow a healthy diet, exercise and stop smoking. Smoking can actually bring about an early onset of menopause by one to two years. (Having your ovaries surgically removed has also been associated with the earlier onset of menopause by two years).
In addition to diet, exercise should be done 30 minutes a day, two times a week. This is recommended to help strengthen your bones. In the absence of estrogen during menopause, there is poor calcium absorption, and one is at risk of osteoporosis. It is advised that you take 1200 mg of elemental calcium and 800 units of Vitamin D, which aids in the absorption of calcium.
8. I have several other health issues such as diabetes and high blood pressure. Will menopause aggravate my existing health conditions and/or will it increase the risk of me developing other diseases?
Menopause does not increase risk per se. Aging by itself complicates all those. Like menopause, you cannot escape aging so what you can do is strive to be in the best shape possible. Practice good hygiene; exercise; and eat a balanced diet of fruits and vegetables and lean meats. Of course, eat less salt, sugar and fats.
Once you turn 40, you are advised to regularly take a pap smear and mammogram to check for any abnormalities. But women, regardless of age, should regularly see their OB-GYN to ensure that all things are in check. One should also be cautious of your heart health, because the number one cause of death among women after menopause is not breast cancer, but heart disease.
9. How can I make the transition during menopause as comfortable and as stress-free as possible?
I advise patients to relax. Stress only agitates the otherwise normal process. Remember, this is a perfectly natural and normal phase in a woman’s life, so don’t be afraid of it. If you’re experiencing hot flashes, wear light clothing. Drink lots of fluid, rest, and get exercise to boost the happy endorphins to relieve stress.
Original article from Working Mom’s August 2014 issue, written by Kristel Dacumos-Lagorza. Check out more exciting stories in the latest issue of Working Mom available in bookstores and on newsstands for P120. Download the Working Mom Magazine app for access to all digital editions on your tablet or smartphone, available in Zinio, and Buqo Digital Newsstands. Like Working Mom on Facebook (www.facebook.com/ WorkingMom.Magazine) and follow them on Twitter and Instagram (@WokingMomMag).
ALSO READ: Daily Diaries: When A Parent’s Loss is a Loss of All Parents