Burning questions about menopause

The Baltimore Sun

Here's a hot flash for you - or rather, a bunch of them.

Rebecca Hulem is a Los Angeles-based nurse practitioner and consultant who is known as "The Menopause Expert."

Her 2003 book, Feelin' Hot? A Humorous, Informative and Truthful Look at Menopause, is about ... well, the title is pretty self-explanatory. Hulem decided to write the book and to maintain a Web site (themenopauseexpert.com) after experiencing a particularly rocky Silent Passage.

"I was having mood swings, fatigue, difficulty focusing," she says. "I thought everyone else was changing. I didn't have a clue what was going on, and I'm a health professional."

Hulem recently took an hour from her busy schedule to answer a slew of burning questions:

When is the average onset of menopause?

In the western hemisphere, the average age is 52 for menopause, and 48 for perimenopause. For some women, the physical and emotional disruptions of perimenopause can occur as early as their late thirties.

How long do symptoms last?

Between two and 10 years. A very small number of women, between 2 and 4 percent, will continue to get hot flashes for the rest of their lives.

How many women have troublesome symptoms?

Nearly everyone who lives long enough to go through menopause will have some symptoms, but not all women experience them to the same degree.

The exception is women who are on birth-control pills. Because the pills contain estrogen and progesterone, they suppress the symptoms that result when those hormones naturally decrease.

And the most common symptoms are ...

Irregular periods, hot flashes, night sweats, mood swings, heart palpitations and difficulty sleeping.

What is the biology behind some of these side effects?

Estrogen monitors body temperature, so when the level of this hormone drops, our thermostats temporarily go out of whack. This can result in hot flashes.

Progesterone regulates our sleep. When that hormone starts to decrease in perimenopause, many women have trouble getting to sleep. In contrast, when women hit menopause, they have trouble staying asleep.

Why?

That's estrogen, or rather, the lack of it. Many women in menopause wake up at 2 a.m., which is the time of day that estrogen naturally is at its lowest level in our bodies. I used to say that I was going to start a chat room at 2 a.m. All the women with menopause would get online then, and we'd solve the world's problems.

What about the weight gain often associated with middle age? Is that just our metabolisms slowing down?

No, there's also a hormonal contribution. You'll notice that women in menopause tend to gain weight around the middle. That's because our bodies can convert fat to estrogen. But the chemical that does the conversion is secreted from our adrenal glands, so the fat has to be close to those glands for that process to take place. Our bodies really are amazing machines.

Have you seen Menopause The Musical? If so, what did you think of it? [Laughing] It's hilarious! It's an informative, light-hearted way to get across the message that menopause is not the end of life. Instead, it's a whole new story. Many women find that once they are through menopause, there are all kinds of options and choices they never had before.

Copyright © 2021, The Baltimore Sun, a Baltimore Sun Media Group publication | Place an Ad
72°