Woman’s health expert, Dr Karen on menopause

Woman’s health expert, Dr Karen on menopause

An expert on women’s health, Dr Karen Coates is Australia’s leading holistic medical doctor and naturopathic physician and is the published author of the health book ‘Embracing the Warrior - an essential guide for women’. We had the privilege of asking Dr Karen some frequently asked menopausal questions in this, the last week of our hormonal health series.

How can I tell if what I’m experiencing is caused by menopause or some other condition?
Menopause means the cessation of menstrual bleeding – also called “the change of life”. Signs that you’re in menopause should occur naturally, around the age of 48 to 54 years. Periods may start to skip a month. Hot flushes and classic menopause symptoms like mood swings, irritability and vaginal dryness may come and go. These symptoms can also be a sign of thyroid imbalance, chronic stress, or other gynaecological disorders. Confirmation of menopause is best done when periods have been absent for a couple of months – your doctor may order lab tests that show a classical pattern of menopause, with very low female hormone levels (the oestradiol form of oestrogen and progesterone) and a high level of the pituitary hormone called Follicle Stimulating Hormone, or FSH.
In the first 12 months during the 'change of life’ hormone levels in blood tests can fluctuate from normal pre-menopausal levels to very low fertility hormone levels in a matter of weeks as your body moves into and out of menopause as a normal part of this transition. If blood levels are done around a late menstrual period, it can falsely reassure a woman she is not in menopause. If this is the case, doctors will often recommend two or three blood tests over several months to confirm the diagnosis.

How long do menopause symptoms usually last?
Women transition through menopause differently, depending on their innate biological clock, along with lifestyle issues and stress levels. Menopause for some women is a smooth transition from monthly periods to none in a matter of weeks. Sadly, for others, this transition can take several years. Peri-menopause can start for some women in their early 40s and occur when the balance of the two fertility hormones, oestrogen and progesterone, is disrupted. A woman will notice cyclical symptoms, like severe breast tenderness and premenstrual irritability and insomnia related to a lower level of progesterone hormone, but oestrogen is still pumping, producing period bleeds that may be erratic and heavier than usual.
True postmenopausal life starts when fertility hormones settle to a predictable low level with little fluctuation from day to day or month to month. Your body adapts to this lower level of hormones, and, for the most part, hot flushes and acute symptoms disappear.

What can I do about hot flushes?
Hot Flushes occur when oestrogen levels fluctuate up and down, from very low to sometimes very high levels. Before considering pharmaceutical options like menopause hormone replacement therapy, source naturopathic advice on hormonal modulating herbs like red clover, dong quai, and liver support herbs like St Mary’s thistle. Alcohol is one of the most potent hot flush triggers there is, so remember, if you drink, you’ll flush!

Interrupted sleep: Is this normal, and what can I do?
This is common in menopause. If hot flushes disturb sleep, first try the strategies listed above. These tips also help:
• Eliminate triggers like caffeine, alcohol and sugar
• Consider a palm full of pistachio nuts after dinner – these contain the natural sleep hormone melatonin to promote a deeper, natural sleep
• Keep your bedroom cool – invest in a small personal fan to use if hot flushes wake you
• Try an evening cup of sage and dandelion herbal tea. Pineapple sage can be grown easily in the garden and used as an infusion throughout the day
• The herb zizyphus is also a good sleep promotor.

    How should I explain my condition to my partner, family, and friends? What, if anything, should I say to my boss and co-workers?
    An open dialogue with friends, family and work colleagues if appropriate, can provide emotional support and foster an understanding of the emotional challenges that can accompany this transitional time in every woman’s life. Symptoms will settle more easily in a low-stress environment, so look at stress management strategies as an essential member of your menopausal team.

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