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Fielding questions relating to menopause

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Woman in White Robe Flower Care HolidayOne of the subjects that draws frequent questions from our customers and that land on my desk as the senior pharmacist here at IsraelPharm is how best to manage the onset of menopause and how to live with it forever more. It’s understandable that lots of questions relating to menopause crop up because, after all, it relates to half of the population, and given the fact that people generally, and women in particular, are enjoying longer life spans, the absolute number of years that people are living with the symptoms of menopause is growing all the time.

As always, we do our best to provide relevant information and respond to questions relating to menopause with evidence-based answers backed by experience and knowledge. As a middle-aged man, I do not have personal lived experience on the subject of menopause, but a popular columnist who regularly publishes in the Jerusalem Post, Andrea Samuels, does

I was happy to read her article in the leading Israeli English-language newspaper by one of their most popular columnists. In it, she talks about her own experience facing up to the transition into menopause. With her permission, I am reproducing it here, hoping that it will provide useful answers to all of your questions relating to menopause.

With Andrea’s permission, the following is a full reproduction of her articles entitled The Menopause Diaries (part I was released on February 24, and part II was released on March 15). 

Questions about menopause Part I – Jerusalem Post February 24th

The bumpy ride begins

Join me as I navigate my way through this difficult journey into the world of elasticized waistbands, hormone replacement therapy, cold showers, and sleep deprivation.

Women of a certain age will no doubt be familiar with the M word. For some, it simply passes without so much as a by your leave. These lucky ones are few and far between. Most women, on the other hand, are slain by myriad, seemingly endless challenges of the effects of menopause. Hot flashes, sleepless nights, and bulging waistlines are just the tip of the iceberg.

I slid smugly into my 50s, wondering what the fuss was all about. Feeling young and sprightly, I scoffed at those who warned me of the perils that lay ahead, convinced that mind over matter would see me through this difficult stage in my life. A strong woman like me simply wouldn’t be defeated by it, rather like how I convinced myself that having kids wouldn’t alter me one jot. Well, I was wrong about that too. I’ve never been the same since – although the upside to losing your freedom and your figure in one fell swoop is becoming a mother. Menopause is an entirely different matter, however; there’s nothing to commend it, apart from one welcome factor – no more periods!

Trying to stave off the inevitable

I managed to stave off the inevitable until a year or so ago when the hot flashes began. So mild at first, they barely registered. As someone who’s always cold, they were actually quite comforting, if anything. “This isn’t so bad,” I told my husband. “Can’t think what the fuss is all about.” And then it hit me like a train. All at once.

Suddenly, all my clothes shrank. I was barely able to sleep for more than two hours at a stretch, and I slowly started to resemble my late grandmother who barely had a hair on her head, as I recall, when she died, aged 99. I soldiered on in a state of denial for months. Maybe it was the odd glass of wine or the sneaky bars of chocolate that were causing my clothes to shrink.

Maybe it was the dogs wandering around my bedroom that caused me to wake repeatedly throughout the night. And maybe the years of dying my hair had finally taken its toll, causing it to fall out in large clumps.

It wasn’t until I’d gone for months without a period that I decided enough was enough. Finally, I put on my big-girl pants and made an appointment to see my doctor. Now, I’m no longer in denial. Now, I have to face reality and deal with the stresses and strains of menopause.

Join me as I navigate my way through this difficult journey into the world of elasticized waistbands, hormone replacement therapy, cold showers, and sleep deprivation.

Looks like we’re in for a bumpy ride!

Questions about menopause Part II – Jerusalem Post March 15th

I know that a lot of women fret over what to take for menopause symptoms, but for me the choice is clear: hormone replacement therapy (HRT). It is a treatment used to relieve the symptoms of menopause by restoring levels of female hormones – estrogen and progesterone – which become lower at this time.

Although every drug carries the risk of side effects, I have done some rudimentary research, so I’m convinced that I’m fine to take it. Not for me the plethora of herbal remedies that so many try, taking one after the other until eventually they find something that actually works.

Visiting the doctor

Life’s too short for that, I decided, before showing up at my doctor’s office with a long list of menopause symptoms that include fatigue, bloating, hair loss, poor concentration, and, of course, no period for seven months. My doctor, a young Israeli woman (everyone seems young to me these days), listened intently as I rattled off my list, silencing me every now and then with a thumb and forefinger gesture that only Israelis can pull off, before tapping away on her computer. I assumed that she was updating my file, although I wouldn’t blame her if she was trying to stay awake by engaging in a game of online chess as I droned on.

Eventually, she referred me for a slew of tests, just to be sure I was “on the turn.” “Why waste Maccabi’s time and resources?” I wanted to say. “I’m over 50, I’ve not had a period for seven months, my hair’s falling out – and I’m exhausted! Just give me a prescription for HRT, and I’ll be on my way.”

Of course, I didn’t say that. Instead, I dutifully answered her questions regarding my suitability for HRT, after which she said that not only was I a suitable candidate for the drug, but that she thought I should take it to protect my heart, since I have high cholesterol and a family history of heart problems (I’ve been taking statins for years).

Finally, some good news!

Before leaving her office, I assured her that I’d go for the tests and speak to her afterward.

IT’S FRIDAY morning, and I’m standing in a long line at Super-Pharm. The ticket machine spews out number 110, and they’re only on 97, so it looks like I’m in for a long wait.

Before leaving the house, I told my long-suffering husband that I was going to pick up my prescription for HRT. “Is that a good idea?” he asked. “Well, the doctor said I should take it, so I’m going to,” I replied. “Let’s look at the side effects,” he continued, grabbing his phone. “Side effects of HRT,” he murmured under his breath while tapping away on the screen. “Headaches, nausea, muscle cramps, mood changes…” he trailed off.

I carried on getting ready to go out, trying not to get exasperated. “Do you think you could push it back a week?” he asked hopefully. I looked quizzically at him. “It’s just, the mood changes…” he continued, nervously. I pretended not to hear him and slipped out. Mood changes? Apparently, I’ve become rather difficult to live with – impossible, even. And yet, I had no idea.

Something else to add to my list.

IsraelPharm has solutions for questions relating to menopause

We offer many proprietary products that address special issues of menopause. AndroFeme®1 is specifically designed to address the issues that come with menopause. Visit our sister website to learn more about this product, which provides special properties unavailable in any other product.

Some commonly asked questions relating to menopause.

Q1. Can menopause occur before the age of 45?

Statistics show that menopause can start in a wide time bracket but primarily sets in around the age of 45 to 50. It can also start earlier, in which case it may be due to conditions known as premature ovarian insufficiency or premature menopause. That can happen naturally or due to specific medical treatments or conditions. Anyone who is experiencing symptoms indicating the onset of menopause before the age of 45 should talk to a healthcare provider to determine the cause and discuss potential treatment options.

Q2. Are women living longer with menopause?

It’s possible to approach questions relating to menopause using basic arithmetic. It is quite easy to work out that more and more women are spending longer periods living with menopause. Based on public actuarial tables, we can see that life expectancy at birth for females born in 1930 was calculated as being 62 years. Working from that, with the accepted rule that, on average, females start puberty a bit before the age of 15, and menopause begins at around age 45. This means that in the mid-20th century, women were fertile for roughly 30 years and experienced menopause for about 17 years. By contrast, the life expectancy of a woman born in 1970 is calculated as being around 77. This means, on average, a woman would be fertile for the same three decades, but would then be in menopause for close to double the previous figure (32 years). This makes menopause a more significant time in a woman’s adult life than previously and makes the changes experienced in menopause more important.

Q3. Does menopause have an impact on a woman’s sex life?

Women entering into the phase called perimenopause or already experiencing full-blown menopause can relate to the concept that menopause is a significant change in life and that it can have a major impact on sexual experience.

  • Changes in estrogen levels are one of the pivotal transitions leading up the the start of menopause. Estrogen was the leading determinant of all hormonal levels controlling fertilization cycles and sexual characteristics. The decline in estrogen production that comes with menopause can lead to problems such as vaginal dryness, thinner vaginal linings, and reduced tissue elasticity. These changes can cause discomfort during sex and lead to avoidance of the act.
  • Declines in hormone levels during menopause can affect levels of sexual desire and arousal. A decreased libido may be a new reality for women as they enter perimenopause, potentially leading to a decrease in sexual pleasure, which will lower levels of desire for sexual activity.
  • Mood swings, increased anxiety, and shifts in self-esteem that come with hormonal changes combined with the physical transformations associated with aging can reduce sexual confidence and satisfaction.

Q4. What does low estrogen levels that come with menopause mean for your heart?

Estrogen has many impacts on the whole body, and is not just involved in controlling a woman’s fertility cycles when she was in her breeding years. Its direct relevance on heart health come from its action in keeping blood vessels like arteries more flexible. A basic cause of heart problems such as hardening of the arteries can set in once estrogen levels start to decline, and this can increase the risk of heart attack. As well, dangers of a sharp rise in blood pressure are almost doubled. High blood pressure damages the smooth inner linings of artery walls. In the long run, stiffer blood vessels make it more likely that you could suffer a stroke due to a blockage.

More direct damage to the arteries can come from any changes in sleep cycle. While troubled sleep can come to anyone as a consequence of aging, for menopausal women there are other disturbances like night sweats, restless legs and mood swings as well. Poor sleeping patterns affect the heart’s rest periods and this can result in hardened cholesterol plaque, which raises risks of heart disease.

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