HEALTH AND LIFESTYLE

Health and Lifestyle FAMILY WELLNESS

Discovering Health After Menopause

by DR TAINA TURCASSO, ND RM

For most of us, the narrative has been that menopause, which marks the end of a woman’s reproductive years, is the beginning of the end of a lot of things. This may have been true some time in the past but the postmenopausal years make up quite a large portion of a woman’s life and those years can be filled with vibrant health, athleticism, and overall wellness. In reshaping this narrative for our generation and future generations, it’s important to lead by example and use the changes in the body that occur through menopause to promote a healthy and happy life, and not a steady decline.

First of all, what is menopause? Most of us have heard the word without really understanding what it is, what it means for our bodies, and why it happens in the first place. Menopause is defined as having gone 12 months without a period. The average age of menopause, in Canada, is 51.5 years but of course it can happen before or after that age. Most of what happens physiologically that we refer to as “menopause,” societally, is actually perimenopause, or the time before the moment of menopause. Perimenopause can stretch on for eight to 10 years before menopause, and for those who are still menstruating regularly, begins with a change or irregularity in your cycles. This doesn’t mean that your cycles will necessarily just get longer and longer until they disappear and it doesn’t mean that pregnancy is not possible. I have seen many women who had surprise pregnancies in the years leading up to menopause because they assumed that once their cycle becomes irregular, pregnancy is no longer possible but of course it is, just less likely. Menopause is driven by the decrease in hormones (estrogen and progesterone) produced by the ovaries which can begin in your late 30’s. As less of these hormones are produced, ovulation eventually stops and fertility declines. Most (if not all) of the symptoms associated with perimenopause or menopause are a result of declining levels of progesterone and estrogen and we are not only interested in managing symptoms from a comfort perspective (air conditioning, anyone?) but also in preparing for and mitigating the physical changes that may have an impact on your health. Most people are familiar with symptoms of menopause such as hot flashes but it is also common to experience vaginal dryness, sleep disturbances, difficulty concentrating, decreased sexuality and poor self-image. Menopause can also be associated with decreased bone density, increased cardiovascular risk, and joint pain.

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“...the postmenopausal years make up quite a large portion of a woman’s life and those years can be filled with vibrant health, athleticism, and overall wellness.”

Treatments for menopause can include lifestyle modifications, prescription medications, botanical (herbal) supplements, nutritional supplements or “nutraceuticals,” IV and injection therapies, acupuncture, physical treatments such as chiropractic and massage, and counselling. Historically, conventional treatments were limited to hormone replacement therapy, or HRT but now the treatment options, as well as the overall understanding of menopause, have vastly improved. While conventional HRT is appropriate for some people in menopause, there are risks associated with hormone-based treatment so the ideal is to tailor treatments to the patient.

A comprehensive approach will consider the history of the individual and assess their risk for reproductive cancers, cardiovascular disease, and osteopenia. If screening hasn’t been implemented, now is the time to set up a schedule. A treatment plan should be established that either replaces or promotes the diminishing hormones, supports symptoms as they come with one (or many) of the many modalities available, and emphasizes the role that lifestyle modifications play in decreasing risk of cancer, cardiovascular disease and osteoporosis. Supplementation (again, tailored to the individual) will at minimum play a role in promoting bone health. I think that one of the most important pieces is to check in every few months in the beginning to make adjustments and then a bit less frequently as things continue to change. Management of menopause is by no means “one-size fits all” and it will evolve as you move through the process.

While all of this is important, I am also interested in knowing what comes next for people going through menopause. What are their goals? What do they want to see happen for them physically? Emotionally? In many cultures, postmenopausal women are celebrated. This can be the beginning of a new, exciting part of life. If you see it coming, try to use it as an opportunity for growth, for change, and for health.

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Health and Lifestyle THIS IS LIFE

You Can Have Both

by TYLA CHARBONNEAU

I feel like I am living in a place of duality and I can go from having so much hope and then I instantly question why the world is the way it is, and despair creeps in. We currently live in a world where the pandemic is coming to an end (hopefully) and there is joy and hope for the future. Within this however there is also fear and worry about what this means for us. Summer is bringing the sunshine and the natural benefits of vitamin D and camaraderie. And yet people are still struggling, they may not be telling you they are but beneath those smiles sometimes can be pain. We have a lot of questions for the near future: What does ‘going back’ to the office or work look like? How will socializing go with others?

When we ponder this we often turn to black and white thinking. Most of us grew up thinking things are either good or bad, happy or sad. In fact, our brains actually like to think like this, we actually have to work hard to create a grey area and make up additional narratives to this or that. This thinking is problematic because I can be incredibly grateful for my life and feel sad or frustrated about events in it at the same time. The key word in this sentence is “and” and it can make a big difference in your life. Consider this, our parents did the best they good and may have also taught us some unhealthy behaviours and habits. We can make a mistake in life and still be a good person. The ability to embrace this simple word stops us from globalizing ourselves and the world around us. This is called dialectical thinking and it allows us to see the good and also to acknowledge the difficulties or the challenges we face. It supports the idea that we can consider multiple perspectives before finding reasoning in our thoughts. Marsha Linehan the creator of Dialectical Behavioural Therapy defines it as “a synthesis or integration of opposites.”

How can use this simple word to make a difference in our lives? Well if we return to the questions posed at the beginning of this article, we can consider that a return to the office might be a welcome change and it might feel overwhelming. That is okay. We might be excited to socialize with others and need to leave after an hour. That is also okay. The next time you find yourself being really hard on yourself when your inner critic wants you to only see the story in one light, take a breath and think of all the possibilities that might exist.

Sometimes it can be helpful to use your hand to come up with all the different perspectives of a situation.

You can for sure use one finger to play out the negative scenario your critic wants you to believe and you have to come up with other options as well. It is quite possible at the end that two possibilities may be right. You may have to own that you were unkind to someone and that does not mean you need to spend the rest of your day beating yourself up for being a terrible person. You can be unkind in moments and own your stuff and know there is a reason behind it. You can have both.

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“Most of us grew up thinking things are either good or bad, happy or sad. In fact, our brains actually like to think like this, we actually have to

work hard to create a The content provided in this article is for information purposes only. It is not meant as a substitute for grey area and make up professional medical or psychological advice, diagnosis, or additional narratives to treatment. If you find yourself in distress, please reach out to your local physician who can provide mental health this or that.” resources in your community.

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