Menopause
Sep 12, 2024
Dr. Ashley Rawlins, PT, DPT
4 min
If you aren’t already in menopause, here’s what typically happens: Picture yourself in the midst of your frantically busy, 40-something life. You’re rifling through the contents at the bottom of your bag, when you suddenly realize that you haven’t used a tampon in months. After calculating if there's any way you could be pregnant (nope), it dawns on you that oooh... this could be the start of menopause.
The first emotion you’re likely to feel is an overwhelming sense of dread. Because the one thing — maybe the only thing — that everyone knows about menopause is that it’s awful. Really, really awful.
But, is it?
A recent article in the British Medical Journal entitled "Normalising Menopause" called this longstanding assumption into question. Are we sure that menopause is nothing but suffering? According to the authors, "a systematic review of standardized menopause questionnaires found only questions asking about negative symptoms and experiences... there was no opportunity for women to report positive experiences of menopause."
Medical surveys don’t ask how good it feels to experience life without a period.
Medical surveys don’t ask how good it feels to experience life without a period, to fearlessly wear white pants and sleep on hotel sheets any day of the month, to save money on menstrual cups and Thinx, to not worry that you could get pregnant in a country where bodily autonomy is not afforded to all people.
The research that does exist shows that, for many individuals, menopause is not awful at all: Symptoms can vary widely from one person to another, and some lucky folks have no symptoms at all.
Most encouragingly — and contrary to what many doctors will tell you — you don't have to "just deal" with the "natural" discomfort that comes with fluctuating hormone levels. Effective treatments are available to help you feel good in your skin, at every stage of menopause.
The upshot: If you're looking for some positive news about menopause, you've come to the right place.
While studies show that 80% of women experience symptoms that affect their mental and physical well-being during the time surrounding menopause, only 20% of those women have severe symptoms— the other 60% experience mild symptoms.
For those who do have noticeable symptoms, there are conflicting reports about how long those symptoms last — some studies claim the average duration for vasomotor symptoms (VMS) like hot flashes and night sweats can last for 10 years with a peak just around your final period. But others show symptoms that last an average of two years, starting at around age 51.
The most common symptoms associated with menopause include hot flashes, vaginal dryness, sleep problems, mood changes, weight gain, and hair loss. However, most of these symptoms overlap with general signs of aging, not to mention the impact of chronic stress and lack of sleep. That means it can be tricky — or sometimes impossible — to pin a specific symptom on menopause.
The more we perceive menopause as the root cause of our symptoms, the more we dread it.
It's a shame that menopause catches so much of the blame, because the more we perceive menopause as the root cause of our symptoms, the more we dread it. Studies report that women who did not think of menopause as a medical condition were more satisfied with this phase of their lives, whereas the 20-40% of women who linked menopause to serious, debilitating symptoms either worried about it or dreaded it.
Which begs the question: If we were better educated about the positive side effects of menopause, what would change?
One of the most common misconceptions about menopause, according to Dr. Suzanne Gilberg-Lenz, author of Menopause Bootcamp, is “that it’s the end — when it’s actually a beginning,” she says. “Take sexual health — there are so many ways to enjoy intimacy and sex as we age, when we no longer have to worry about pregnancy. Things like pelvic floor physical therapy; clear communication about desires, needs, and wants; appropriate vaginal hormone use; the right lubes, and even cannabis-based products can assist in staying happily sexually active.”
If you have symptoms, whether mild or severe, these are just a few of the treatments available to help you:
When estrogen levels fluctuate, prescription medication and natural supplements can help relieve symptoms of menopause. Unfortunately, not all doctors know when or how to prescribe them. If you have trouble finding a doctors who has experience treating menopause, consider looking online. Companies like Alloy and Evernow connect patients with specially trained MDs.
According to Dr. Suzanne Gilberg-Lenz, integrative medicine and lifestyle changes can work wonders for improving menopause symptoms. In addition to focusing on sleep, “fitness – especially resistance and weight training and mobility and flexibility work,” and “well-researched and vetted botanicals can help with everything from stress, sleep, sexual health, hot flashes, brain fog, nutrition, and gut health— nothing is one sized fits all,” she explains. “In general, if we listen to our body's signals (such as hot flashes or mood shifts), we can take the opportunity to pay attention, refocus on self-care and boundary setting, and practice true self-love.”
Integrative healthcare providers like Gilberg-Lenz are few and far between. If there are none in your area, consider checking out sites like Gennev and Midi where you can work with OBGYNs, registered nurses, and other providers on a holistic plan that may include sleep, nutrition, fitness, and/or medication.
“Many systems of your body are affected by the estrogen changes of menopause, including your genitals and urinary tract,” says Dr. Ashley Rawlins, PT, DPT at Origin. “Low estrogen in the vulva and vagina can cause these tissues to become dryer, thinner, and less flexible, leading to an increased risk of developing pain with sex (penetrative or non-penetrative).”
“Those with vaginal pain during sex may need to work on blood flow and flexibility of the pelvic floor tissues, while those with urinary incontinence may need to focus more on strengthening and coordination,” explains Rawlins. An individualized pelvic floor exercise plan including vaginal dilators, yoga stretches, breathing exercises, core strengthening, walking, and kegels can help improve blood flow, flexibility, strength, and any pelvic floor dysfunction.
Some amazing women have channeled their own learnings into entrepreneurial ventures in order to help people with menopause. A few examples:
At Origin, we agree with Netflix’s Sex Education star Gillian Anderson when she told People, “Perimenopause and menopause should be treated as the rites of passage that they are — if not celebrated, then at least accepted and acknowledged and honored.” And with a world of positive information about menopause still to be revealed, we're guessing that celebration will soon be in order.