What’s the Smart Way to Deal with Menopause? 

Trinitas psychologists Dr. Rodger Goddard and Patricia Neary-Ludmer discuss strategies for coping with the ‘change of life.’  

Goddard: The topic of menopause is often taboo in our society. It is not the subject of lively dinner conversations or casual talk. It is not something that people automatically flip to in a magazine (or program into your DVR). We are more likely to hear about menopause as the punchline in a joke on TV or in the movies—tossed out to explain a woman’s frustration, unusual actions or bizarre behavior. It is unusual to encounter a frank, positive discussion between health professionals on this issue. In our society, youth and beauty are valued, worshipped and cherished. Aging and the intricacies of body changes and emotional states as we age are often pushed aside and shunned. Women undergoing menopause often take on our society’s view that something negative and bad is happening to them. Menopause can be made worse when it is viewed through the lens and prism of the media and the taboo assigned to it.

Neary-Ludmer: Then there is the additional stress of day-today life. A menopausal woman may very likely be working full-time, managing growing children, caring for her home and helping with the needs of senior parents—all while dragging around bone tired in a brain fog. Also, many of the symptoms of menopause, such as anger, mood swings and lack of sexual desire, can impact the marriage and family. If so, supportive psycho-educational counseling can be very helpful. This is an important phase of life. If we believe what we see and hear in the media, it can turn into something shameful or humiliating.

Goddard: Although it is accompanied by many difficult and potentially painful physical and bodily discomforts, the time of menopause can be embraced as a time of introspection, discovery, growth and valuing of the mysteries of life. It can be a time of bringing together the wisdom of a woman’s life and sharing that wisdom with others. It can be a time of creativity and connection to what is sacred and meaningful in life. The physical discomforts and pain of menopause can be dealt with and overcome. It is said that women are better at dealing with pain and discomfort than men. Menopause necessitates a woman coping not only with physical discomforts and pain, but also with the negative thoughts and emotions that our society assigns to it. Understanding menopause and finding positive, productive and creative ways to deal with it can make an incredible difference in a woman’s second half of life. Just as George Bernard Shaw said that “youth is wasted on the young,” it can also be said that aging is wasted on those who are unable to appreciate its special, new and sacred ways of experiencing life. One problem encountered by many women going through menopause is the tension that can occur between husband and wife. A husband may be insensitive, fearful of, or not able to understand menopause. Wives may feel inadequate, uncared for and less lovable. Communication and sensitivity are essential during this time.

Neary-Ludmer: Although the average age for menopause is 52, each woman has her own unique journey with this stage of her life. Each woman’s hormonal profile can differ in terms of estrogen, progesterone, and testosterone. Early menopause can be brought on, at any age, by medical conditions such as cancer treatments or hysterectomy. About 25 percent of women begin menopause this way. Scientists have also found that if there is a family history of early menopause, the woman is 60 percent more likely to enter menopause early. Strictly speaking, menopause means no menstruation for at least 12 months. Symptoms include sweats, hot spells, hot flashes, fatigue, mood swings, craving sweetness and carbohydrates, difficulty sleeping, joint pain, concentration and memory difficulties, thinning hair, increased facial hair and dry skin and eyes. It is important to understand that women may also experience perimenopausal symptoms. Perimenopause refers to the time period where menstruation is still taking place but the female hormone levels are beginning to shift. Symptoms can be subtle to severe. Perimenopause can last months…or as long as a decade.

Goddard: It is important to be on the lookout for menopause problems that may be excessive and beyond what is expected. Women should not hesitate to see a doctor on a regular basis during menopause. Keep in mind the frequency, duration and intensity test: If your symptoms seem to occur more frequently, last with greater duration or have much greater intensity than what you would expect, see a doctor. Menopause brings with it many confusing and difficult decisions concerning whether to use Hormone Replacement Therapy and/or other special medication, herbal, supplement or dietary remedies. For example, Dr. Andrew Weil, a pioneer in integrative medicine, suggests that menopausal women should increase their intake of omega-3 fats, as they help to lessen the hot flashes and depression that may occur with menopause. The key is to be diligent, stay in control, investigate and determine what is right for you based on sound research. When is comes to any health issue or medical problem, the more information we have, the easier it is to make a decision. In fact, research shows that, in general, the more active a stance we take and the more we exert conscious decision-making and control over a medical issue, the more positive the outcome.

Neary-Ludmer: The most important active step you can take during menopause is to find a trusted doctor to perform a thorough medical evaluation and guide you through this time. In addition to Hormone Replacement Therapy, there are several options to consider. They range from low-dose birth control pills to help with mood swings to getting into a regular yoga or exercise routine to adjusting your diet and sleep patterns. Beyond the physical, of course, are the emotional issues.

Goddard: Think body mind-heart-soul. Taking care of our bodies involves eating health foods and controlling our stress levels. Menopause often necessitates a change in diet and renewed efforts to control our stress. Menopause can bring with it tension and anxiety. It is good to strengthen our ability to reduce tension, anxiety and stress. This can be done by learning how to calm ourselves throughout the day, doing a daily yoga routine and using deep mindful breathing throughout the day to calm ourselves down. Regular exercise has also been found to help decrease the negative effects of menopause. Taking care of the mind involves identifying and solving problems, as well as clarifying what is most important to us and taking the actions necessary to achieve those most cherished goals. It also involves using productive and tough thinking to fight against our negative emotions and thoughts. Taking care of the heart involves getting support from others and dealing with our emotions in productive ways. Women should find ways to have open discussions with husbands, boyfriends or partners during this time period. Taking care of the soul involves nurturing ourselves and treating ourselves with extra care. Being creative, pursuing your passions, communing with nature, taking time to meditate and connecting with the beautiful and sacred things in your life is important.

Neary-Ludmer: At the same time, it’s also important not to minimize or underplay the impact of menopause. This can be a 10-year process, and a chapter of a woman’s life that is often accompanied by insults to her self-image, feelings of increased vulnerability and insecurity. Women need support and encouragement to negotiate the body changes and emotional ups and downs. Lastly, they need to be reminded that post-menopause can be an exciting chapter of their lives. They will feel renewed and empowered.

Editor’s Note: Dr. Rodger Goddard is Chief Psychologist at Trinitas and Director of the hospital’s wellness program which provides companies, agencies and schools with onsite programs to improve health and productivity. Dr. Patricia Neary-Ludmer manages the Family Resource Center in Cranford, which is affiliated with Trinitas’s Department of Behavioral Health and Psychiatry.