"However, you experience menopause, it’s so important to remember you’re not alone." In the the final episode of season one, Dr Mary Jane Minkin shares some of her story highlights.
"However, you experience menopause, it’s so important to remember you’re not alone." In the the final episode of season one, Dr Mary Jane Minkin shares some of her story highlights.
menopause: unmuted is designed to raise awareness, encourage communication, and share information. It is not designed to provide medical advice or promote or recommend any treatment option.
Links
menopause: unmuted
E6: Sharing Stories
It's time to unmute menopause.
Welcome to menopause: unmuted, a new podcast series sponsored by Pfizer.
Menopause is a major life transition accompanied by a multitude of symptoms, health and relationship considerations that women, unfortunately, don't talk about enough–and we want to change that.
Women from across the US have been coming together to share their menopause stories.
“What really got me is when the hot flashes got to the point when you’re standing in front of a customer and all of a sudden you start to drip sweat, and nobody says anything.”
“For me, it's more of a marker of stepping into the next phase. It's more of a philosophical place where my energy is going and not so much coping with physical changes.”
“It was being set free from buying all the sanitary towels all those years, and without having the pain of a period. Absolutely worth it. Absolutely worth it.”
I’m your host, Mary Jane Minkin. I’m an obstetrician gynecologist and Clinical Professor at Yale University School of Medicine. In our previous episodes, we’ve been listening to Rachel, Charlene, Kathie, Rebecca and Susan tell the stories of their own menopause.
And for the final episode in the season, I want to take you through some of the highlights from their stories. We'll cover some of the physical symptoms, but I'd like to start with Susan, who I think really captures the reason we’re making menopause unmuted.
“So, I think society wise, it's very, very difficult, because you don't really know who to talk to, and most people don't really want to talk about it, even in talking with some people about, ‘hey, I think I'm going to do this podcast. It sounds like a great opportunity’ they’d be, ‘why do you want to do that? Why do you want to expose yourself,’ and I'm thinking expose myself to what? And at that, that is, I think the barrier, the barrier has to do with kind of, ignorance.”
Susan pretty much sums it up, it all comes down to communication, and that’s the focus of this episode. So, if you’re a menopausal woman, I hope you’ll be inspired to communicate with confidence, to your family, friends and health care professionals.
And if you’re close to a woman going through menopause, I hope this episode will give you a deeper understanding of what she might be going through, so that you can help to keep the lines of communication open.
So, let’s unmute menopause.
Hot flashes are probably the best-known menopause symptom–and they can be really disruptive to a woman’s day to day life not to mention the impact on sleep.
In episode 3, we heard how Charlene’s hot flashes caused her so much embarrassment at work that she began avoiding face to face meetings. There are quite a few things that a woman can do to ease the burden of hot flashes, here’s Kathie with a few tips.
“Eventually,I started realizing, oh, I need to ask other people, maybe they can give me ideas of what they do. I remember asking a co-worker and she told me, you know what she said what I do when I feel it coming on, I put my wrists under the water. And that seems to cool me down. So, I tried that and I don't know it, it seemed to work sometimes and then at other times, it didn't work, but it was still worth a try. And gosh, then I did ask somebody else and they said you know at all times, make sure you have a fan. And so, I bought certain fans whenever I would get somewhere and they have fans, I always have fans everywhere.”
“Then I started noticing that if I kept still and just kept still and quiet and let it come, and then it would go away, I would feel better. So, once I did that, and as soon as it started coming on, I just stayed calm.Then it would come on, and then it would leave.”
“Then the next thing that helped me personally was somebody telling me that when they would ease up on their sugar, instead of eating a lot of sweets and sugar, they felt much better. So I said, okay, there's no harm. Let me scale back on the sugar. And that seemed to help me, not saying that they went away, but they became better and less intense. But I must say that the time, the night sweats went away for me totally. And I haven't had them since was me, really making sure that I work out at least three to four times a week; walking, nothing vigorous, but absolutely put in time in workout. When I do that, I don't get them at all. And the moment I stop, if I stop for a week, and I haven't done any workout, they come on strong. So for me, it's my inspiration to really work out so that works for me.”
I can’t over emphasize the benefit of exercise–at whatever level of intensity works for you. Strength training is particularly good because it helps build muscle mass, which will boost your metabolism. This helps you burn fat which in turn will keep your body cooler.
But, one of the challenges of hot flashes (like many other symptoms of menopause) is communicating just how intrusive they can be. Susan shared a really fantastic strategy that worked for her.
“After the hot flashes, and then you're not sleeping and then your body starts changing. A great example is my husband at one point was like, ‘do you have to always have these hot flashes?’ And I'm like, I have absolutely no control over hot flashes. So, I ended up giving him a commentary for a day. So, every time that I had a hot flash, I would say, I'm having one. I'm having one. By about mid-afternoon he finally said, okay, I get it, you're having them a lot. And I think that was something that if I hadn't have actually told him initially, and done that commentary with him, it would have been something again, that I would have just taken on that, you know, I'm the only one that's having to go through this and I'm going to fight it on my own.”
It's hardly surprising that with the discomfort of hot flashes and broken sleep, mood changes are another difficult symptom for many women, and the people close to them. I respected what Rachel had to say about this, that it’s important to acknowledge and validate how you’re feeling, because dismissing your emotions, only adds to feelings of stigma.
“I was working really hard on not minimizing or invalidating my concerns, and my disappointments and my complaints. You know, we, we do that to women a lot, you know, we say, ‘oh, she's on the rag’, ‘oh, you must be expecting your period’. You know, and we'll dismiss ourselves you know, ‘I'm sorry for being so emotional, I’m premenstrual’, we dismiss our minds and our emotions and our reactions and responses to the world based on our hormones, and I was trying not to do that. I wanted to figure out can I separate; you know how much is exacerbated because I know what I'm feeling is valid. And I don't want anyone to say, you know, you're acting like a crazy menopausal person, because then the rage would really take over and the badassery would really come out and I'd have to be really mean to someone.
“I don't remember the onset of the rage. I just remember being very angry a lot of the time when I was in the house, feeling unhappy a lot of the time when I was out of the house, and being very quick to be triggered to the rage.”
Anger and rage can be uncomfortable emotions to experience, especially when we know our loved ones are bearing the brunt, but suppressing yourself only uses up more energy and can lead to emotional burn out.
Finding ways to acknowledge these difficult feelings can help reduce their power.
I really loved this solution that Rebecca’s daughters came up with, it shows such empathy as well as being deeply practical.
“So early on, when I first exhibited the menopausal symptoms, I certainly had mood changes and mood swings. So, when I first started going through the mood changes, I didn't really know what was happening and certainly my, my two daughters did not know what was happening. So, they, they made me these little symbols, which I have in my hand, one’s a smiley face one’s a frown face. And the bottom bracket says mood with a colon, and so what they invited me gently, kindly and lovingly to do is when I was in a good mood to give them a little fair warning, and show the smiley face and when I was not in a good mood to just show the frowny face so that they could steer clear, and everybody would be happy and well adjusted. And I found, just like, with most things in life, if you bring the people who are closest to you in to what's happening, and you talk about it, and you communicate about it, it's so much easier, as opposed to trying to hide what's happening or be embarrassed about it. You know, it just ends up making it harder on everybody.”
One of the side benefits of this approach from Rebecca and her girls, was that it helped begin the conversation about all aspects of reproductive health, beyond the purely biological facts. It’s so helpful to get comfortable with that from an early age.
Another emotional symptom of menopause that can really come out of the blue is anxiety, and it can be a shock if you’ve not experienced it before. But there are ways to cope, here’s Charlene again.
“One of the other symptoms that I probably didn't really mention much was the, the anxiety that I would feel and knowing that I couldn't say anything, I would feel it was, was like knots in your stomach and, and I don't know your hands would sweat like the normal feelings of anxiety is like, I-don't-want-to-do-it-have-to-do-it-but-I don't-want-to-do-it. I don't. I don't want to go to work. I want to stay home, and I want to stay away from people because they don't understand, and I want to talk to someone. But they're not there. And sometimes I felt emotional. I felt as though I wanted to cry, and I didn't have really a reason to cry. Or, I thought I didn't have a reason to cry. But when I think back, I did have reasons to cry.
“Going through menopause quietly wasn't easy. What I realized that I had to do was I had to find answers to why I was feeling the way that I was feeling. And I did a lot of research cause you can Google anything these days, and I would, I would Google symptoms of menopause, menopause, I would Google, how to handle, how to how to walk through, through life with this, how to talk about it, what you can say to start a conversation. I did a lot of research on each of the symptoms that I was going through to get an answer. I had a better understanding when I did research. So, during my research, I learned that there are things that you can do to help you to manage your emotions. I read about meditation and sitting still and actually breathing, and that would help.
“What I did find for myself is that even though I was having all these physical changes, I also had the emotional kind of where I was having just crazy anxiety that was coming out of nowhere, at that point, then had some tools that I was able to utilize with, you know, deep breathing, I was using some yoga. The other thing that I did in the midst of all of this is, I also added in doing even more formal meditation and I'm glad that I actually started that earlier, much earlier than when I was in the crux, and the worst part.”
Both Susan and Charlene realized that there are ways to take control over things which can make you feel so out of control. And I want to encourage you to discuss all aspects of menopause with your health care provider, it doesn’t just have to be about physical symptoms.
You can speak about menopause with an OB/GYN, primary care provider, nurse practitioner or midwife. There are even specialized menopause practitioners who can provide more information.
This is menopause: unmuted where we’re listening to real women share their menopause stories. I’m your host Mary Jane Minkin and if you’d like to find out more visit menopauseunmuted.com
Not everyone will find it easy to start a positive menopause conversation with their health care provider straight off the bat. In episode 3, we heard how Charlene’s early menopause seemed to make her doctor uncomfortable. And in episode 2 Rachel really struggled to get effective advice to help her with her weight gain.
But remember that you are an active participant in that relationship, and you don’t have to put up with poor communication. Kathie sets a really great example about fostering good, long-term relationships.
“All my physicians have been the same physicians I've had for years. The reason I do that is because I want to cultivate a relationship with my physician, that, especially as I’m aging, that's one of the most important relationships I'm going to have, is with my physician. And so if I have a relationship with them where I'm able to be open to them, and then even find out more about who they are as a person as opposed to just a physician, that builds trust, once it builds trust, then you know, that physician has your best interest at heart. And then you are also able to be open. And so because I'm that way, I always insist that I get to know the physician first. Before they treat me before anything, I have to sit down with them, tell them who I am and I ask them who they are, on a personal level, as much as they willing, and able to tell me all about themselves. After I create that relationship, and then they built that trust, then you will find that, in fact, I insist on having appointments where the doctor has more time, whether it's early in the morning does the first patient or late the last patient, because I really want them to spend time with me. And that has worked out brilliantly for me really has. And I do love my physicians I really do.”
Changes to sexual function can be one of the most difficult topics to discuss with your doctor, but I want to reassure listeners that there are a lot of options available to women these days. Menopause does not have to mean the end of your sex life. And so much can be achieved through honest and open communication, Rachel really gets it right here:
“Well, I can imagine the kind of conversations I would have to have with someone new. In my mind, I'm very open and straightforward and brave, in order to say, here's what's going on with me at this time in my life, and if we become sexual, this is what I'm gonna need from you. I think the conversation would have to be very explicit. Some things that are easier to say like, intimacy is not the same as intercourse. So, a lot of physical intimacy, arousal can take longer. So, we may have to talk about more foreplay. I would need to make sure that any partner–I'm stealing this line from someone–but that any partner was not ‘illcliterate’, that they were aware of female genital geography. And I would have to be very open and clear about what I needed from myself and from the partner and that person would have to be very patient and responsive in the moment because sometimes that means stopping or changing or slowing down.
“I am describing a considerate lover but more importantly, I’m describing being a person who tells what will hopefully be a considerate lover, what she needs. You can have a considerate lover and never open your mouth and still not get your needs met. You know. So, it's more about that two-way street and I think that would have to be initiated by me, you know, I'm sure male sexuality changes with age as well. And women throughout their whole life, I think we should be talking to our partners much more throughout our whole life. But I think it's truly, truly vital after menopause, because things work vastly differently.”
That’s almost it for the first season of menopause: unmuted. I've been inspired and reassured by the honesty in the stories we’ve heard. Before we wrap up, I want to leave you with this final thought from Susan. Menopause can be a tough journey at times but talking can help to strengthen both you and those around you.
“The beauty for me was that I have, my sister is great. And so the laughter of being … we're very close in age. We were on the similar paths, and being able to talk to her and laugh about some of the things that we were going through and kind of just find humor in it, I think really helped to kind of ease the, the anxiety and the stress of it. I think that was very helpful. I will say it would have been nice to have more of a pack that you could go to where you didn't feel like it was only you know, a family or your very, very closest friends.
“And I think that's something that, that women, the more we talk about it, the more we come out and, you know, bond, come together and realize, hey, we're all in this together, then the more opportunities that we're gonna be able to break those barriers and break down those fences that have been placed before us, where we do feel like we're isolated or that we cannot talk or that we have a much harder time finding, quote, kind of that pack, our pack. You know, those people that we can bond together with.”
However, you experience menopause, it’s so important to remember you’re not alone. The stories we’ve heard in our first series of menopause: unmuted reflect so much of what I’ve heard from the thousands of women I’ve treated in over 40 years of practice. I want to say a huge thank you to Kathie, Rebecca, Susan, Rachel and Charlene for speaking with such inspiring honesty.
I’m Mary Jane Minkin, thanks for joining us today, check out our show notes at menopauseunmuted.com
Whatever your age, and whether it comes naturally or is brought about by surgery or medications remember that talking, research from reliable sources and good self-care can make menopause easier. It’s all about finding out what works for you – and your health care provider is there to help.
Special thanks to the Global Women's Health team at Pfizer and to Studio Health for producing this series.
Until I’m back with season 2, keep talking.
Disclaimer
This podcast is powered by Pfizer.