As a nurse, I belong to a continuing education / latest research site called Medscape. It’s nothing short of wonderful. When I think of the sheer poundage of my professional magazines that I subscribed to in the past, it boggles the mind. (And stimulates my guilt reflex when pondering how many trees gave their lives so that I might give better nursing care.)

Now with a couple of keystrokes, I can stuff my few remaining brain cells with the latest nursing and medical knowledge. Amazing. I love love love the internet. But I digress – which happens to me a lot since The Big M.

I’d like to share a few of the latest research findings regarding menopausal women.

Hot Flashes Sufferers Live Longer?
I received a tweet the other day that stated “research shows women that have a large number of hot flashes live longer.” I went to the actual study and found that in truth, it was women that reported night sweats in addition to their hot flashes. They had a 30% lower mortality rate from heart disease than women who didn’t suffer from nocturnal overheating, irrespective of risk factors or HRT (hormone replacement therapy) usage.

Wow. I believe that I will likely live to 210 years of age if this is true. Thank God for wicking sleepwear. (Stay tuned for the debut of our Menopause Marketplace to find great wicking sleepwear vendors.)

Does Depression Affect Menopausal Symptoms?
This study found that women suffering depression reported more menopause symptoms. Conversely, the authors were surprised to find that menopause also seemed to lead to more depression. The first thing I have to say about these results is “Well , DUH!”

The second is that this sounds a little like “Which came first, the chicken or the egg?” Which we could debate forever, but why would we want to?

Most important were the conclusions of the study – that identification and treatment of depression might help with symptoms of menopause as well.

True enough, but at what cost? We are already seeing a number of articles promoting antidepressants to treat menopause, which really is like trying to shoot a fly with an elephant gun. While I am the first to say that menopause symptoms suck, I also believe in the remedy with the least side effects that helps.

I strongly believe in antidepressant drugs when necessary. When depression causes significant disruption of daily life activities or relationships or suicidal thoughts, then pharmaceutical treatment along with professional therapy can be life saving.

But we need to assess a matter of degree with depression. Some mild depression, e.g. feeling sad and blue, weepy, not motivated during menopause affected all of the Goddesses to some degree. When we shared it with one another, it lessened greatly. It was wonderful to find out that it was normal and it was likely temporary.

Two of our goddesses have suffered from depression pre-menopause and have taken antidepressant therapy successfully. The rest of us just felt crappy for awhile.

Risk for Major Depression Increases During and After Menopause

Basically this study found that the risk of major depression doubles during perimenopause and menopause when compared with premenopause. That sounds about right. To put that in perspective, if two of your twenty friends suffered a major depressive episode before any of you went into menopause, then it might be likely that 4 of your friends would suffer a major depressive episode. Leaving 16 feeling blue and “normally” depressed.

I couldn’t find out how the researchers defined major depressive episode. One of the researchers did make this statement, which was billed in the Medscape article as the take-home message for clinicians. “When women come in and are thinking that they have some extra difficulties with life and feel down and blue…take it seriously. It is not just a passing thing.”

Okay, that worries me. Because it describes nearly every menopausal woman I’ve known at some point in her journey. I personally felt down and blue, and was dragging my weary arse through the days during the worst of the Big M. I was also hot, cranky, and sleep deprived which likely made it worse. But it WAS just a passing thing. It was normal. The best treatment I experienced (besides sleep and cooling measures) was support and commiseration from my Menopause Goddess sisters.

While I’m delighted that we are doing some research on The Big M, I have to wonder why we aren’t looking into bioidentical hormones, herbal therapies, and the effects of support groups. Could it be because there is no funding for these types of research?

So ladies, remember the one Latin legal phrase I learned in nursing school “caveat emptor”. Let the buyer beware. You are the buyer of your own health care. Pick and choose. Ask questions – lots of them. Ask about side effects and risk-benefit analysis. And not to be a conspiracy theorist, but ask yourself who might have funded a given research study? Who stood to gain?

Lastly, make sure that you are followed by a physician or nurse practitioner, not led. Most health care professionals I know actually appreciate a patient who is actively involved in her own care. And if they don’t? I’d shop around for a new health care professional/partner.

My good friend and sister Menopause Goddess, Saskia, sent me this wonderful email that is currently circulating the web. It’s a must-read and worth reading again if you have seen it.

“Recently, in a large city in France, a poster featuring a young, thin and tan woman appeared in the window of a gym. 

It said, “This summer, do you want to be a mermaid or a whale?”

A middle-aged woman, whose physical characteristics did not match those of the woman on the poster, responded publicly to the question posed by the gym.

 To Whom It May Concern,

Whales are always surrounded by friends (dolphins, sea lions, curious humans. They have an active sex life, get pregnant and have adorable baby whales. They have a wonderful time with dolphins stuffing themselves with shrimp. They play and swim in the seas, seeing wonderful places like Patagonia, the Bering Sea and the coral reefs of Polynesia. Whales are wonderful singers and have even recorded CDs. They are incredible creatures and virtually have no predators other than humans. They are loved, protected and admired by almost everyone in the world.

Mermaids don’t exist. If they did exist, they would be lining up outside the offices of Argentinean psychoanalysts due to identity crisis. Fish or human? They don’t have a sex life because they kill men who get close to them, not to mention how could they have sex? Just look at them … where is IT? Therefore, they don’t have kids either. Not to mention, who wants to get close to a girl who smells like a fish store?
The choice is perfectly clear to me: I want to be a whale.

P.S. We are in an age when media puts into our heads the idea that only skinny people are beautiful, but I prefer to enjoy an ice cream with my kids, a good dinner with a man who makes me shiver, and a piece of chocolate with my friends. 

With time, we gain weight  because we accumulate so much information and wisdom in our heads that when there is no more room, it distributes out to the rest of our bodies. So we aren’t heavy, we are enormously cultured, educated and happy. Beginning today, when I look at my butt in the mirror I will think, ¨Good grief, look how smart I am!”

Let me just say for the record, I’m proud to be a whale. Lady Leviathan – that’s my new self image and I’m feelin’ good about it! Now if I could just learn to sing…

I feel like I’ve inadvertently applied for citizenship in a new country – the Procrasti-Nation. Oh, I’m still keeping my US passport and all the freedoms we enjoy. But since the Pause, it seems I’ve adopted a whole new cosmology. Why do today what you can put off ’til tomorrow? Or forever? Why not do something frivolous or fun instead of my chores or commitments?

Our national anthem here in Procrasti-Nation might be “Feelin’ Groovy”. Or “Don’t Worry, Be Happy.” Instead of the lofty Latin “e pluribus unum”, our motto could be “I’ll Do It Later.”

Our national pastime: cloud watching. Far more entertaining than baseball, I think, and you don’t have to keep track of stats or wear jerseys.

So here I sit, writing my weekly blog entry at the last possible moment. I was going to write more about the Goddesses’ caregiving insights at our annual gathering, but I just couldn’t marshall my thoughts. The topic is so important that I’ll have to do it later.

That’s what happens when you live part-time in Procrasti-Nation. The important stuff waits while you do something less pressing, maybe even downright trivial. Like untangling your ‘ball’ of necklaces or reading your Facebook news.

Although I don’t “accomplish” as much when residing in this new place, I have to say that I’m a big fan of procrastinating. I spend more time petting the cats and dog. I’m more present to my friends when they drop by. And I’ve found a lot of stuff takes care of itself if you just leave it alone.

I’ve also fallen into some fun new projects because I was avoiding those items on the top of my prioritized to do list. Case in point: I was at a women’s writer’s retreat with Venus Karen Leland and a host of other wonderful, creative goddesses last summer. We were writing, reading, and critiquing one another.

One day, when we were supposed to be working on our various projects, I found myself taking a yet another unplanned vacation to Procrasti-Nation. One of my passions (passionettes, actually) is digital photography. Since all of us were engaged in the big living room with our laptops, I had to look busy. On the spot, I created a photo blog that I named “The Digital Diva”.

Weirdly enough, it took off. Enough so that my husband, Dewitt, asked if we could do another blog like it to just showcase our iPhone art. So Digital Diva / Digital Dude was born. We’ve taught classes and just written an article about creative iPhone apps and photo art for Outdoor Photographer magazine (it’s due out in a few months.)

Most of the time I spend in Procrasti-Nation does not lead to new blogs or much of anything save untangled silver chains. Like they say on the weight loss commercials, actual results may vary. Still, it feels like a gift that menopause has given me: an actual pause in my busyness and frenetic doing. And that’s why I’ve decided to emigrate there. Every now and then.

Yesterday, our new rescue dog chewed through the irrigation hose. One of our cats has a mouth infection requiring antibiotics and special food prep, while the other feline family member was screaming at the top of his lungs for no apparent reason. To add to the general household bedlam, the phone was ringing off the hook, the dock informed us that our new-old car shipped from the mainland needed to be picked up, and Dewitt got the news that his knee injury is a torn medial meniscus, which will require surgical repair.

All this was a recipe for menopausal meltdown. My usual equanimity just flat out deserted me. I collapsed in on myself with the gravitational pull of a black hole.

“Are you okay?” asked my hubby, Dewitt. Instead of answering with the usual “Fine,” or “I’ll get over it,” I shared (read spewed forth) my feelings of overwhelm. He listened sympathetically (BTW,a GREAT thing to do for your goddess, men). “Well, just remember, you don’t have to do it all or do it alone. We’re a team here.” was his sage response.

The weird thing is that I immediately felt better. The black hole continued to shrink throughout the day and was completely dissolved in my evening medicinal red wine. I forget that I don’t have to carry all the weight of my feelings of overwhelm, sadness, or general freakout alone. I don’t have to “protect” my husband, even when he is injured or not doing so well himself.

Here’s the thing: misery may love company, but when said company is allied against it, it slinks off to bother someone else. I’ve usually been good at sharing my flip-out times with my girlfriends, but have rarely shared them with family. What’s that about? Being strong? Suffering in silence? Creating calm even when I don’t feel it inside? Because??????????????

Okay, I never make New Year’s resolutions, but I’ll make an exception. I’ll share my feelings with my mate from now on as well as my girlfriends. Supermom doesn’t live at this house anymore. A Menopause Goddess does. And some days, it’ll be a little more Menopause and a little less Goddess. But it will be real. And it will be shared.

My husband injured his knee over New Year’s and has literally been unable to walk. Which means that I now have to do his chores as well as my own, while waiting on him. Sort of caregiving lite, you might say.

Initially, Dewitt was certain that he’d need an MRI and surgery as it wasn’t getting better. Then his brother mentioned that he’d had similar injuries and was on crutches for a time but it eventually healed on its own.

“Oh yeah,” I said. “That could be true. Remember when I sprained my ankle so badly and was on crutches for a few weeks, then hobbling for a while after, but it healed on its own, too.”
“No,”he said. “I don’t remember that at all.”

I stared at him, astonished. How could he not recollect an event that is lodged so firmly in my memory. After all, I was unable to walk for a good, long while.

And then I realized why he had zero recall. This wasn’t a case of elder forgetfulness nor memory lapse. He didn’t remember the event because his life didn’t change. At all. Except for a small detour to the Urgent Care Center, nothing changed for him. I still made dinner, did the shopping, even went to my job as a nurse educator, slowly executing the stairs with my crutches. Luckily I had injured my left leg, so I could still drive.

Why? Why do we women carry on as if nothing has happened when we are ill or afflicted with an injury? All those meals fixed, laundry and errands done, and work done while incubating a fever of 101+, horrific cramps, the stomach flu leads to one question? Are we freaking nuts!?! Or do we have a heretofore undiscovered martyr gene embedded in our feminine DNA?

We goddesses are well equipped for caretaking and ill equipped for the necessary job of caring for ourselves. And at this stage of life, we are looking at some long term caretaking events in our near future (if we haven’t already immersed ourselves in them.)

How will we cope? With caring for aging parents, with unforeseen injury and illness to our significant others? What balancing acts might we find ourselves performing?

Caregiving turned out to be the uber topic this year at our annual Venus gathering. Ironically, two of our very own Menopause Goddesses were unable to make the meeting at the last minute due to caretaking emergencies. Perhaps we should have talked about it last year!

Many hours of discussion and sharing later, we uncovered the main secret to artful caregiving (where you care for yourself as well as those who are in need of your care). It is this: Ask for help. This will save your bacon. Over and over again. And likely the bacon of the one(s) under your care.

People want to help. And we need to let them. We need to ask for their assistance and then accept it with gratitude and grace.
Even those under our care can help, in ways we hadn’t considered. We can ask them too. Everybody gives. Everybody receives. Everybody cares.

We still don’t know the prognosis for Dewitt’s knee. We have to fly to Honolulu on Friday to see a specialist and maybe he’ll have to have that MRI. We’ll know more then.

In the meantime, this evening I called out “Hey gimpy boy, get in here and do these dishes. You only have to stand for that.”
“Be happy to, you only have to ask me,” he grinned as he hobbled the few steps to the kitchen.

New Year’s resolutions. They can be a setup for judgment, stress, and failure. While the “clean slate” of January 1 can certainly inspire us to set goals and intentions, it can also overburden us with expectation.

Before embarking on a future view for 2010, take some time to review and jot down what you accomplished in 2009. Accomplishments need not be lists of tasks completed, milestones reached, or jobs finished. (Although certainly those qualify.)

Achievements might be just as easily be shifts in attitude, changes in self knowledge, feelings of connection, or new worldviews All too often we don’t take the time to savor or appreciate what we have done, seen, or felt over the past 365 days. We don’t allow for the “Ta Da” before we rush on to the next “To Do”.

So for the next few days, Menopause Goddesses, let’s compile a list of all we have done and experienced during 2009. In this eye-of-the-storm lull between Christmas frenzy and New Year’s celebrating, let’s ruminate on the past. Give yourself a great, glorious pat on the back for all that you have done and been this year.

We can work on our walloping To Do list later. For now, shout “Ta Da” out loud and celebrate all you’ve accomplished for the last twelve months.

The sun is shining brightly and we are ready for Christmas. I’ve taken my own advice and am relaxing, enjoying the season. Tonight we will go down to Teri’s store, Kalele Bookstore and Divine Expressions to hear the kupuna (Hawaiian elders) sing Christmas carols. You might remember Teri from the blog entry spotlighting her last year: “Daring To Dance: A Menopause Goddess Lives Her Dream”.

I’ve jettisoned the Christmas cards in favor of a photo collage that can be emailed. (And I am not completely sure that I’ll get that done. Nor am I worried about it. February 14 is soon enough for an update.)

I’ve decorated the house with those stuffed Santa, angel, and moosie dolls and hung some stockings.  It took all of about 15 minutes. (See photo with our cat Frankie snuggled up with the Christmas finery.)

I’m not baking Christmas cookies. I may not eat any holiday sweets unless someone makes me eat them. (And of course, my Menopause Goddess friends know enough to twist my arm and then forcefeed me. Thank you all in advance.)

I did manage to decorate a tree this year, possibly the world’s tiniest tree. No lights to untangle, no tinsel, and it can be used again next year. It looks so nice on my computer keyboard. Very festive. (see photo.)

The point of all this holiday non-doing is that an outing to hear Christmas carols at Teri’s store is not a burden or an obligation that I have to squeeze in among all my other commitments and holiday prep. It’s a pure joy. My calendar is gloriously unstuffed. No menopausal meltdowns or mania have visited me this season.
I have time to appreciate the year’s end, family, cats, friends, and fun. Mele Kalikimaka, as we say here in Hawai`i, to all goddesses and their families.

Menopause and Christmas can combine to produce exponential amounts of stress. In our constant desire for peace, harmony, and joy, Theresa-Venus and I have a few ideas for more ease and less pressure this holiday season.

1.  Give the best Christmas gift ever to your girlfriends:  no gift. Theresa-Venus and I did this last year and liked it so much we are doing it again. Let’s face it. Most of us at this stage of life feel that we already have too much stuff. The pressure to buy the perfect gift, then wrap it and deliver it is more than we need and can precipitate menopause meltdown.

2.  Jettison the Christmas card or letter.  Most of us are deluged by either chatty, newsy (read long) holiday letters or a lovely card containing nothing but a signature. Some cards have only a printed signature, which may have you wondering “What’s the point?” If you wish to send a yearly update to friends and family, wait until February 14. Frankly, most of us will appreciate it so much more and it won’t get lost in the flood of holiday greetings.

3. Do not bake cookies. With our metabolic rate slowing down and the sedentary days of winter just beginning, we don’t need the sweets or the guilt that comes with eating them. Buy those packages of little carrots shaped like tubes for snacks. Mmmmmm yummy. If you must eat cookies, know that someone else will be giving you some anyway. Do not bake any. And definitely NO cookie exchanges!

4.  Do not wrap gifts. Purchase Christmas gift bags or boxes from your favorite big box or warehouse store. Place each gift in a bag and voila, all the gifts will be wrapped. You will have reclaimed several hours and taken nearly all the stress out of gifting.

5.  Decorate sparingly. Try getting a smaller tree and let the grandkids decorate it. No grandkids yet?  Consider no tree unless you feel that it isn’t Christmas without it.

Put less (or no) lights outside. Strategically placed Santa, Reindeer, and Angel cloth dolls can make your home festive with very little work or time expenditure. You can find these at your local craft fair, drugstore or even grocery store.

Unless you are preparing for a shoot for Architectural Digest or House Beautiful, a frenzy of decorating just isn’t worth it.

6.  Have a Christmas potluck. Don’t spend all day cooking as if you were creating a second Thanksgiving. Go for a walk, have a snowball fight,  play with the kids instead. Read a book aloud as a family or sing carols together.

Your friends and family will not miss any of the usual Christmas trappings and if they do? They’ll soon find that they enjoy being in the company of a relaxed, pleasant, unstressed you much more than all gifts, cookies, and decorations in which you can bury yourself.

There’s a saying most of us have heard. “This moment is a gift, that’s why they call it the present.” Sure, it’s a little corny, but it really is true. Happy holidays.

Lately, I’ve been getting as much mail from men whose mates, moms, and menopausal female pals are looking like a puzzle they just can’t figure out. So for them, I’m offering a few small tips for dealing with us while we are going through the Change.

#1 Choose Your Words Carefully
While you are tippytoeing on those eggshells, here are a few phrases that will get you on your way with the least amount of breakage:

“I love you.”
“I’m sorry.”
“Have you lost weight?”

I’m forever grateful to Shellie Rushing Tomlinson of All Things Southern for sharing these gems. Check out her video on Hot Flashes and Mood Swings in the August 3 blog post of this year “Gotta Love Those Southern Menopause Goddesses” to further understand why you can’t say these three phrases too much.

My own hubby, Dewitt, often sounds like a well-trained parrot as he trots these out over and over. Do I mind his constant repetition? No I don’t. It doesn’t matter how or why he is saying it, just that he is. It’s a way for him to express to me that he knows I’m having a menopause moment. Or year. Or two.

#2 Don’t help. Listen.
We know that it is a man’s nature to want to help in situations where damsels are indeed in distress. However, I can assure you that unless you can magically change our very DNA or make it rain female hormones on command, there is nearly nothing you can do to help. Except listen. Without speaking. And maybe handing us a cool damp cloth for our fiery forehead when we start to sweat like pigs.

#3 Surprise us with housework

I came home today from lunch out with two of the Venuses. I looked at the kitchen sink where I’d left the stack of dirty dishes only to find them washed and air-drying in the drainer.

This is guaranteed to get us right in the heart. And sometimes even in other sensitive places, where our libido has hung a sign reading “On Vacation, Indefinitely.” Yep, porn for women is men doing chores without asking what needs to be done (that is a key part – if we have to tell you what to do, the surprise factor is pretty much lost. As are points.)

The other night, Dewitt jumped up and dried dishes that I was washing, after throwing in the laundry. I gotta tell you, he never looked sexier to me. Hmmmmmmm, housework as aphrodisiac.

#4 Preemptive mood strikes

Along with the aforementioned three mission critical phrases, offering chocolate, neck rubs, wine, and the TV remote are effective mood enhancers that can smooth out some of the emotional swings before they happen. And if they do occur? It’s less likely that you’ll be caught in the crossfire.

These are enough to get you started. Heck, if you only implemented the advice in these four simple tips, you’d be well on your way to being the ideal menopause goddess mate, friend, or companion. We’d love you for it.

Photo for this blog posting is the cover of a fabulous, fun book called Porn for Women. Photographed by Susan Anderson, From the Cambridge Women’s Pornography Cooperative, published by Chronicle Books of San Francisco.

My husband once remarked that it was a wonder that more couples don’t get divorced during the  Big M transition. And certainly it’s true that if we who are undergoing this forced journey don’t understand much of what’s occurring, our mates and loved ones are left completely befuddled.

The combination of physical changes and emotional changes can put a strain on the most loving relationship. Loss of libido, depression and apathy, irritation with everything your loved ones say and do, fatigue, hypersensitivity to noise, temperature, and touch are just a few of the manifestations of this hormonal rollercoaster ride.

Christiane Northrup, author of The Wisdom of Menopause, starts her book of 500+ pages with this sentence “It is no secret that relationship crises are a common side effect of menopause.”

Okay, well it may not have been an intentionally kept secret, but I sure never heard anything about this. (Or any other of the myriad manifestations of the hormonal sh*tstorm we call the Big M.) And I’m a registered nurse for pity’s sake.

Dr. Northrup goes on to elucidate that whatever is wrong or dysfunctional in your relationships will be greatly exacerbated by menopause. I think that is true.

However, in all my talks and sharings with menopause goddesses and their loved ones, I’m finding that a huge amount of upheaval can exist in the most functional relationships.
The Venuses spent a significant part of every meeting focusing on our primary relationships. Suddenly sexual desire disappears. We may not have leisure time interests in common with our spouses. The kids are no longer a focus.  How then do we connect with one another?

And now our intimates want to spend more time with us (the men are changing, too, don’t forget.) We are just beginning to explore our creativity and may want to spend more time alone or with girlfriends  How do we reconcile these needs with our desire to be connected with our loved one?

It has been all too easy to assume that every freakout or episode of bitchiness is hormonal – “oh she’s just going through menopause”  rather than a legitimate reaction to circumstances.

Additionally, deeper difficulties may be brewing or problems long ignored have just come to the surface.

However, it is just as deluded to assume that this sea change isn’t hormonal. Especially if the change is fairly dramatic, seemingly without warning.

Theresa and I found that we went from zero to sixty on the irritation meter in seconds during the worst of our transition. Talking with the other Venuses showed us that we were not alone.

It became clear to us that we needed to ascertain when our anger was a legitimate problem, a true trampling of our boundaries versus a hormonal side effect. Let me tell you truthfully, it can really be hard to discern the difference.

Looking backward, I can offer this advice. Proceed with caution and take it slow. We found that irritation might flare up in a circumstance that we could certainly rationalize as being justifiable anger. But we often decided not to act or say anything right away. We mused. We waited. We paused.

If we were still pissed off in a few hours, we reevaluated and decided on a plan of action for confronting and discussing the problem. If our irritation had literally vanished, we knew that hormones might have played a part. And we let it go.  No harm, no foul.  Especially no harm. To us or anyone else.

(A little history sidenote here – none of the Venuses is a shrinking violet, unused to sharing her feelings, including anger. If you have always contained your anger and irritation, this may not be the best plan for you. You may need to let some anger out. After all, some Change is good!)

And some good news.  The worst of the emotional and hormonal upheaval seems to last around two years, give or take a year. So be patient. Get to know your irritation levels; when they require intervention and when they don’t. Warn your loved ones when you feel especially out of control so they won’t take it personally. Best of all, they can support you. They love you.  They want to help.  Let them.