Category — Hot Flashes

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.

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 friend, M (you’ll remember her as the Menopausal Squirrel), felt pretty good about her health care practitioners. She liked and trusted her gynecologist right up until she began her menopause journey with a plethora of symptoms including hot flashes, mood swings, and insomnia. That’s when things got ugly.

On an office visit, she asked  about remedies and symptom relief. Her gynecologist recommended HRT. M. wasn’t too keen on that idea given the press since the WHI study. “What else can  I do? ” she asked. “Antidepressants” was the answer.  “No other options?” she queried. “There’s nothing else we can do,” she was told.

She walked out of the office and never went back.

Now I’ll be the first to admit that it can’t be pleasant to have a hot, bitchy woman demanding relief and answers in your office when you don’t really know what will help. And I truly understand as a health care practitioner how much you want to offer a definitive answer to such questions. Especially when your local drug rep has just offered you a sheaf of paperwork detailing why this might be a great new use for an old favorite drug.

Still, I gotta think that “I don’t know” might be a better start than “How about an antidepressant?” A fabulous followup might be “I’ll try to find out what other options might be helpful.”

A simple medical professional review session is in order here for all healthcare professionals involved in the care of menopausal women. And all menopausal goddesses are invited to read along to learn how to frame some of their questions in discussions about symptom relief or management.
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Review Statement # 1:   There is no silver bullet.
This is a phrase often used in health care circles to mean that there is no single drug, therapy, or regimen that will eradicate, alleviate, or cure any given syndrome or set of symptoms.

(It is well known that health professionals speak their own language – not sure where the silver bullet metaphor came from unless it was referring to the single thing that can kill a werewolf. While we may feel like we change as much as these lupine creatures during menopause, there really is no silver bullet for us.)

Review Statement # 2    All treatments have adverse or side effects.
Duh! And antidepressants have some whoppers!

Review Statement # 3    All Patients Are Individual
You wouldn’t think that this would even need saying. I heard it over and over again in nursing school. Still…………..

Review Statement # 4    Choose the least interventional option first for any symptom or disease state.
Okay, fans, moisture wicking clothing, natural progesterone cream, and go up from there. Need I say more?  To suggest that HRT or antidepressants are the first or second or only answers goes contrary to this very basic rule. Never try to shoot a fly with an elephant gun.  At least not until it goes rogue.

Review Statement # 5    Conduct a Risk-Benefit Analysis before prescribing treatment.
Take into account severity of symptoms, prognosis, and medical history versus possible benefits minus adverse effects or danger of future medical problems. In other words, examine the risks and potential benefits for each individual patient together with that patient. The operative word being Together.

Are antidepressants bad?  Or wrong? Heck, no. If one is suffering from depression that interferes significantly with daily living, these drugs can literally be lifesavers. This type of clinical depression is an indication that the benefits might outweigh the not inconsiderable risks. Should they be a first line for hot flash relief? Absolutely and unequivocally NO. The risk-benefit teeter totter will be weighted the other way.

Review Statement # 6    Involve the Patient In His/Her Own Healthcare
Duh again. Yes, it’s inconvenient. Yes, it will likely take longer. And the outcome will likely be far more satisfying for all concerned.

To be fair, I can’t tell you how many physicians over the years have told me that their patients don’t want to be that involved in care decisions; they just want to be told what to do. It’s possible we consumers have been at fault by not communicating our desire for involvement or by being too compliant or passive.

We need to prove them wrong and take an active role in symptom relief and control. Empower yourself, ask questions, seek information and move ahead as a full fledged participant in your own Menopause journey.

What did M do when she left her MD’s office? She shopped around., albeit hot flashing, grumbling, and sleep deprived.

She found an integrative wellness clinic that offered wellness counseling including dietary solutions and bioidentical hormones. Options were offered only after extensive testing for her hormone status, including thyroid as well as cortisol, estrogen and progesterone levels. She’s feeling 100% better. Especially since she is now in partnership with her healthcare provider/s.

Want to learn more about your own options? Check out Women In Balance, a non-profit organization dedicated to educating women about their health and wellness options.

I’ve started collecting Menopause Moments; real-life vignettes of all the wild and weird sequelae of the Big M. Why?  Because when these RIDICULOUS things happen, we mistakenly believe we are the only ones who have ever been afflicted so bizarrely. And that’s just not true. Thankfully!  Weirdness loves company – especially of the girlfriend persuasion.

Here’s a stranger than fiction Menopause Moment starring my friend M. She just recently began the menopause transition but it already has twisted up her life in unimaginable ways. One normal/abnormal day, she suffered one of those mind-altering, body immolating hot flashes.  You know the ones – where you are boiling from the inside out.

She rushed into the bathroom where they have a pedestal type sink and turned on the cold water. Just splashing it on her face would have been like spitting on a forest fire, though, and she knew it.  So she took off her shoes, climbed up on the sink and plunged both hands and both feet into the sinkful of water.

As her volcanic level temperature was drifting down from eruption to ooze, her mate opened the door to see her all hunched up on the edge of the sink. “Wow!” he said. “You look like a menopausal squirrel.”  She looked down at herself, looked back up at him, and they both burst into  peals of laughter.

I’m telling you; we can’t make this stuff up!  It’s just too outside the normal realm of human experience. Yep, the Big M. It ain’t for sissies and it sure does make us squirrely. The good news?  Squirrels have a sense of humor. So share your menopausal moment – we could use the laugh! It’s the only thing getting us through.  That and chocolate. Let’s hear it for menopausal squirrels!

If life is a dance, Menopause just might be an unwanted dance partner. But we can’t refuse to dance, so we just have to find new steps or laugh when we can’t remember the old ones.

This past week I was attending a Hawai`ian Healing and Hula workshop with Kumu Hula (Hula Master) Kawaikapuokalani Hewett. The workshop was organized by Holistic Honu Wellness Center in Sacramento, California. Yep, hula in Sacramento even though I live in Hawai`i.

Hula is a fantastic discipline for Menopause Goddesses. Firstly, it offers low impact aerobic conditioning. You gain flexibility in your body AND your mind. Learning the songs and chants are a great exercise for training memory – and you have the added benefit of learning it in a new language which stretches the old brainpan even more.

I’ve been dancing hula for about ten years now. I started before the word Menopause ever crossed my mind. While I like to think that my dancing has improved over time, thanks to the Big M, there are occasional glitches I couldn’t have foreseen.

Case in point:  we had just learned a new dance and as is the norm, each row of dancers moved up to the front in turn to practice the full song in front of our Kumu. I was feeling pretty good, I knew the words, steps, and gestures so it was with no anxiety or trepidation that I moved forward with my row of hula sisters and brothers.

Suddenly, as the first strains of the beautiful music began, a volcanic vent opened inside me. Fiery heat spread through my entire body; I began sweating like a pua`a (pig), and my mind went truly blank. It was as if the screen in my mind were wiped clean. I got an image of those gray Magic Slates we had as children where we could write or draw on them with a special “pen” and then pull it up and away from the backing to completely erase all marks. That was my mind. A hot flash had just erased EVERYTHING!

Well, time and hula wait for no one, so the music began. And I limped through the song, praying for snow and for my memory to return.  By the end of the song, the tropical tantrum was easing off and I managed to eke out a finish while my dignity just packed up and left me.

So I did what I always do in these circumstances.  I laughed. Deep in my belly and down to my toes.

And  then I sat at dinner with my hula sisters ( Big hugs to you, Jeane and Janny) and we shared our Menopause stories from blank slates to volcanic hot flashes to memory loss moments.  These fabulous women even wrote a song together a few workshops back about Menopause and memory loss.  Trouble is they can’t remember the words anymore. But hey, they still remember the sentiment.  And we’ll never forget the hilarity.

In hula, it’s much less important that you dance a song with technical perfection than that you dance with your whole heart and soul. The same can be said of life. Including and maybe especially the second half of life. So that’s my goal:  to be fully present to the dance; all the changes and all the new steps, with openness, grace, and a fully developed sense of humor.

I’m not from the South. I have no roots or ancestral connections there, although my Mom and Dad retired to Alabama’s Gulf Coast some years ago. But I LOVE Southern women.

I love the steel magnolia- tell it like it is in such a genteel tone that you may not get it til later- way of communicating. And I especially love Southern women’s humor.

My latest fave is Shellie Rushing Tomlinson, who does “On The Porch” chats about All Things Southern.

And here is one she did on a topic near and not so dear to our hearts: Hot Flashes.

Forward it to your menopause goddess sisters, and especially to all the men who will benefit greatly from her wisdom and understanding of how to deal with the Change.

“I’m having a hot flash
A tropical hot flash
My personal summer is really a bummer
I’m having a hot flash.”

lyrics from Menopause the Musical.

Theresa Venus and I went to see “Menopause the Musical” the other night. Fabulous, funny, outrageous, and true. We flat out loved it.

To the tunes of songs from our era, four gorgeous women of menopausal age sang about hot flashes, “brain collapse”, weight gain, and emotional meltdowns. We laughed so hard we cried. As did the large numbers of men in the audience. Hey, we aren’t the only ones going through this transition; our loved ones have to take the ride with us.

The only piece that didn’t quite resonate with us had to do with libido. These women were commiserating that their husbands didn’t want to have sex much anymore – and they needed to resort to Mother’s Other Little Helper: a vibrator.

While the segment was uproariously funny, it just didn’t describe the experience of most menopause goddesses I know. Oh sure, there is a rare one like Bobbi Venus who actually had an uptick in her libido with the Big M, but that just does not describe the usual story we hear. And live. Just ask our husbands. One day we lusted for them, the next we couldn’t remember what lust is.

Thankfully, our libido does return, though also thankfully not to the horndog levels of our twenties and thirties.

The musical ended with a celebration of the Change as the four principals walk out in slinky black trimmed with rhinestones. “We have changed,” they tell us – “for the better.” And they called all the women in the audience up to kick up their heels together on stage. A perfect finish.

If you get the chance, go see it when it comes to a town near you. And if you’ve already seen it, heck, call us up and we’ll go see it again with you.

For info, visit Menopause The Musical.

When I was in nursing school many moons ago, I learned next to nothing about the Menopause transition. Our 1100 page textbook on Women’s Health was called "Maternal Child Health" and devoted a single paragraph to the Big M – defining it as the cessation of menstrual periods. Thankfully, more is being taught in nursing school now (not too sure about medical school…….).

A male nursing student wrote a song about Menopause for his nursing school class – here it is, straight from You-Tube. Enjoy!

Menopause goddess Theresa Venus turned me on to this hilarious Jack In The Box commercial. When consciousness about The Big M invades prime time, commercials, AND fast food? America is paying attention! Yep, we are finally going to be talking about it. And laughing, weeping, and bitching. Take a look.

My hot flashes have generally been well regulated lately. In other words, they come and go occasionally, but are mild and short in duration.

But that other form of heat, the emotional "Flame On" that makes me feel like a midlife superhero out of control, has been a bit more prevalent lately. I’ve previously been upset and mortified by these hot-headed events, but I’m taking a different tack these days. I’m trying to tap into this extra "energy" and use it wisely. Let’s face it – the energy will just build until it explodes volcanolike and I don’t want the lava laying waste to those innocents around me.

The other day, I was in the garage, feeling virtuous about getting my Christmas stuff organized early (a necessity, since we are traveling for 2 weeks in December.) And I realized after a fruitless search for the ornaments and decorations that there WAS JUST TOO MUCH CRAP IN OUR GARAGE AND HOW DID WE BECOME SUCH PACKRATS AND WHO ACTUALLY LIVES LIKE SUCH PIGS AND ……..

And things started flying into the middle of the space usually occupied by the car. I was in the midst of a full-fledged menopausal meltdown – a hormonal hissy fit of the highest order. Believe me when I say that nothing could have stopped me. By the time I exhausted myself, still irritated and panting, I had a plan. I’d use this "energy" to motivate myself. (And my poor unsuspecting husband.) I’d purge us of all this junk.

Of course, the timing of this heat-inspired brilliance was grossly inconvenient. We don’t really have much time before we leave and plenty of projects to complete. Yet, if there’s one thing I’ve learned about Menopause: it will always manifest at the least convenient, most annoying and embarrassing of times. All you can do is to put on your big girl panties and just go on.

My husband called later that day from the airport to say he was returning from his business trip. "You can’t park in the garage," I informed him. "Okaaaaaaaaaaay," he said carefully. He’s lived with a Menopausal Goddess long enough to know what to say AND what not to say. "And we’re getting a dumpster and getting rid of all this stuff we haven’t used in the last century, so get ready." "Great," he feigned enthusiasm, another calming trick he’s learned through this transition.

We spent the better part of a week going through stuff. Every time something irritated me, it was off to the garage and the Perfect Purge. After it was all over, the dumpster on its way and useful stuff off to the local thrift store, we toasted each other and the energy of Menopausal Meltdowns. We feel cleaner and lighter – kind of like we imagine a forest feels after a good fire blazes through.

So I’m less freaked out about the hormonal hissy fits. Anger is a form of energy; nothing more or less. It’s how we channel it and what we do with it that counts. And the next time I feel this energy coming on, I’m going through my closets!

(Don’t forget our girlfriend’s special for Christmas: buy one copy of "The Big M" and get the second at half price! Click here The Big M