Category — Physical Menopause Symptoms

The Big M Wisdom © lynette sheppard

I clicked on a tweet (on Twitter) the other day promising to answer our questions about menopause. And got the same old rhetoric that I’ve read countless times in books, in articles, on websites. Finally, I gotta comment and reanswer each question as a true menopause goddess. I’m tired of the B.S. I’m not picking on any one site or author (which is why I won’t include the link to this particular Q & A article.) I’m addressing all of them that put this kind of information out for women. Below are their questions and answers in plain text, my answer is in bold. And I do mean BOLD!

The info started with:
Are you or a loved one approaching the time of life many women fear — menopause? If so, you probably have questions about this sensitive subject.

Well, we didn’t, I’m sorry to say. We didn’t know it would be so momentous. So it caught us completely by surprise (read mind-numbing shock). But once it started? You bet your sweet bippy we had questions! And we sure wanted answers!

Here are 6 answers to help you go through menopause as comfortably as possible:

Oh Goody. Let’s hear them.

1. Why is menopause a puzzling time of life?

Before reaching the change of life, many women don’t know what to expect. That can be scary! There are horror stories floating around that can make women unnecessarily apprehensive, but you need to know that menopause is a normal part of your journey through life.

Oh sweetie. Menopause IS a freaking horror story. For most women who haven’t started immediately with hormones anyway.
Of course, it’s NORMAL. Puberty and childbirth are NORMAL, tsunamis and volcanic eruptions are NORMAL, but that doesn’t make them any easier to take. Especially if we don’t know what is coming!!

2. At about what age does menopause begin?
Most women cease having periods between the ages of 45 to 55. However, menopause can be induced earlier by surgery.

Yeah, well perimenopause can start years earlier. And for many women the symptoms start or are the worst in perimenopause. So you’d better amend those ages. And let me say that I talk to women in their sixties still dealing with it, so 55 sounds like a nice cutoff but it just ain’t always so. So the answer to this question? Whenever it wants to!

3. What are some of the symptoms?

During the early stages of menopause, called perimenopause, a woman’s menstrual cycle becomes irregular. When menopause has been completed, a woman no longer has periods at all. One of the most widespread symptoms of menopause is hot flashes and a high percentage of menopausal women have them. Some women experience feelings of depression while they are going through menopause and mood swings can accompany the change of life.

There is so much understatement here that I almost don’t know where to begin. Let me start with hot flashes. Widespread symptom? High percentage have them? Allow me to explain. Hot flashes are not short private vacations in the tropics. Because vacations are enjoyable. Think of the worst flu fever you’ve ever had – now quadruple it. And you’re not even close to how bad it is.

Depression and mood swings? We have more ups and downs than Six Flags. Tire commercials can move us to tears and the sound of the refrigerator or our cat breathing can piss us off. And again, none of the fun.

4. What about hair loss during and after menopause?

Hair loss sometimes occurs to some women with the aging process. This is one of the most distressing side effects of menopause. However, there are a lot of women who don’t lose their hair during this transitional period in their lives. Some women have higher levels of the hormones that cause hair thinning. If you are experiencing hair loss, you should check with your doctor about treatment options.

Having been one of the “some women”, I can tell you that yes that losing your hair is distressing. As in I was afraid I would be bald soon!   It’s actually terrifying.

As for checking with my doctor about treatment options? I consulted with more than one physician. They were less helpful than the DMV and ten times as expensive. Like us, they have no experience with menopause that hasn’t been squelched by immediate hormone therapy. If I had to depend on them, I’d still be freaking out. Or bald. Or both. (For more info, search hair loss here on the blog. Or write me.)

5. Are there any special nutrition recommendations for women going through menopause?

You might want to consider adding soy products to your diet to assist your estrogen levels. Be sure to get enough vitamin A to help your skin and hair to be as healthy as possible. Health food stores offer a variety of herbal extracts to help with menopausal symptoms.

Hmmmmmm special nutrition recommendations. Other than you can’t eat anything every again without gaining weight? Oh yeah, soy is one of the top food allergens, and can interfere with thyroid function. Since everything you eat turns to fat, might as well make chocolate your main food group. And wine. Lots of wine.

6. What medical help is available while you’re going through menopause?

Your doctor may prescribe treatment options to help lessen disturbing side effects of the change of life.

A combination of estrogen and progestin may be recommended by your doctor — if you don’t have a history of breast cancer in your family. There are treatments to help you if you are suffering from hot flashes that disturb your sleep and other symptoms as well

Or s/he might prescribe antidepressants, the latest “magic” cure for The Big M. I highly recommend holistic or complementary physicians/nurse practitioners who look at the whole person and don’t start with either HRT (hormone replacement therapy) or antidepressants as the first (sometimes only) approach. Check out Holistic Medical Association or Women In Balance to find a practitioner near you.

Although cessation of menstruation can be a puzzling time dreaded by many women, there are a number of advantages to this period of your life’s story. It’s a new chapter opening before you! You will probably be able to enjoy greater freedom than ever before to pursue interests you could not pursue before because of family responsibilities. Why not investigate new opportunities and challenges in this new chapter of your life!

While this is true, it doesn’t compute when we are in the beginning or worst stages of The Big M. There are few things worse than perky, upbeat proclamations about how this is the best time of our lives. Eventually it may be. (It certainly is for the goddesses.) But we went through a few RIDICULOUS years before we came out the other side feeling whole again. Different, but whole. Menopause. It will set you free but it will really mess with you first.

One of our readers, Vanessa Scott, sent me the following news release. More and more, I’m hearing from women who have problems with urinary leakage, stress incontinence and the like. Vanessa is a consultant for vaginal surgery. Surgery is one option, but there are others that you may wish to try first, if these issues have been plaguing you. Be sure to check out Wet Matters website hosted by Stephanie and Beth. As a physical therapist and MD respectively, they are fierce advocates for helping women who suffer from pelvic floor dysfunctions. They offer educational info re: all options, including surgery.

Finally, it is important that we begin to talk about these issues openly. Especially with one another. That’s the first step to regaining our health. Oh, and it is not just menopausal women who suffer from these problems. Many of our daughters will have urinary and vaginal health issues after pregnancy. It’s wonderful to know that there is help.

Here is the news release from Vanessa:

The Fight for Mother’s Rights – 1st Annual Vaginal Rejuvenation Awareness Day (April 30th, 2010)

San Antonio, TX

Vaginal-Surgery.info is excited to announce the 1st Annual Vaginal Rejuvenation Awareness Day will take place on Friday, April 30, 2010.

With Mother’s Day right around the corner, now is the perfect time to shine some light on a condition millions of mothers suffer with daily and yet never talk about.

Vaginal relaxation, Stress Urinary Incontinence (SUI), bladder or uterine prolapse and cystocele/rectocele are very real medical problems for mothers that can be corrected.

Unfortunately, a majority of the women suffering from these physical issues are too nervous or embarrassed to discuss them with their doctor or even gynecologist.

Vaginal Rejuvenation Awareness Day aims to open the dialogue on this sensitive and often misunderstood subject and provide women a safe place to ask questions, explore their options or just have a voice.

According to Vanessa Scott, vaginal surgery consultant and founder of Vaginal-Surgery.info, “90% of the women I meet with have never talked about this problem with anybody else, not even their husband or partner. I believe that information and knowledge are the first steps to empowering these women.”

It is reported that 30 million American women suffer from symptoms of vaginal relaxation, primarily due to childbirth.

In less than 1 year, Vaginal-Surgery.info has had visits from women in more than 109 countries. This is truly a global problem. The changes to a woman’s body during childbirth are the same whether a woman is in the U.S. or Algeria.
“Frankly, vaginal rejuvenation is often sold as ‘better sex’. I think that has a lot to do with the surgeons that pioneered cosmetic gynecology. However, in my experience, better sex is usually secondary for these women. The primary benefits are actually no more urine leakage or prolapse issues and simply feeling “normal” again. Better sex really just ends up being the icing on the cake.”

Anybody can participate in the 1st Annual Vaginal Rejuvenation Awareness Day by doing the following:
ο On Friday, April 30, 2010, visit the Vaginal Rejuvenation page of our website. (http://vaginal-surgery.info/vaginal-rejuvenation.html)
ο Click on the links to Vaginal Rejuvenation Awareness Day to:
o Give your opinion on vaginal rejuvenation.
o Ask questions about vaginal rejuvenation.
o Add your responses to our online polls.
o Share your thoughts and comments.
o Read what others have written to expand your own understanding.
“We all have a mother. And her body went through some amazing changes in order for us to be here today. I think we owe it to mothers everywhere to give their bodies a platform to be heard. If you are experiencing any of these symptoms, I encourage you to take part in Vaginal Rejuvenation Awareness Day and help further the conversation for women everywhere.”

I’d like to be a jellyfish
‘Cause jelly fish don’t pay rent…

They’re just simple protoplasm
Clear as cellophane.
They ride the winds of fortune,
Life without a brain.”

from the song Mental Floss by Jimmy Buffett

Now that my menopause brain fog has lifted, I notice an interesting new mental phenomenon manifesting itself. It’s a little like what longtime meditators call monkey mind (and I call Menopausal HDD). Still, it’s different. Monkeys jump from tree to tree exuberantly. Monkey mind jumps from thought to thought, idea to idea quickly. There’s almost a manic energy to them.

This new syndrome is more like jellyfish mind. While myriad thoughts intrude themselves, one atop another, I find myself floating among them. I’m drifting in a sea filled with plans, ideas, to-do’s, memories, wishes. Like a jellyfish, I float from thought to thought as they wave and brush against me.

I don’t mind the floating either. Which is weird. Because I like to be focused. Heck, I need to be focused. But too often, I just float from one thought to the next, one thing to the next, serenely. I feel like a caricature of a Zen master (mistress?).

And since it is time for another blog entry and I am surrounded by flotsam and jetsam in my own little ocean, I’m going to write about the various kelp-thoughts that brush against me. The warning here is that these topics may not go together at all. Yet they have at least The Big M in common. Okay, there’s the disclaimer – don’t say I didn’t warn you.

Estrogen Addiction Say What?
Yep, Apparently our hot flashes are due to an estrogen addiction. UBC Professor of Endocrinology Dr. Jerilynn C. Prior presented her findings on estrogen addiction and its treatment with progesterone at Women’s Health Congress 2010 in Washington DC. Not a joke. Really.

According to Dr. Prior, when a woman has a hot flash:

“she’s experiencing a massive release of brain chemicals … Integrating what we know about hot flushes has led to the hypothesis that the brain exposed to prolonged high estrogen levels reacts like the brain of an addict without a fix when estrogen levels drop. The best animal model of hot flushes is the heroin-addicted mouse.”

Apparently, the treatment for this estrogen addiction is progesterone, since “estrogen and progesterone work together in every tissue of a woman’s body.”

Okay. I’ll bite. Massive release of brain chemicals sounds right on. Furthermore, I’m a big believer in natural progesterone cream. But as I’m floating in my little sea, these thoughts brush against me. Do we have to name everything so that it sounds like a disease or disorder? When Mom Nature cold turkeys us at Menopause, does she know what she has done? And is progesterone now our methadone?

Dr. Prior and her team suggest that women who have taken estrogen will have tons more hot flashes when they stop the hormones. Does that mean instead of 20-30 per day, I’ll have 40-50? I gotta tell you, it doesn’t make me excited about stopping my bioidentical patch anytime soon. And I am definitely planning to decrease and ultimately discontinue it, having passed that magical three year mark. Will I need truckloads of progesterone to combat the dreaded withdrawal from my estrogen addiction? Do I need a 12 step program?

There were a bunch of other kelp thoughts I was going to share, but I’ve drifted too far past them and run out of room. They’ll likely show up in the next post.

As Jimmy Buffett continues in his song,

“In one ear and out the other.
Don’t you get criss crossed.
I recommend you try a little
Mental floss.”

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 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!

When I was dragging my weary bod around like a lead weight during perimenopause, I figured it was just part of the Change.  But when my hair began thinning, my hands and feet were cold even though I was so hot generally I felt like a living furnace, and my weight was going up, my nurse mind went “Aha!”.  I need my thyroid tested.  Although these symptoms are nonspecific and indeed can be from low estrogen and progesterone, I knew they could also herald hypothyroidism.

So off to my MD I went.  She ordered T3 and T4 levels as well as the more specific blood test TSH which stands for thyroid stimulating hormone.  Basically, this is the hormone that tells your thyroid gland – hey, more thyroid hormone is needed, kick it into gear and produce some.  So if you are low on thyroid hormones this TSH level should be high.

Mine wasn’t.  It was normal. My blood tests were all normal.  I didn’t think much more about it, although the symptoms continued.  My previous MD left her practice and I found a holistic practitioner who is an MD, homeopath, herbalist and runs a complementary medicine clinic.

Complementary medicine is just what is sounds like.   All the tools of Western medicine are used and complemented by other disciplines such as nutritional healing, homeopathy, herbs, massage, acupuncture, and more.  (Also called integrative medicine or holistic medicine.)

This new practitioner performed a complete physical exam and pronounced me hypothyroid as I had every clinical symptom and sign.  The blood tests?  Just not sensitive enough.

Many physicians now believe that hypothyroidism should be diagnosed on the basis of symptoms rather than blood work.  If still unsure that low thyroid hormone is the culprit, they simply place the patient on a very low dose of supplemental thyroid hormone.  If there is improvement, the diagnosis is clear.

I started my Naturethroid and within two days was sleeping through the night, my hands and feet warmed up, I had energy again, and I was calm.  It took longer for the weight gain and hair loss to stabilize, but they did.

And as time has gone on, my dosage of thyroid hormone has been decreased gradually until I take very little.  My own hormone factory has kicked in again.  I have energy and am at my ideal weight.

I’m not sure why, but with the onset of Menopause, it seems that many of us also lose thyroid hormone.  Maybe all our hormones are more intricately linked to one another than we know; maybe it is part of the overall Change.  Whatever the reason, it’s worth checking out.  We may not have to feel so tired, heavy, low energy, and mentally foggy.

To find a practitioner near you, I suggest you check out the American Holistic Medical Association.  Their website is http://www.holisticmedicine.org/ You may also Googling complementary and integrative medicine in your area.

When I was a young girl, vaginas were not a topic for polite conversation. Or any kind of conversation, save in the odd sex education class.

Times have changed. And with the advent of Menopause, so have we. The Big M is not polite, and we need to confront one of its more disturbing manifestations head-on. Namely, vaginal dryness.

It isn’t vaginal dryness that we notice right off the bat. It’s the first time we have sex and it HURTS. A normal, healthy sex life is something most of us have taken for granted for many years. Suddenly, physical intimacy becomes pain. Who saw that coming?

Loss of libido occurs and that is distressing enough. Yet, when desire returns and we find that sex is painful, it can be a devastating experience. I’ve received soooooooo many letters about this phenomenon. As one of the single goddesses wrote after a disastrous encounter, “It was one of the most humiliating experiences of my life.”

Because our normal lubrication has “dried up” with the hormonal changes of aging, we may need help. Thankfully, we have options these days.

Our best course of action is to supplement with a good lubricant. Use before intercourse and keep it handy in case you need a little more during. Emerita makes one of my favorites called “Natural Lubricant”, a water-based, non-greasy lubricant. It feels very similar to our own natural lubrication. Hence the name.

Emerita also makes a product called “OH! Warming Lubricant” which can help fuel the “fire down below” in a gentle, sensual way while providing “natural” lubrication. The Venuses like this one a lot. Available at health food stores, major drug store chains and direct from Emerita.com.

Another of my favorites is called “Wet Naturals” which also feels like our own lubricant. Wet Naturals has three varieties. Beautifully Bare is most like natural. Sensual Strawberry is lightly flavored and scented, not sticky. Silky Smooth is a silicone based lubricant that is great for massages and also works underwater. (Hey, whatever floats your boat.....) Available at major US drugstore chains and >Drugstore.com.

Another option is topical estrogen applied vaginally. This is a form of HRT (Hormone Replacement Therapy) and requires a prescription from a physician. Topical estrogen is more effective than either patch or pill for vaginal dryness.

The Mayo Clinic discusses several forms on their website The Mayo Clinic:

1. Vaginal estrogen cream (Estrace, Premarin, others). You insert this cream directly into your vagina with an applicator, usually at bedtime. Your doctor will let you know how much cream to use and how often to insert it, usually a daily regimen for the first few weeks and then two or three times a week thereafter.

2. Vaginal estrogen ring (Estring). A soft, flexible ring is inserted into the upper part of the vagina by you or your doctor. The ring releases a consistent dose of estrogen while in place and needs to be replaced about every three months.

3. Vaginal estrogen tablet (Vagifem). You use a disposable applicator to place a vaginal estrogen tablet in your vagina. Your doctor will let you know how often to insert the tablet, for instance daily for the first two weeks and then twice a week thereafter.

While vaginal dryness may initially freak us out, it doesn’t have to signal the end of our sexual vitality or enjoyment of physical intimacy. As with so many manifestations of the Big M, we learn workarounds and find our way to a new “normal”.

And hey, all you goddesses out there, we’re open to recommendations for other products or remedies. After all, women sharing their wisdom is how we will all survive (and ultimately thrive) on this midlife journey.

Women In Balance, a non-profit organization, and leader in hormone balance education for women, announces one day health conferences at the Waterfront Marriott Hotel in Portland OR on Saturday August 1st, 2009 and in Orlando, FL on October 24, 2009.

The need for unbiased information on hormone balance and natural options has received great attention since Oprah Winfrey had a series of episodes discussing bio-identical hormone therapy. Women In Balance created a national series of all day conferences because of the groundswell of interest in hormone balancing and it’s impact on overall health.

"Our mission at Women in Balance is to empower women to take charge of their hormone health. Our informative conference is a wonderful way to begin the journey to optimal health", says Dr. Jane Murray MD, chair and founding member of Women in Balance, and Medical Director of Sastun Center of Integrative Health, in Overland Park, Kansas. The Conference package includes exciting national speakers, a workbook, goodie bag of product samples and a health conscious luncheon, for $50.

The event has limited seating to create an intimate space for participants to allow questions of the speakers, and networking opportunity with other women with similar issues. Topics include: Understanding Hormone Balance – How your body really works, Lifestyle approaches for Hormone Balance – Dealing with your new normal, and Options for Midlife Health – Empowering yourself to hormone balance.

To register for the conference please go online to: WomeninBalance

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!