May is Women’s Health month. The Mayo Clinic says one issue that female patients often misunderstand is menopause. An estimated six thousand women begin to experience this condition every day. That’s more than two million women every year. The clinic says women in the United States have an average life expectancy of eighty one. If true, that means women in the U.S. spend more than one-third of their lives in menopause.
“Ma, I think I know what’s the matter. It’s the change,” said actress Sally Struthers, as Gloria Stivic in the 1970’s sitcom “All In The Family.”
“You mean spring is coming?” responded actress Jean Stapleton, as Edith Bunker in the series.
Fans All in the Family may remember this scene
“Don’t you see? The forgetfulness, the hot flashes. It’s the change of life,” said Gloria.
“At my age?” responded Edith. “I am not supposed to change yet, am I?
“It says in the article that it can happen any time after 40,” responded Gloria.
“And when it does, it can turn you into an old woman,” said Edith.
In this 1972 episode of All In the Family, Edith Bunker was one of the first women to talk publicly about menopause and the change of life with hot flashes, forgetfulness, and mood swings.
The Cleveland Clinic describes the menopause transition as the drop in hormones as a woman’s reproductive system shuts down. The average age of menopause is 51, but the symptoms vary with each woman. It can be unclear when the menopause transition starts, how long it lasts, or the correct names and treatments to use.
“We spend about 40% of our lives in menopause and most people don't know anything about it. The science is catching up with it now,” said Dr. Connie Dabezies, who recently helped establish the USA Health Eastern Shore OB-GYN office in Spanish Fort to provide an academic approach to women’s health. Dabezies is one of only seven practitioners in Alabama certified by the North American Menopause Society. She says perimenopause is the stage leading up to menopause. For most women, perimenopause starts in their 40s and can last seven to ten years.
“What can I expect? It's changes in their menstrual cycle,” said Dr, Dabezies. “They've stopped or they're spotting or they come in with systemic symptoms, hot flashes, mood swings, decreased libido, depression, anxiety, weight gain.”
Dabezies says women and whales are the only mammals who experience menopause and live beyond their reproductive years. But for most of human history, life spans were short, and most women didn’t outlive the menopause. Today, the menopause transition for some women is a few hot flashes. For others, the symptoms make it difficult to work or get through the day.
“For six years or seven years it was sweats and flushing of the face. You can't concentrate. You get mood swings and are very irritable,” said Lisa Blackmon from Mobile. She had a hysterectomy and went through medically-induced menopause.
“You gain weight like nobody's business,” Blackmon recalled. “You lose your muscle mass because of your hormones. You don't realize how the hormones that are secreted by your uterus and your ovaries make you a woman and how much that it affects everything about your body. Everything changed. Everything changed on me.”
Once a taboo subject, more women like Lisa speaking out about going through menopause. Some are even finding the funny side…
“There is a thing called perimenopause and it comes at you in the middle of the night like a ghost,” said comedian Leanne Morgan. She describes menopause in her stand-up act.
“It will last ten years and you will feel like a middle school girl. People think of menopause as when perimenopause starts, but that’s not it, it’s another thing. Get to your healthcare provider and tell them your symptoms.
“The libido thing can become an issue in marriages or long-term relationships,” said Fatiha Jonson. She’s a women’s health nurse practitioner at the University of Alabama in Birmingham. She entered health care to bridge the gap in women’s health and encourages women to bring their spouse or partner into an appointment to talk through the changes from menopause.
“Having that conversation with their spouse present helps address the elephant in the room that maybe that wife or that female patient cannot have with their significant other alone,” said Jonson. “And it normalizes, this is what's going on. It's not just me who doesn't want to do anything because I'm tired.”
The treatment of symptoms is also part of the confusion of menopause. The North American Menopause Society reports that Hormone Replacement Therapy is one of the most effective therapeutic options for treating hot flashes and other menopause symptoms. We met Doctor Connie Dabezies at the beginning of our story. She’s one of the few doctors in Alabama certified in menopause. She talks symptoms, health and family history with each patient to recommend the right treatment.
“Women come in very educated about their pregnancies. But they come in with menopause and don't know what's happening and don't know how to treat it. They don't even know if they want to treat it because they are scared of hormones. I sit down with patients in individualized care and do shared decision making. If we want to go on hormones, this is what I'd recommend you go on. Let's see how you do, then come back in three months. Let's see if we've improved. Let's tweak the hormone imbalance if we need to et cetera. And then we talk about coming off of it.
Dabezies also warns her patients of misinformation about treatments or promises of staying young.
“It's not all pharmaceutical and medicine. Sometimes it's just lifestyle changes. Sometimes it can be as simple as a dietary change or an exercise program,” she said
Dr. Dabezies encourages women that menopause can be a great time when they finally have more time for themselves and can do things they always wanted to do.
