This special feature is brought to you by the Women's Health Collaborative.
A COMPLEX PHYSIOLOGICAL TRANSFORMATION
A Meditorial by: Roberta Kline, MD (OB/GYN)
Women go through many changes during the menopausal process that affect their physical, emotional, and spiritual health. It is often a time of awakening and increased awareness of the need for focusing on their goals and their own self-care.
The increase in awareness of the role of hormones and options such as hormone replacement therapy has been a great door opener to better care that has benefitted many women. Indeed, estrogen is a ubiquitous hormone that influences almost every aspect of our biology, and many of the diseases we see that increase after menopause are linked to these hormonal changes. But not every woman is a good candidate for or benefits from hormone replacement therapy, nor do all women choose this path.
This then leads them to search for solutions that are aligned with their beliefs and health needs. With so much information (and dis-information) available, it quickly presents its own challenge as each woman tries to sift through what is right for her. In truth, each woman is unique, and how she navigates menopause and life beyond requires an individualized approach.
Cardiovascular disease (including high cholesterol, high blood pressure, and stroke), breast cancer, osteoporosis, osteoarthritis, dementia, diabetes, metabolic syndrome, hypothyroidism, urinary incontinence, sexual wellbeing, and weight gain are among the many health issues that increase after menopause. While the underpinnings for most chronic diseases often exist 10 – 20 years before they appear, menopause can accelerate the disease process.
SIFTING THROUGH CONFLICTING STATEMENTS
Whether you are undergoing the variety of disruptive symptoms of menopause or are facing the barrel of that age range, it is important to take note of HOW to discern what information applies to you. In this age of information overload, there isn’t a symptom or question you can’t look up using a search engine or scrolling through various social media sites or chatrooms. With so much information available, it is easy to become overwhelmed. While getting different opinions from various healthcare practitioners can help, it can sometimes lead to more confusion for women as they try to patch together different opinions and recommendations without really getting to the core of what they need to support their health in the way that makes sense for them. This leads to a core set of questions that I hear repeatedly from my patients and clients about how to be more proactive, what do tests results really mean, and what sources can they trust?
PROACTIVE SCREENING
Proactive health screening is designed to detect potential health problems earlier, so you have more options and potentially better outcomes. In addition to standard screening tests, I will individualize recommendations depending on health history and genomic profiles. The genomic profile is highly useful as it can provide important guidance for hidden health risks, along with dietary and supplement needs, enabling a much more focused use of resources for proactive screening strategies.
That said, here are a few additions I commonly recommend for women as they enter menopause. All of these can be done through your regular ObGyn or PCP, but it’s important to understand that they are looking for disease, not imbalances that can lead to disease, so I will also interpret them through a different lens.
• Bone Density Test
• Request a bone density scan if you have not had one by menopause or age 50.
• Blood Work
• Get comprehensive blood work that goes beyond the basic CBC and chemistry panel, including vitamin D, omega 3 and 6 fatty acids, ferritin; hsCRP, homocysteine, fractionated lipid panel, uric acid; TSH, Free T4, Free T3, Reverse T3; HbA1c.
• Pelvic Exam
• Even though routine pelvic exams are no longer recommended for asymptomatic women, changes related to menopause such as atrophy and lichen sclerosus, both of which can contribute to painful sex, as well as skin cancer can be detected early.
Menopause is a time of entering a new phase in life. In addition to the biological changes, it is often a time of psychospiritual awakening requires reconnection to their inner compass. There is a letting go, a closing of one chapter so that a new one can begin. It involves a shift toward introspection and an increased connection to intuition, while at the same time viewing the world through a wider lens of fairness and justice. Many women feel a call to step into their real selves, often after a lifetime of following someone else’s rules. It’s like the rose-colored glasses come off, and they start questioning fundamental beliefs about their identity, roles and values that have guided their work, relationships, and daily habits.
They then have new questions, including who are they becoming, how do they find the courage to embrace their new self and live life on their terms, and how do they navigate this all with grace. I have found several ways to help women tap into their inner knowing to answer these questions for themselves. One of the key tools I use to facilitate this process is Human Design.
The release from many societal expectations and forging a new path can ultimately be liberating, but it can also be a challenging time. Many cultures view menopause as a sacred passage to the divine feminine, with a deeper wisdom and authentic connection to self that is highly valued. Rituals and mentors help women navigate this profound transition with grace. However, in a culture that prioritizes youth and values outdated roles, we do not offer rituals, guidance, or support. Instead, women have suffered in silence either because they were afraid to speak up, or their questions and concerns went unheard or were even dismissed.
This is slowly changing. As more women talk openly about menopause, it is losing its taboo status. It brings the gifts and challenges into the light, so we can collectively shift the narrative and support women in navigating their new chapter. Supporting individual women in their journey also reaps benefits for the greater community. Providing women with the resources they need to enter this next phase of life with purpose and meaning in addition to physical health lifts us all.
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