This guide, for women in their late thirties to late fifties, is meant to demystify the menopause condition, symptoms, remedies, side effects, and emotional impact. The information about rememdies includes both traditional and alternative treatments. The author stresses the benefits of good nutrition and fitness.
About the Author
Maureen Miller Pelletier, M.D., is board-certified in OB-GYN specializing in menopause, PMS, and pelvic pain. She received her medical degree from Tufts University and completed her residency at the University of Cincinnati.
Deborah S. Romaine has contributed to more than a dozen books, including several Complete Idiot's Guides.™ She has an MA in English and creative writing from the University of Washington.
Table of Contents
I. ENTER PRIME TIME.
1. What Is Menopause?
Navigating the Silent Passage. A Woman's Life Is a Circle.
Of Cycles: Menstrual and Life. Luna: Maiden, Enchantress, Mother, Wise Woman.
The Climacteric Stage: We're Not Talking About the Weather.
When Does Menopause Start? How Long Does Menopause Last? Is There Life After Menopause?
The Medicalization of Menopause.
When Did the Doctors Get Involved? Can You Postpone the Body's Aging Process? Menopause Is Not a Disease.
Embracing Each Change of Life.
2. Mapping Menopause: Facts, Folklore, and Fears.
The Crone Goddess: Ancient Cultures Revere the Wise Woman. Wisdom of the Ages: A History of Menopause.
Medieval Myths and Mysticism. Mona Lisa: Life in the High Renaissance. The Victorian Era: Button Up.
What's It All Got to Do with You?
Fast-Forward to the Information Age. Can You Ever Be Too Rich, Too Thin… or Too Young?
100 Years Ago, Women Didn't Live to Be 100!
Baby Boomers Break the Age Barrier. You May Spend as Much Time Over 40 as Under. Coming of Age, Coming into Our Own.
3. The Power of the Second Spring.
Age Will Not Be Defied.
Supplements to Reverse Aging: Do They Work? To Long for Youth Is to Forego the Future. A Gateway to New Life Experience.
How Do You Feel About Menopause? A Self-Exploration. Changing the Face of Beauty.
Draw a Picture of a Beautiful Woman. Who, You, Old? No…
Being Proactive About Menopause.
Staring Down Media Stereotypes. Putting Your Best Face Forward.
II. MIDLIFE METAMORPHOSIS.
4. Perimenopause: Approaching Menopause.
The Progress of Understanding. When It's More Than Really Bad PMS.
Signs and Symptoms of Perimenopause. The Relationship Between PMS and Perimenopause. Charting Your Period Patterns.
Oh, Those Fluctuating Hormones!
Perimenopause Is Not Early Menopause. Dealing with the Storm in Your Body.
Should You Take Hormones for Perimenopause?
Low-Dose Birth Control Pills. Hormone Replacement Therapy (HRT).
How Long Perimenopause Lasts.
The Possibility of Pregnancy. Menopause: The Calm After the Storm.
Self-Care During Perimenopause.
Keeping Your Body Healthy. Staying Calm and Comfortable.
5. Menopause and Your Body.
The Parts: Your Organs. The Messengers: Your Hormones.
The Mother Hormone: Estrogen. Preparing for Pregnancy: Progesterone. Not Just for Men: Testosterone.
Your Reproductive Cycle Before Menopause. What Happens Inside Your Body During Menopause.
Hormone Heaven or Hell?
This Is Your Brain at Menopause. Biochemical Changes. Physical Changes. Is Your Body Prepared for Menopause?
Habitit, Habitat: A Self-Quiz. Nurturing Good Nutrition and Lifestyle Habits.
Menopause: It's a Process, Not a Moment.
6. Fertility, Midlife, and Menopause Babies.
When Your 40th Birthday Wish Is for a Baby. Are You Still Fertile at 40?
All About Eggs. Subfertile Is Not Infertile.
Becoming Pregnant at Midlife.
The Lowdown on Midlife Motherhood. The Physical Considerations of Pregnancy. The Emotional Considerations of Pregnancy. Your Support Network.
Exploring High-Tech Possibilities.
What You Should Know About Fertility Drugs. Intrauterine Insemination (IUI): Hit the Spot. The ART of Conception: IVF, GIFT, and ZIFT. Considering Donor Egg or Surrogacy. What You Need to Know About Costs and Insurance.
Other Options: Adoption and Living Child-Free. Just When You Thought It Was Safe….
How Long Is Birth Control Necessary? Accepting and Adapting to a Surprise Pregnancy
7. Do You Need Your Uterus? Hysterectomies and Surgical Menopause.
Your Uterus and You.
Your Uterus Before Menopause. Your Uterus After Menopause. Your Cervix, Fallopian Tubes, and Ovaries.
Why Your Doctor Might Recommend Hysterectomy.
Cancer and Other Tumors. Fibroids. Endometriosis.
“As Long as We're in There…”
What Really Needs to Come Out? Tubes and Ovaries. Why Remove Your Appendix?
Understanding the Risks.
Informed Consent. Getting a Second Opinion.
Hysterectomy: The Procedure Options.
Abdominal Hysterectomy. Vaginal Hysterectomy. Laparoscopically Assisted Vaginal Hysterectomy (LAVH).
Preparing Your Body and Your Mind for Surgery.
What Happens Before Surgery. What to Expect After Surgery. When Will You Be Back to Normal? Surgical or Induced Menopause. Potential Complications.
Alternatives to Hysterectomy.
Watchful Waiting. Natural and Complementary Therapies. HRT and Other Medical Approaches.
8. Early Menopause.
What Is Early Menopause? Why Does Early Menopause Happen?
Surgery. Premature Ovarian Failure. Autoimmune Disorders. Polycystic Ovary Syndrome (PCOS). A Family Affair. Cancer Treatment. Smoking: Guaranteed Early Menopause. Stress-Induced Temporary Menopause.
Navigating an Early Passage.
Coping with the Emotions. Facing the End of Your Childbearing Years. Age: The Clash of Biology and Chronology.
Should You Attempt to Delay Early Menopause?
III. CH-CH-CHANGES: MENOPAUSE SYMPTOMS.
9. Hormones for Healthy Menopause.
Condition or Transition: Taking a Point of View on Menopause.
Condition: Menopause Is About Hormonal Imbalances. Transition: Menopause Is About Hormonal Shifts.
What's Your Hormone Quotient? A Self-Quiz. Endocrinology 101: A Quick Review.
Stress and Menopause. Healthy Amounts of Cortisol and DHEA. Estrogen, Progesterone, and FSH.
Are Balanced Hormones the Solution to Menopause?
How Hormonal Balance Can Relieve Menopause Signs. How Hormonal Balance Can Exacerbate Menopause Signs.
Finding Your Balance Between Condition and Transition.
10. A Shift from Left Brain to Right Brain.
How Your Brain Thinks.
Your Analytical Left Brain. Your Creative Right Brain. Are Women Right More Often Than Men?
Left or Right, What's Your Style? A Self-Quiz. Estrogen and Short-Term Memory.
Memory Challenges During Menopause. Estrogen, Memory Loss, and Alzheimer's Disease. HRT and Memory Improvement.
Thinking Outside the Box: Nonlinear Thought.
Whole Brain Thinking. Ambiguity and “Fuzzy” Thinking.
Learning to Trust Your Wise Woman Hunches. Tuning In to Your Wise Woman Senses.
11. Take a Ride on the Wild Side: Mood Swings.
I Love You So Much…Go Away and Leave Me Alone!
The Roller Coaster of Your Emotions. Coping with the Extremes. How to Know When You Need Help.
Are Your Slowing Hormones Dragging You Down?
The Season of SADness. More Than the Blues: Depression.
Keeping a Handle on Stress.
Calling Timeout. Lean on Your Support Network. Lighten Your Load.
Natural Ways to Reduce Stress.
The Power of Exercise. Easing Your Cluttered Mind: Meditation. A 10-Minute Meditation Exercise.
There's a Light at the End of the Tunnel, and It's Not a Train.
12. Hot Flashes, Thinning Hair, and What's Happening Down There.
Who Turned Up the Heat?
Coping with Hot Flashes. Medical Treatments. Natural Remedies.
Bring on the Flannel and the Blankets!
When Hot Flashes Turn to Chills. Medical Treatments. Natural Remedies.
Sleepless in Midlife. AUB, DUB: When Is the Bleeding Too Much?
Could It Be Cancer? Narrowing the Possibilities. Choosing Appropriate Treatments. Living with DUB.
What's Happening to Your Body?
What Your Hairdresser Won't Tell You. Vaginal Dryness and Itching.
Making Peace with Your Changing Body.
13. Sexuality, Those 10 Extra Pounds, and Menopause.
Losin' That Lovin' Feeling.
Androgens and Sex Drive. Other Hormonal Influences. Viagra for Women? Beyond Hormones.
What Used to Be Fun Isn't Anymore.
Sex and Your Body's Changes. Sex After Hysterectomy. If Sex Becomes Uncomfortable or Painful. Adapting Can Be Fun.
When the Scale Betrays You.
Is Weight Gain Inevitable? Metabolic Changes. Healthy Eating to Support the New You.
A Self-Quiz: Where's the Fat? Staying Connected with Your Partner During Menopause.
Understanding and Expressing Your Needs. Maintaining Reasonable Expectations.
Keeping a Healthy Perspective and Positive Self-Image.
IV. HRT OR NO HRT, THAT IS THE QUESTION.
14. What Is Hormone Replacement Therapy (HRT)?
OHT, HRT, ERT… Arrhhh!
The Benefits of Taking HRT. The Risks of Taking HRT.
The Kinds of Hormone Replacement Therapy.
Estrogen Replacement. Combined Estrogen-Progesterone Replacement. Androgen Replacement. If You've Had a Hysterectomy.
If Menopause Is So Natural, Why Replace Hormones?
Is HRT as Good as the Real Thing? Challenges of Replacing Estrogen.
HRT and Heart Health.
How Estrogen Affects Cholesterol Levels. Your Heart Health: A Self-Quiz. HRT and Heart Disease.
How Estrogen Affects Your Cancer Risks. Is HRT Good for Your Bones?
Osteoporosis, Estrogen, and Your Bones. Your Osteoporosis Risk: A Self-Quiz. Your Bone Health Without HRT.
15. Taking HRT: What's Your Preference?
What Does It Mean to Take HRT? Does HRT Reverse Menopause? All About Estrogen.
Synthetic Estrogens. Natural Estrogens. Animal-Based Conjugated Estrogens. Plant-Based Conjugated Estrogens. Designer Estrogens.
All About Progesterone.
Continuous Progesterone Replacement. Sequential Progesterone Replacement. Pulsed (On/Off) Progesterone Replacement.
What Form and Dose of HRT Is Right for You?
By Mouth: Pills. By Skin: Transdermal Patches. Intravaginally: Vaginal Suppositories and Creams. By Needle: Intramuscular Injection.
Is HRT for Life?
Changing Your Form of HRT. Stopping HRT.
Androgen Therapy. Do You Need Testosterone? The Testosterone Patch. Birth Control Pills: An HRT Alternative?
16. Making Your Own Decision About HRT.
An Individual Matter.
What's Right for Someone Else… Can We Talk? Having a Heart-to-Heart with Your GYN.
Weighing the Benefits and Risks of HRT.
Characterizing Your Menopause Experience. Looking at Your Risk Factors. What HRT Can and Cannot Do for You.
What HRT Option Is Best for You? A Self-Assessment. Giving Yourself What You Need.
High-Tech Medicine for the All-Natural Lifestyle. Perfecting Your Menopause Balance.
V. MENOPAUSE TREATMENT AU NATUREL.
17. Taking the Integrative Approach to Menopause.
What Is Integrative Medicine?
The Western Standard: Allopathic Medicine. Natural Traditions in Healing and Healthcare. Blending Allopathic and Natural Traditions. Why Take an Integrative Approach to Menopause? The Revolution in Mind-Body Healthcare.
Getting Integrative Care for Menopause.
Start with Your GYN. Other Healthcare Professionals Who Can Help. What About Psychologists? Building Your Menopause Care Team.
When Insurance Will and Won't Pay. Menopause Management: It's Your Life, and You're in Charge!
18. Turning to Nature for Hormone Support.
When Are Hormones Natural?
The Difference Between HRT and Natural Hormone Support. Discussing Natural Hormone Support with Your Doctor.
Phytoestrogens: Estrogens from Plant Sources.
Isoflavones. Lignans. Coumestans. Resorcyclic Acid Lactones.
The Safe Way to Use Natural Hormone Support.
Identifying What You Need. Knowing What You're Getting. Choosing an Herbalist. Foods or Supplements? Potential Complications and Interactions.
What If You Don't Take Any Hormones?
19. Soy, Herbs, and Other Botanicals: Nature's Menopause Miracles.
Is It True, No Hot Flashes with Soy?
Estrogen Receptors: Completing the Connection. Soy Isoflavones. The Myriad of Soy Benefits for Your General Health.
How to Get Soy in Your Diet—and Like It. Other Sources for Phytoestrogens.
Not Just for Rabbits: Red Clover. Peas, Lentils, and Other Legumes.
Traditional Chinese Herbs.
Dong Quai (Angelica). Ginseng (Panax). Motherwort.
Other Helping Herbs and Botanicals.
Black Cohosh. Chasteberry (Vitex). Damiana. Dandelion Root. Evening Primrose Oil. Sage.
Chamomile. Gingko Biloba. Kava. St. John's Wort (Hypericum). Valerian. Wild Yam: Natural Progesterone?
Giving Natural Remedies the Respect They Deserve.
20. Nutrition: Eating Your Way Through a Healthy Menopause.
Are You Eating Right for a Healthy Menopause?
What and How Much Do You Eat? A Self-Quiz. Poor Nutrition and (Over)Weight. How Much Should You Weigh? Meeting Your Nutritional Needs Through the Foods You Eat.
Here a Diet, There a Diet, Everywhere You Look a Diet.
The Good, the Bad… the Diets. Healthy Weight Control: Forget Deprivation and Get Off the Scale! The Curse of the Extra 10 (or So) Pounds.
Cultivating Healthy Eating Habits.
Whole or Refined: Does It Matter? Stay Close to the Source. Healthy Portions. Troublesome Favorites: Caffeine, Cola, and Chocolate.
Foods for a Healthy Menopause.
Back to Soy. Flaxseed Oil, Fish, and Omega-3.
Vitamins and Minerals for Menopause.
Vitamin C and Citrus Bioflavonoids. Calcium and Vitamin D. Beta Carotene and Vitamin A.
Get Moving: The Role of Exercise.
21. Acupuncture, Biofeedback, Massage, and More.
Integrating Alternatives into Menopause Care.
Learning What's Available During Menopause. Are Complementary Therapies Right for You?
Acupuncture: Ancient Tradition, Modern Therapy.
Body, Mind, and Spirit Unified. Meridians: The Highways of Your Body's Energy Network. Unblocking the Flow. Painless Needles (Really!). Westernized Acupuncture: Tradition Meets Technology. Choosing a Qualified Acupuncturist.
Biofeedback: Sending Messages to Yourself. The Healing Power of Human Touch.
Hands-On Healing: The Wide World of Massage. Hands-Off Healing: Reiki.
Chiropractic: Removing Spinal Energy Blockages. More Alternative Techniques to Try.
Therapeutic Relaxation Methods. Visualization.
VI. SELF-CARE WHILE YOU'RE GOING THROUGH MENOPAUSE.
22. This Is Not Your Mother's Menopause.
The Silent Passage Is Not So Silent Anymore.
From Support Groups to Cyber Chats and Beyond. Sharing What You Know. Journaling: Keeping Your Dream Book.
Our Mothers, Ourselves?
Joining a Club That Has Your Mother as a Member. Admission to the Wise Woman Club Is Freeing.
A Notion of Perfection.
Perfect Bodies, Perfect Minds, Perfect Lives. Even Martha Stewart Can't Escape Menopause. Craft and Artistry of the Ingenious Wise Woman.
For Now, the Inner Revolution.
Gloria Steinem, Are You Listening? Mirror, Mirror… Loving What It Means to Be You.
23. Well-Meaning Family, Friends, and Co-Workers.
When You Feel Like Yourself… But You Don't. All in the Family.
Of Menopause and Men. Of Menopause and Being a Mother. Of Menopause and Being a Grandmother. Amazon, Without the Dot.Com: Life Child-Free.
Menopause and the Working Woman.
Seasoned Executive Material or Over the Hill? Coping Strategies for the Workplace. Rebirthing Your Career: Creating Your Own Opportunities.
Friends Forever. Can I Help You with Those Groceries, Ma'am?
VII. VIBRANT, FEMININE, WISE, AND WONDERFUL.
24. Channeling the Energy Power of Menopause.
Your Body as a Map of the Universe.
Ancient Energy Systems for Vitality and Health. East Meets West: Chakras and Your Spine.
Synchronizing Chakra Energy During Menopause.
Kundalini Energy: Awakening Your Subtle Body. Base Support: Energizing the Root Chakra.
Yoga to Strengthen, Lengthen, and Revitalize. Meditate and Relax… Yes, You! Finding Your Place in the Universe.
Menopause Mandalas. Walking the Labyrinth: Purposeful Patterns.
Tapping Ovarian Wisdom.
The Energy of Life: Ovarian Chi. Ovarian Energy and the New, Creative You.
25. Exercise: Menopause Magic.
How to Live to Be a Healthy 100: Exercise. Exercise and the Human Life Span. Whatever You Do, Keep Moving.
Fitness Level? What Fitness Level?
Exercise and You: A Self-Quiz. Getting Started When You've Never Exercised. Ask Your Doctor First. Tracking Your Progress.
Movin' and Menopause.
Special Benefits of Exercise During Perimenopause. Special Benefits of Exercise During Menopause. Special Benefits of Exercise After Menopause.
Fly Like a Butterfly, Sting Like a Bee.
Use It or Lose It. The Late Bloom Lasts Longest.
26. Staying Healthy After Menopause: Outer Changes.
The Female Body-Mind After Menopause.
What's Happening Inside Your Body. Calm After the Emotional Storm.
Routine GYN Care After Menopause. Pelvic Exams and Pap Tests.
Uterus Redux. Cervical Cancer. Ovarian Cysts and Cancer Risks.
Nurturing Breast Health.
How to Do a Breast Self-Exam (BSE). If You Find a Lump in Your Breast. What Does a Mammogram Tell You? Should You Have Screening Mammograms? Breast Cancer Risks. HRT and Breast Cancer. What You Can Do to Help Keep Your Breasts Healthy.
Creating Healthy Self-Care Habits.
27. Staying Healthy After Menopause: Inner Changes.
Building Strength for Maturity.
Osteoporosis: Preventing Brittle Bones. Bone Density Testing. Calcium In, Calcium Out. Gaining Strength Through Weight-Bearing Exercise. Treatments from the Pharmacy. Therapies from Nature. Bone Density and Breast Cancer.
The Heart of the Matter.
Why Your Risk for Heart Disease Increases. HRT and Heart Disease: The HERS Study. Red Alert: Warning Signs of Heart Trouble. What You Can Do to Keep Your Heart Healthy.
Keep This in Mind.
Staying Mentally Alert. HRT and Alzheimer's Disease. The Wise Woman's Wisdom.
The Heart and Soul of a Healthy Body-Mind.
Appendix A. Glossary.
Appendix B. Resources.
Appendix C. Hormones at a Glance.