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Here today, gone tomorrow. It’s an expression that applies to many things.
Fashion trends are definitely here today and gone tomorrow. So are fads, like big hair, piercing, and favorite songs. Even figures of speech come and go. When was the last time you heard someone say, “Groovy!” What about, “Well, I never!” (I always picture an older, refined woman saying that one.)
Have you noticed that things that aren’t political sometimes seem political? You know, when people feel they have to take a side, label themselves this or that, and confine their opinions and choices to what’s consistent for their side?
Opinions about abortion are political … even though abortion itself is really more personal and medical than political.
Opinions about global warming are political … even though geologic effects of climate and ecology are more scientific than political.
Opinions on your health care are political … even though your employer, insurance company, and government are less qualified than you are to decide what’s best for you.
And on and on.
The point is that we tend to take sides and politicize things that really aren’t political.
How you manage your menopause is not political. Despite the fact that there tend to be “two camps” of thought, you don’t have to take a side.
Three’s the “Traditional Medical Camp” which promotes pharmaceutical hormone replacement. People in this camp focus on estrogen, and believe you should replace your estrogen when your ovaries stop producing it at the time of menopause. They don’t “believe in” herbs, acupuncture, hypnosis, or diet for managing menopause. And if you request anything other than pharmaceutical management options, a person entrenched in the Traditional Medical Camp will scoff and dismiss your request. They’re loyal to the Traditional Medical way of doing things.
And then there’s the “Alternative and Complementary Camp,” which promotes non-pharmaceutical options and denounces hormone replacement. People in this camp focus on progesterone, and believe progesterone is the solution for all your menopausal woes. They instill fear of estrogen to persuade you to use progesterone instead of estrogen. And if you request hormone replacement, a person entrenched in the Alternative and Complementary Camp will shame you for failing to remain loyal to the “natural” way of doing things. They’re patriots of Alternative and Complementary Medicine.
As with politics, every person in either camp is absolutely certain that their way is the best way. They’re sure that they’re right and everyone else is wrong.
Fortunately, your menopause management doesn’t have to fall into one camp or the other. You don’t have to choose sides. You can sample offerings from both camps, form your own opinions, and construct your own management technique.
Think of all the options in both camps a one big smorgasbord.
There’s no need to label one camp good and the other bad. Or one right and the other wrong. There’s no need to take a side.
Wouldn’t it be great if un-politicizing other things were this easy?
You know how you have to swear to tell the truth, the whole truth, and nothing but the truth … so help you God, in a court of law? Well, I don’t think that should be confined to just the courts. I think it should be a requirement for a lot of things, including public announcements about research findings.
Don’t you feel like you get conflicting information every time you hear a report about a research study? One report says Vitamin E is good for you; another says, maybe not. One day, two glasses of red wine prevent disease; the next day they don’t. One guideline tells you to get a mammogram every year; another says every two years.
How in the world are you supposed to know what’s true when you hear non-truths, half-truths, and everything but the truth?
Wouldn’t it be so much better if all research reporting required that you get the truth, the whole truth, and nothing but the truth?
One particular study really brings this other-than-the-truth phenomenon to light. It’s the Women’s Health Initiative (WHI), which came out in 2002.
Before 2002, women routinely took hormone replacement therapy (HRT) when they began experiencing the symptoms of menopause at about age 51. Most women would continue taking the hormones for the next ten years, or even indefinitely. The belief at the time was that hormone replacement therapy for menopause replaced a deficiency in female hormones. A “deficiency” is absence of anything the body needs to function normally.
Just as insulin deficiency (diabetes) requires insulin replacement, and thyroid hormone deficiency (hypothyroidism) requires thyroid hormone replacement, estrogen deficiency at the time of menopause was viewed as a deficiency state that warrants replacement therapy.
Now, if you have a deficiency state and don’t replace the missing substance, what happens?
You experience a list of about 20 symptoms that make you feel awful. And, eventually, your body breaks down because it lacks something it needed to function properly.
Previous research had shown that, without hormone replacement, women had higher rates of blood clots, stroke, heart attack, breast cancer, osteoporosis, and Alzheimer’s Disease.
So, the WHI set out to discover if taking hormone replacement therapy could prevent these diseases. Now this is a far cry different from using hormone replacement therapy to alleviate the symptoms of menopause … with the added benefit of decreasing your risk for these diseases.
Using hormone replacement therapy to directly, specifically, and primarily prevent these diseases is a whole different story! In other words, that’s using it to do something entirely different from its intended purpose. But, of course, explaining that would constitute telling you the whole truth.
Well, you didn’t hear the whole truth about the purpose of the study. You only heard half the truth.
And that’s not all.
The media report to the public on the results of the study weren’t exactly the truth, either.
Here’s what you heard: Hormone replacement for menopause carries more risks than benefits. For example, in the WHI study, it increased the risk of blood clots 100%. It also increased the risk for strokes, heart attack, and breast cancer.
Before I tell you the truth, the whole truth, and nothing but the truth, let me tell you what happened when women heard that media report: They all flushed their hormones down the toilet. They became terrified of taking hormones. Consequently, doctors, seeing the public’s fearful reaction, became unwilling to prescribe hormones. They were concerned about the possibility of litigation that might ensue if a woman developed any of these diseases.
So, in the blink of a single media report about a single research study, women went from taking hormone replacement therapy as a benefit … to condemning hormone replacement therapy as a curse.
Hormone replacement went from being the fountain of youth to being the kiss of death.
So, I ask you: Which is it? What’s the truth? How did something that had been so standard and beneficial become so offensive and risky, just because of one research study?
Here’s how: You heard the non-truth, the half-truth, and everything but the truth.
So, what is the truth?
Non-truths and half-truths take many forms. One form is to make a statement that is essentially “true,” but presented in such a way that makes it sound much more devastating than it really is.
Let’s take one single statement that was included in the WHI media report and reveal all the facts:
The media report stated that “Hormone replacement therapy for menopause increased the risk of blood clots 100% in the study subjects.” In other words, the risk of a blood clot increased 100%.
So, what does a “100% increased risk” mean to you?
Does it mean that 100% of the women who took hormones had a blood clot?
Does it mean that the risk of a blood clot increased 100%?
Does it mean that women who took hormones had a blood clot 100% of the time?
Hmmmm? Makes you think, doesn’t it?
Well, if the media report had given you the truth, the whole truth, and nothing but the truth, you wouldn’t be wondering what “100% increased risk” meant. You’d know!
So, now I’ll reveal the truth.
The WHI study examined 10,000 women. That’s a lot of women!
The average age of those women was 63. Hey, that’s a whole lot older than the typical woman who takes hormone replacement therapy for the symptoms of menopause! They’re normally only around 51. And, hey, older women have more blood clots, anyway.
But here’s the shocking part of the truth:
Without hormone replacement therapy, 8 women (out of 10,000) had a blood clot.
And, now for the punchline:
With hormone replacement therapy, 16 women (out of 10,000) had a blood clot!
So, the “100% increased risk” meant that instead of 8 women having a blood clot, 16 women had a blood clot … out of 10,000.
But, of course, no one bothered to tell you that. All you heard was “The risk of a blood clots increased 100%.”
Does “16 women out of 10,00 had a blood clot instead of 8” sound as devastating and drastic as “The risk of a blood clot increased 100%”?
Surprised?
Or maybe you’re a little angry.
If so, you have every right to be. You got the non-truth, the half-truth, and everything but the truth. That’s not fair.
If only you’d heard the truth, the whole truth, and nothing but the truth, you would have had the opportunity to evaluate the significance of that study fairly. And I’ll bet a lot fewer women would have flushed their hormones down the toilet.
Puberty!
Wasn’t it just wonderful? There were so many changes occurring all at the same time.
Remember your first period? Did you think, “Oh God! Am I going to have to put up with this mess for the rest of my life?” Wasn’t it inconvenient to have to have pads or tampons on hand all the time? And didn’t your periods interfere with your fun at times?
Oh, and let’s not forget the acne that mortified you every time you needed to look your best.
What about hair growth. Suddenly, you had to constantly groom the hair on your legs, in your armpits, and in your crotch. The upkeep never seemed to end.
Of course, there were also the interesting emotional changes: mood swings, irritability, even depression. Do you remember thinking that no one understood you?
And what did puberty do for your interpersonal relationships, especially with your parents? Did they think your puberty was a breeze? I’ll be that some aspects of your puberty were worse for them than they were for you!
Don’t you sometimes look back on all the chaos your puberty created and wonder how you and your family ever got through it?
Well, I know the answer. You all got through it because your parents knew what puberty was ahead of time. They were prepared for it. They were patient with it. And, despite the fact that you thought no one understood you, they probably understood you better than you understood yourself.
Even if you were clueless and clumsy, your parents stayed the course. Not only that. All of society knew how to recognize puberty and give you a little slack. There was a collective consciousness that paved the way for you and made it as easy for you as possible. Everyone talked about puberty. People shared experiences about puberty. There were special services and community events that targeted puberty.
Can you imagine what your puberty would have been like if nary a sole had known what puberty entailed?
What would have happened if your parents hadn’t understood? What if they had no clue about puberty? How do you think things would have turned out?
Well fast forward to peri-menopause. Instead of being 13, you’re 50. And guess what? You’re going to experience all that awkward physical, emotional, and social chaos all over again!
And that’s because menopause is puberty in reverse.
When you think about it that way, it makes perfect sense. Puberty is the “On” switch to your reproductive life. Menopause is the “Off” switch. It’s all the same stuff at opposite ends of the reproductive portion of your life.
Puberty is when your periods begin; menopause is when they end.
Puberty is when you begin producing estrogen; menopause is when you stop producing estrogen.
Puberty marks the time when you can start getting pregnant; menopause marks the time when you can no longer get pregnant.
Puberty is when you have a growth spurt; menopause is when you start to shrink.
Puberty and menopause are opposites in many ways. But, Mother Nature is both magical and mystical. There are many aspects of puberty and menopause that mimic one another even though they’re at opposite ends of the reproductive spectrum.
Both involve all sorts of physical changes … with your breasts, vagina, skin, hair, and weight.
Both entail similar emotional changes … with your mood, sense of calm, level of patience (or lack thereof).
Both are fraught with social conflicts … with your parents, your children, your husband.
Puberty and menopause are similar in ways that seem quite logical.
But there’s one striking difference between the two that is completely illogical: Most people are clueless about menopause! Women, men, and children are all unprepared, uneducated, and uncomfortable with menopause.
How can that be? How can puberty be so familiar and socially acceptable and menopause be so elusive and socially shunned?
It just doesn’t’ make sense.
Can you imagine how different your menopause would be if you were prepared for it, educated about it, and comfortable with it?
Wouldn’t it be wonderful if your family expected it and embraced it with the same patience and support they embraced your puberty?
How can it be that the same process, going in opposite directions, causes people to react so differently?
We need to reverse this.
Just as Mother Nature has created menopause as puberty in reverse, we need to reverse our hang-ups about menopause and embrace it as puberty’s older Sister. Not the evil older sister. Not the wicked step-sister. Just the loving, caring, nurturing older sister. Isn’t that what every pubertal girl deserves?
Women (and men) sometimes ask me if there’s a male menopause.
The answer is, “Yes.” But it goes by a different name. And it manifests in completely different ways than does female menopause.
Remember, females are the reproductive gender of our species. We’re the ones who get pregnant. Puberty is the “On” switch to our reproductive lives. And menopause is the “Off” switch.
Men go through puberty, which is also the “On” switch to their reproductive lives. But they don’t have an “Off” switch. Men can father children for the rest of their lives.
Female menopause is a fairly sudden loss of our female hormone, estrogen. At about the age of 51, it drops to essentially zero. And it’s that sudden, drastic loss of estrogen that constitutes our menopause.
The male hormone is testosterone. It’s at its very highest when a male is 18 years old. (That’s why 18-year old guys are so dangerous, and you want to keep you daughters away from them.)
Male menopause is called, “Andropause.” And, unlike female menopause, male andropause is a slow, steady decrease in the level of testosterone over time. Nothing sudden. Nothing rapid. Men just lose their testosterone little by little, year after year, for the rest of their lives. But, even if they live well past the age of 80, it never drops to zero.
Andropause manifests as some of the same bodily changes in men as menopause does in women. Men gain weight; they lose hair; they grow hair in their nose and ears; they have trouble urinating when they want to, and they dribble when they don’t want to. They even grow man boobs.
Oh, and the male genitalia actually shrinks. As it’s shrinking, a man notices that his penis just doesn’t get a stiff and hard as it used to. And he can’t help but notice that his ejaculations aren’t as forceful as they once were.
I’m convinced that it’s the physical changes in his crotch that get a man’s attention. I mean, his crotch is one of the few things in life that he notices. That’s why it’s right there, front and center. If it weren’t he might not notice it at all.
Men have emotional changes, too. They mellow. They become less aggressive. They become more sensitive. They slow down. Sometimes, at about the age of 40 or 50, the go through a “mid-life crisis,” and buy a sports car. They may even trade their menopausal wife in on a new model, marry a trophy wife, and start a second family.
Why? Because their decreasing testosterone makes them feel less virile. And, to prove to the world that they’re still the macho guys they once were, they do something to look manly.
Women don’t tend to marry younger guys to demonstrate to the world that they’re still sexy. If anything, they dump their husband and rejoice in their freedom, rarely remarrying.
So female menopause is much more dramatic in terms of symptoms, and male menopause is much more dramatic in terms of behavior.
Fair or unfair, that’s the difference between female menopause and male andropause.
Which seems “better” to you?
One of the most striking things I’ve learned about menopause is that the vast majority of women have numerous misconceptions about it. And the misconceptions are sooooooo prevalent that women pass them from one to the other. Read more
You know how the mere “sound” of a term can lead you to assume that it’s a good thing, and the mere sound of another can insinuate that it’s a bad thing? There are a lot of terms that imply positive or negative qualities simply by the way they sound.
Let’s see what you think.
Don’t you hate it when you can’t have it all? Why do we have to choose one thing or the other. And why is it that, no matter what we choose, we forfeit something else. Why does it always have to be either / or? Why can’t it be both?
Have you ever given any thought to the history of menopause? I mean, how long have women been experiencing menopause? Is it a new thing? And, if it isn’t a new thing, why are people so unfamiliar with it? Read more
Do you remember back when you were in high school and your parents told you that the choices you made then would affect you forever? You might have seen no reason to make good grades or just say “No” to drugs, or observe the speed limit. Read more
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