You may be lucky enough to have a good doctor—one who takes menopause seriously, respects that your feelings and the symptoms going on in your body are real, and cares enough to listen and try to help you feel better.
Or, you may not. Sadly, when it comes to menopause, many doctors have outdated information and perceptions, or they simply don't have the time for the careful diagnosis and trial-and-error process it takes to treat menopause symptoms accurately and safely.
So, chances are, when it comes to navigating the inhospitable terrain of menopause, you'll be largely on your own. That means you need to familiarize yourself with how this enormous change of life actually happens, and what to expect. We talked to a range of women going through menopause, and here's what we learned about what to do to make it through healthy and happy.
Problem: Your doctor won't take your menopause symptoms seriously
Has either of these happened to you?
- Your doctor listens to your list of symptoms, says it sounds like PMS or "period moodiness," and offers you a prescription for an antidepressant.
- Your doctor listens to your list of symptoms, says the only approach is hormone replacement, and offers you a prescription for hormone replacement therapy (HRT).
If so, it's a red flag that your doctor isn't doing all he or she should to help you.
Solution: You're going to have to push harder to get quality help from your doctor. Don't get us wrong: Both antidepressants and hormones are reasonable approaches to some menopause-related problems. But neither should be an automatic first-line solution, and neither should be given without making sure they're the right approach.
So before you zip over to the drugstore with a prescription, make sure you and your doctor have had a thorough discussion about your symptoms, the best dosage, and what you can expect the drug to accomplish, as well as a full rundown of the side effects and risks. And if you find you consistently leave your doctor's office feeling that no one really listened to you, or that you don't know what to do next to feel better, it's time to get a new doctor. Really.
Problem: You're not sure if you're in menopause
Menopause itself isn't medically diagnosed until you've gone one year without having a period. So the phrase in menopause is sort of useless, because it's the period leading up to that, called perimenopause, when most women experience the really crazy physical and emotional changes. And the years afterward, when hormone production has pretty much shut down, bring their own health issues and problems.
Solution: Start by looking closely at your own symptoms. Don't be too certain that being a particular age automatically means you're in menopause: Perimenopause/menopause can start when you're in your late 20s—usually induced by a medical condition, but not always—or as late as the late 50s. But the majority of women start to notice a series of incremental changes and symptoms, increasing in severity, between ages 40 and 50.
If your periods are changing, you're becoming uncharacteristically moody, and you're starting to have night sweats or hot flashes, then you're probably in perimenopause. Notice we say changing, not stopping. This is where some of the greatest confusion lies. Your periods might actually become heavier or occur closer together. They might be the same but you might notice more bloating, moodiness, and new symptoms, such as breast pain or a flu-like achiness. You might have spotting between periods or skip periods altogether, like you did when you were a teenager. In fact, some experts counsel us to think of menopause as a second adolescence—it's that big a life change.
If you're like most women, though, you can skip the only actual diagnostic tool available, a menopause blood test. It's unlikely to tell you much. The test is quite reliable for women who have gone at least a year without a period and for women experiencing premature ovarian failure (a medical disorder), but it's basically useless for women in the midst of perimenopause. The test measures hormone levels, but during perimenopause the hormone levels fluctuate wildly. The blood test only checks where your body is on a particular day, and it could show something completely different a week or even a day later.
So when your doctor says your hormone levels are fine, take that with five grains of salt. Better yet, don't even have the blood test. Common sense tells you that if you're between 35 and 55; your periods are getting squirrely; you're constantly adding and removing layers; and you find yourself inexplicably cranky, weepy, and just plain mean, you're almost certainly menopausal. Then go with that and get help.