In The Pines: More muddling through mid-life & menopause

Thanks, y’all, for the feedback on my last column, a light ‘n’ snarky one about women’s mid-life changes. People seemed especially pleased that I encouraged men to read. Keep reading, folks of all genders!

I mentioned an upcoming talk at the library. I went, despite the grim weather, and enjoyed open, nonjudgmental conversation with local ladies of various ages.

At the podium stood doctors Erin LeGrand and Sarah Hellmann, both OB/GYNs with St. Charles Medical Group. OB/GYNs are doctors specializing in obstetrics and gynecology. They’re knowledgeable about (say it out loud, c’mon, you can do it!) vaginas and vulvas, pregnancies and pelvises, menstruation and menopause.

If they’re up on the latest research, if they listen closely to women, OBs can help us navigate the wild waves of mid-life and onward, when hormones go off the rails. It ain’t just hot flashes; a whole mess of physical, emotional, mood, and sleep disruptions may result.

Hellmann and LeGrand projected slides helping participants understand perimenopause, menopause, symptoms, and possibilities for treatment.

Perimenopause, they said, doesn’t include the years of crazy and night sweats and pain so many of us experience leading up to menopause. Nope. Officially, peri is merely the phase where the bleeding patterns and menstruation change.

Those other lead-up years don’t have a name yet. The Menopause Society is working on the nomenclature, millennia after women started experiencing this.

Both doctors were frustrated by how slow science and medicine have been to study women at all, much less issues that solely affect women—not just how we provide babies and sex, but the totality of our bodies, life phases, and wellness.

To top it off, the most high-profile research has been proven incorrect. Studies from 25 years ago scared women and doctors away from prescribed hormones; turns out the research was inadequate.

Hormone therapies (HRT, MRT, etc.) present low risks for the general population, according to Hellmann and LeGrand. Outcomes in some areas, however, improved with taking hormones.

Not to mention reducing the obnoxious and life-altering symptoms of what my grandmother’s generation called “The Change,” if they dared mention it at all.

How obnoxious? How life-altering? See my last column for a litany of horrific details.

This is America, where worthiness is measured in GDP. So let’s frame it in terms we can all understand:

“Based on workdays missed due to menopause symptoms,” researchers at the Mayo Clinic concluded in 2023, “we estimate an annual loss of $1.8 billion in the United States.”

Nearly two billion bucks! You could buy a yacht bigger than Jeff Bezos’ for that! And host a menopause getaway on it, with music and excellent food and a salt pool, and invite pre-perimenopausal small-town newspaper columnists to come along, hint hint.

LeGrand and Hellman laid things out in a straightforward and sometimes humorous manner, extolling the virtues of weight training and vaginal estradiol cream.

A participant asked, “How do you apply it?” LeGrand matter-of-factly mimed swiping cream onto her finger, and, you know, pushing it up there.

Hosts of the podcast “Wine With Your Gyn,” these two are comfortable moving past society’s juvenile squeamishness and unwillingness to talk about these issues honestly and publicly.

Some women mistrust Big Med and Big Science,** so I asked naturopathic doctor (ND) — Tracy Erfling to weigh in. Tracy, a friend of our family, will be opening a specialty clinic in Sisters focusing on menopause and its associated transitions.

“There is much we can do to alleviate the seeming chaos our hormones are putting our body through,” Tracy told me.

At the philosophical core of naturopathic medicine, she explained, lies “wholistic care” — holistic with a W. Practitioners like Tracy are “trained to assess the whole person with all their unique strengths and challenges.”

Specialist NDs study the science, prescribe conventional hormones and compounded bio-identical hormones, but also work with botanical and nutritional therapies.

“Menopause is by definition a time of change,” Tracy said. “Naturopaths have so many tools in our toolbox to pivot as needed when changes occur.”

So hoorah! People are finally talking about this stuff. Jump in with podcasts like “Wine with your Gyn” and the hilarious, raunchy “Circling the Drain.” Join menopause groups on Reddit, LinkedIn, Facebook.

Even consider asking women in your real life—friends, moms, sisters, probably not co-workers—about their own experiences. Some may blush. But sheesh! We need more information, more stories, and more options.

Let’s de-stigmatize women’s natural mid-life changes. Let’s try out these hormones and herbs. In a medical system that long ignored us, let’s share information and demand better research and more treatments.

* For purposes of flow—pun intended, har har—in this column the word “woman” and its lightly facetious cousins “gals” and “ladies” are meant to encompass everyone who possesses or previously possessed the organs that lead to The Change, regardless of gender identity.

** Contest: which brilliant post-menopausal artist am I double-entendre’ing here? First correct answer emailed to [email protected] wins a free coffee at one of our fine local establishments.