Seven things we start to lose around menopause that we *can* do something about (but you have to act early)
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The menopausal transition brings many physical and psychological changes; some good, some not so good.
After decades of helping menopausal women, I’ve learned a few things that are critical for women’s future health and wellbeing that need to be addressed early at midlife. The things that bother my patients the most can be quite different, however!
This list is dedicated to World Menopause Day, on 18 October. It includes some things that I (as a doctor) am most concerned about for a woman’s future functioning, plus some of things that women complain about the most.
Collaborations with my fantastic health colleagues about these issues inspired us to present the Menopause Uncensored online summit on 16-23 October, to inform people about these — and many other — hot topics of peri and menopause.
BONE & MUSCLE MASS
Women can lose 15 to 20% of their bone density in the first five years after menopause. Now this doesn’t necessarily correlate with their fracture risk, but it’s important to know that 25% of women who have a major hip fracture after the age of 50 will die in the following 12 months… scary!
Strong women are functional, independent women who have a reduced risk of falls and fractures. They can keep doing the activities that are meaningful to them for longer. They remain more socially connected and have better mental health. Strength training from midlife is absolutely non-negotiable!
Muscle and bone loss are highly preventable with the right nutrition, and activities which include strength, balance and some impact (notice I didn’t even mention medication here?). We are privileged to have the expertise of Exercise Physiologist Kirra Rankin (of Capital Hydrotherapy) and Dietician Eleni Georgiou (Tree of life Nutrition) who will speak at the Summit on Monday 23 October.
MOOD
A lot of women complain of “losing their sh*t” in perimenopause, and this is just the tip of the iceberg. Depression and suicide rates peak for women in the 45-55 year old age bracket. If mood changes are impacting on your functioning, relationships and quality of life then you absolutely must seek help ASAP. If hormonal changes are responsible you may still have many years to endure!
Summit Psychiatrist Prof Jayashri Kulkarni AM knows all too well that sometimes hormonal treatment is required for perimenopausal depression rather than antidepressants, which she will speak about in her Summit presentation on Thursday 19 October. Menopause and workplace coach Thea O’Connor will also discuss ‘Menopausal Mindset’ on Monday 23 October.
VULVO-VAGINAL TISSUES
Many peri-menopausal symptoms improve after menopause, but this is one area that just gets worse over time. The tissues become thinner, drier and more easily damaged, which might cause sexual pain. The inner labia start to shrink and can eventually disappear altogether. If these changes are bothering you then DON’T put up with them.
This needs to be treated sooner rather than later. A pelvic floor physiotherapist or women’s health practioner is a great place to start. The right kind of vaginal moisturisers, lubricants and perhaps vaginal estrogens (which can be used even if you’ve had breast cancer) can be incredibly effective at warding off these changes and improving quality of life.
Dr Talat Uppal, gynaecologist and Founder of Women’s Health Road will be speaking about common gynaecological issues in the menopausal transition on Monday 16 October.
HAIR
I don’t think I’ve met a single menopausal woman who hasn’t noticed this (myself included). Even as a GP I haven’t been confident about how to manage it, but thankfully my wonderful colleagues, GP Dr Ginni Mansberg (Founder of Evidence Skincare) and Dermatologist Dr Deepani Rathnayake (Renaissance Dermatology) have enlightened me. There are actually many effective treatment options, some of which are available over the counter.
Loss of hair follicles and thinning of hair shafts does get worse over time, so this is another ‘act early’ area. It can be difficult to work out what’s normal ‘female pattern’ hair loss versus a different kind of medical condition. Expert help may be needed, but there are self-help options too. ‘Skin and hair changes around menopause’ will be presented at the Summit on Monday 16 October.
LIBIDO
Almost 70 per cent of Australian women aged 40-65 reported a lack of sexual desire in a recent study published in the Journal of Sexual Medicine. This is usually due to a combination of physical and psychosocial factors: busy lives, hormonal changes, relationship tension, vaginal dryness, pain or a history of sexual trauma, just to name a few.
Women can take a proactive approach to manage this situation and have fulfilling sex lives. Esteemed sexologist Dr Margaret Redelman OAM has loads of great advice for midlife women and couples to help bring playfulness back into the bedroom. She will be speaking at the Summit on Thursday 19 October, and also helped create our very enlightening ‘bonus content’ guide to sex toys for beginners.
RELATIONSHIPS
Relationships can look very different at midlife. We are older, carry a lot of emotional baggage, maybe re-partnering or have been with our partner for a long time. A multitude of factors can contribute to disillusionment and loneliness within relationships.
Psychologist Todd Zemek creator of the Love Smarter podcast, has plenty of strategies to help couples get communicating again, which he will share at the Summit on Thursday 19 October. Relationship issues can fester over time and become irretrievable, so this is definitely another area where early intervention can prevent a lot of future pain.
WAISTLINE
BMI is not a great assessment tool, and “eat less, move more” just doesn’t work. We know that a woman’s body shape changes from midlife, and that fat accumulates around the waist and organs; this is a risk factor for diabetes and cardiovascular disease, which kills around 1/3 of Australian women. Early action is best, as reversing the weight gain and keeping it off just gets harder and harder as we age.
Many things can work to manage this issue, but it requires an individualised approach. Sydney GP Dr Angela Kwong recognized this and founded Upliftmed to deliver holistic weight loss plans by Telehealth. Angela will be sharing her wisdom at the third and final “Menopause Uncensored online Summit session on Monday 23 October.
Menopause Uncensored features the health professionals mentioned above, plus bonus content, giveaways and SO much more on 16, 19 and 23 October from 7.30 – 9.30 pm AEDST.
Registrants also receive unlimited access to recordings. Details and registrations: hello.wellfemme.com.au/menopause-uncensored-online-summit
UNDERSTANDING MENOPAUSE, SKIN & HAIR CHANGES, GYNAECOLOGICAL CHANGES & WORKPLACE
Session 1, Monday 16 October
- Dr Kelly Teagle from WellFemme
- Dr Talat Uppal from Women’s Health Road
- Dr Ginni Mansberg from Don’t Sweat It and Evidence Skincare
EXPLORE MENTAL HEALTH, RELATIONSHIPS & SEX DURING THE MENOPAUSAL TRANSITION
Session 2, Thursday 19 October
- Prof Jayashari Kulkarni AM from Monash University
- Todd Zemek, Clinical Psychologist
- Dr Margaret Redelman OAM, Sexologist
WEIGHT MANAGEMENT, EXERCISE AND NUTRITION
Session 3, Monday 23 October
- Dr Angela Kwong from UpliftMed
- Eleni Georgiou from Tree of Life Nutrition
- Thea O’Connor from Menopause at Work
- Kirra Rankin from Capital Hydrotherapy
