Goshen News, Goshen, IN

October 13, 2013

Arrival of cool, autumn air no match for hot flashes


— Ahh, Indiana autumn. Pretty, isn’t it? Glowing leaves, crispy air. Perfect season for sleeping with the windows open a couple inches, right?

So cozy under the covers …

Unless you’re me. Unless you wake up wondering what crazy person cranked the heat up — only to find no one did. But you’re sweating. A lot. What the …?

Really, this happened to me recently. I woke up awash in my own sweat. More than once!

However fast my groggy, sleep-state brain works at 4:30 a.m., I quickly assessed: No, no achy feelings. No scratchy throat. No fever. Summer is long gone, and it doesn’t sound like the furnace is running. In fact, there’s that Indiana autumn air coming through the window, remember?

And in an instant I knew: “I’m having a hot flash!” And I knew why: Because I am getting closer to menopause!

IN CASE YOU ARE NOT sure what menopause is: Menopause is a woman’s final menstrual period and is usually considered “confirmed” after 12 consecutive months of no periods when there’s no other known causes for the periods to be absent.

Many of us like the word “absent” near “period,” I know, but read on because menopause and her pals are not always about sweet goodbyes.

For a large sample of U.S. women, menopause occurs, on average, around age 51, though it can occur as early as in a woman’s 30s (considered “premature” menopause) and as late as into her 60s.

Many women experience related signs and symptoms months or years before menopause, called the “perimenopausal” time. (“Peri” means around.)

And I am pretty sure I’m peri. Perimenopausal.

After my second baby was born in 2006 — I was 34 — I picked up a book about perimenopause. I knew “the change” was probably yet a ways off, but I was curious what it was all about, figuring my childbearing years were over.

A few years later — age 38 — I was surprised to be pregnant. So I put that book away and dusted off my pregnancy books, thoughts of perimenopause gone, traded for thoughts of the maternal year.

After my “elderly” birth and early post-partum stages, I again begin to think about what’s next. (It ain’t more babies, so it must be that absence of periods.) Right, perimenopause.

But then I forgot, just forgot. I’m a busy person, for one, and my hormones are here and there — still nursing a toddler, using hormones to avoid pregnancy — so I figured, “Who knows? We’ll just see.”

SO NOW I’M SEEING, more like feeling, hot flashes. As most people know, hot flashes are a cardinal sign and symptom of menopause.

According to womenshealth.gov, women can experience perimenopausal symptoms some two years to eight years before their last period. So a woman in her early 40s is a prime candidate.

Wait, there’s more! Here’s what else we’re likely to enjoy in perimenopause: irregular periods, trouble sleeping, vaginal and/or urinary problems, mood changes, decreased libido, increased risk of osteoporosis and forgetfulness (womenshealth.gov).

Most issues tie back to those volatile chemical-like messengers — our hormones — and their constant ebb and flow. I’m convinced, sometimes, hormones really do rule the world.

But let us not despair. If menopause and her assistant, peri-, are just part of life, we have what we need to manage her. Here’s some advice culled from authorities like the American College of Nurse Midwives, the U.S. Office of Women’s Health and the North American Menopause Society:

1. Eat well. That means lots of fresh fruits and vegetables for sure, taking it easy or eliminating altogether sugar and bad fats and getting extra B vitamins, calcium and Vitamin D, usually in the form of supplements.

2. Regular moderate exercise. Of course it always comes down to this duo — diet and exercise — doesn’t it? Think of some 2-plus hours of gets-your-heart-pumping exercise a week plus exercise that focuses on muscle strength.

3. Reduce stress. I think we can consider these three the “optimal health trifecta” — diet, exercise and stress reduction. Remember moodiness? Forgetfulness? Plus the fact that menopause means a highly significant life change, the end of the childbearing years altogether? Right. Reducing stress, keeping family and friendship relationships healthy — important.

4. Stop doing stuff that’s bad for you. That would be smoking, for sure. Eliminating soda pop — sugared or diet, they’re both bad for you — is a good idea.

5. Check in about your gynecology. You can see a nurse practitioner, gynecologist or midwife — whomever knows about this stuff — and have regular screenings. Remains important even after menopause.

6. Consider other options. Most notably, hormone replacement therapy. Some care providers prescribe hormones that help alleviate some symptoms. Read up on the benefits and risks before choosing any treatment for anything, this one included. HRT has been associated with increased risk for blood clots, strokes, heart attacks and breast cancer, but, like any intervention, it can be an effective strategy for managing troublesome symptoms.

7. Have some kind of “bodywork” done regularly. This is straight from me, my opinion. Visit a chiropractor; get massage treatments. From a reputable provider, get hands on you that know how to get you and help you stay “aligned.” It’s not just about spines or cracky necks, either. It’s about innervation — your nerves — and helping things work without interference.

SO, I’LL FOLLOW this advice myself and keep you posted. While I joke and act all cynical about perimenopause, I actually welcome it and the “wise-woman” status it just might afford me. And the hot flashes? They were, well, interesting. Might even have felt “good” with the chilly autumn air coming through the window …

Goshen News columnist Stephanie Price is a wife, mother, teacher, childbirth educator, midwife’s assistant and nursing student from Elkhart. Contact her at wholefamily@goshennews.com, 269-641-7249 or on Facebook at the page “Whole Family Column by Steph Price.”