Blog of the Society for Menstrual Cycle Research

The Last Snowflake

April 24th, 2013 by Heather Dillaway

Photo by Heather Dillaway, April 2013

My kids and I read a book about “the last snowflake” a few years ago. The book was a story about how the last snowflake felt as it hit the ground each winter – lonely because his friends were ahead of him and probably melted already, or maybe carefree and floating on the wind to say the last goodbye to winter. This year my kids and I keep trying to wonder when that last snowflake would fall. Was it a few weeks ago? No. Was it last weekend? No. Well, here it is snowing again today so will I see the last snowflake tonight? At some point this snow has to end – it’s late April! When WILL that last flake fall?
Plenty of people have written and sang about the “last snowflake” (do a web search and you’ll see). It’s a great thing to philosophize about: when will it come, what will it look like, will I miss it, am I ready for what comes after it, and, in general, how do I feel about the transition it represents? Am I glad to see that last snowflake of the season, or am I melancholy about it? Am I ready for the warmer weather, or did I like wearing warm sweaters and fleece pajamas? Do I like winter after all, even though it’s hard and long and seemingly never-ending, until it’s over? I like spring a lot but it’s always so short in Michigan and we head right into hot weather, there’s really not much in-between. Plus spring and summer mean the ramping up of activities and a busier schedule – am I ready for that? A part of me is already missing that last snowflake even though I don’t know if I have seen it yet….but then again, I’m pretty ready for winter to be over. Can I feel two things at once? Can I be sad and glad to see that last snowflake?
Why am I writing about snowflakes? Because I read a piece on the Red Hot Mamas website the other day about a menopausal woman’s last period that reminded me that of my thoughts about last snowflakes. In “A Gentle Good-bye,” Christine Merser talks about how she did not get to say goodbye to her last period at age 42, that it came too fast and she mourns (at least in part) the idea that she’ll never menstruate again. She acknowledges the hardships menstruation sometimes caused and the hassles that were part and parcel of it, but also reminisces in its life-giving qualities and feels a sense of loss. She feels her last period was a “benchmark moment” and suggests that in not knowing that her last period was indeed her last, she did not get to say that “gentle goodbye” that she wanted to say. She also talks about menopause as representing the “October” of her life, signifying ends rather than beginnings, but at the same time wants it to mean new and better things. The idea that the last period cannot be predicted but is hoped for, but then may be bittersweet when it’s finally reached is something that I’ve heard from so many women. Menstruation is hard, especially when it is unpredictable in perimenopause or before, but a part of it is also safe and representative of a kind of stability and identity that is hard to give up. Merser proposes that cessation of menstruation is the “first thing she can’t fix” about her body. Regardless of the freedoms that you might get when it’s over for good or the things about it that you will gladly give up, women aren’t always quite sure they really want to be done with menstruation forever once they sit back and think about its meanings. So they ask, Am I glad to see that last period, or am I melancholy about its passing? Am I ready for the midlife and beyond, or did I like being younger? Am I ready to give up my monthly reminders of womanhood? Do I like menstruation after all, even though it’s hard and long and seemingly never-ending until it’s over? I might like midlife a lot but it seems like it might be short and it might head me right into aging for real, so how long will I really be in this good midlife stage? Does a part of me miss my period before I’ve seen my last one?
Like snow, menstruation can be unpredictable, uncertain, burdensome, and a hassle, and we might all be very happy to say goodbye. BUT, for those of accustomed to the seasons and the good parts of each season, we might also be somewhat sad to see snow and menstruation leave us. Especially if we don’t get to say a chance to say goodbye.
Disclaimer: This analogy probably only works for those who live in Northern climates and are used to the good and bad things that come with snow. And yes, I’m sort of making light of menstruation here, but my feelings about the last snowflake this year are noticeable to me and I thought it might be fun to play with this analogy.

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Posted in Menopause, Menstruation, Perimenopause | 2 Comments »

Menstruation, Consciously?

April 17th, 2013 by Ashley Ross

In Heather Dillaway’s re:Cycling post of March 28, “The Physical Body and the Lived Body”, she invited a conversation about the importance of understanding the “lived bodily experience” when we examine menstruation. She suggests that “we cannot comprehend menstruation until we separate the physical body from the lived body”. Her inquiry reflects the dilemma many of us face when we attempt to enter the female experience through our cognition. Inevitably we rely on what we’ve heard repetitively and from many sources; what we’ve been taught, cajoled, shamed, brainwashed, and had whispered to us. In this way our experience has been formed from the outside in. This is what Dillaway delightfully (albeit cognitively) calls the “governmentality” of (our) bodies – that is, all the rules that surround bodies, all the norms that suggest exactly how our bodies should be and behave”.

If we agree reframing and embodying our own experience is called for, the logical question is no longer WHAT is our lived experience (that would still keep us in our heads) but HOW do we experience our bodies to discover our experience from the inside out? What are we called to do, or perhaps more relevantly, to BE, to develop the ability to fine-tune our inner attention, to deepen our listening and to familiarize ourselves with the terrain of our interiority?

How we chose to do this — how we each bypass the machinations, the loops, the highly developed editing abilities of our minds, the habituation of needing more, more, more information — is as personal and varied as the individuality of each inner landscape. However, I would like to suggest the following three components as a place to start:

Photo by Ashley Ross

“Going inward” only can happen when we slow down. This is a timeless realm, where attention will only settle on our experience, like a butterfly on a flower, when the air is still.

We also need to bring our curiosity to the unknown. We won’t free ourselves from the tyranny of imposed meaning until we are willing to enter into our experience and be willing to not know what we will find. Not even think we might know. Simply not expect to know.

We also need to build up the courage, the resources, the terra firma, the self-esteem, nay, the self-respect to go in and gently, lovingly touch those uncomfortable, painful, and often vulnerable parts of ourselves. These wary parts might even back away from us at first, but in truth, have been waiting for us to arrive for a long time. As the poet Mary Oliver says, “you only have to let the soft animal of your body love what it loves”.

These three mindfulness-based practices are at the foundation of a conscious embodiment of our menstruation, hormones and peri/menopause. They offer a way into our experience that allows understanding to bubble up from the experience itself. If we can BE in our bodies, if we can sit quietly and notice who we are when we menstruate, when we ovulate, and the tempo of our own monthly cycle, in this way we permit ourselves the experience of knowing ourselves from the inside out.

Who knows, something unexpected and remarkable might happen. By bringing consciousness into our experience, it might shift the experience itself…

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Posted in Menopause, Menstruation, Perimenopause, Philosophy | 2 Comments »

Stopping Depo-Provera: Why and what to do about adverse experiences

April 11th, 2013 by Laura Wershler

Laura Wershler interviews Ask Jerilynn, clinician-scientist and endocrinologist

A screen shot of comments to Laura Wershler’s blog post of April 4, 2012: “Coming off Depo-Provera can be a woman’s worst nightmare.”

With 250 comments – and counting – to my year-old post Coming off Depo-Provera is a women’s worst nightmare (April 4, 2012) I thought it was time to revisit this topic.

That blog post has become a forum for women to share their negative experiences with stopping Depo-Provera (also called “the shot,” or Depo), the four-times-a-year contraceptive injection. (Commenters reporting positive experiences have been extremely rare.) Many women have experienced distressing effects either while taking Depo and/or after stopping it. They report that health-care professionals seem unable to explain their problems or to offer effective solutions. What is puzzling for many is why they are experiencing symptoms like sore breasts, heavy and ongoing bleeding (or not getting flow back at all), digestive problems, weight gain and mood issues when they stop Depo.

This post aims to briefly explain how Depo works to prevent pregnancy, its common side effects and, most importantly, why and what to do about adverse experiences when stopping it.

What follows is my interview with Dr. Jerilynn C. Prior, Society for Menstrual Cycle Research board member, professor of endocrinology at the University of British Columbia, and scientific director of the Centre for Menstrual Cycle and Ovulation Research (CeMCOR) Section 1 explains how Depo-Provera works and what causes its side effects. Section 2  explains the symptoms women are experiencing after stopping the drug.

1) Taking Depo-Provera: How it works and established side effects

Laura Wershler (LW): Dr. Prior, what is Depo-Provera® and how does it prevent pregnancy?

Ask Jerilynn: The term, “depo” means a deposit or injection and Provera is a common brand name of the most frequently used synthetic progestin in North America, medroxyprogesterone acetate (MPA). Depo is a shot of MPA given every three months in the large dose of 150 mg. Depo prevents pregnancy by “drying up” the cervical mucus so sperm have trouble swimming, by thinning the endometrium (uterine lining) so a fertilized egg can’t implant and primarily by suppressing the hypothalamic and pituitary signals that coordinate the menstrual cycle. That means a woman’s own hormone levels become almost as low as in menopause, with very low progesterone and lowered estrogen levels.

LW: Could you explain the hormonal changes behind the several established side effects of Depo? Let’s start with bleeding issues including spotting, unpredictable or non-stop bleeding that can last for several months before, in most women, leading to amenorrhea (no menstrual period).

Ask Jerilynn: It is not entirely clear, but probably the initial unpredictable bleeding relates to how long it takes for this big hormone injection to suppress women’s own estrogen levels. The other reason is that where the endometrium has gotten thin it is more likely to break down and bleed. These unpredictable flow side-effects of Depo are something that women should expect and plan for since they occur in the early days of use for every woman. After the first year of Depo (depending on the age and weight of the woman) about a third of women will have no more bleeding.

LW: What about headaches and depression?

Ask Jerilynn: It is not clear why headaches increase on Depo—they tend not to be serious migraine headaches but are more stress type. Perhaps they are related to the higher stress hormones the body makes whenever estrogen levels drop. Unfortunately, headaches tend to increase over time, rather than getting better as the not-so-funny bleeding does.  Continue reading...

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Posted in Amenorrhea, Birth Control, coming off the pill, Dysmenorrhea, Health Care, Hormones, Menorrhagia, Menstruation, Ovulation, Perimenopause | 20 Comments »

Understanding Research: Media Reports of Research

April 1st, 2013 by Paula Derry

The Huffington Post published a story last week titled “Last Menstrual Cycle Could Be Predicted With New Model”. The story stated that a research study had just been published about a new method for predicting the end of menstruation in which researchers developed a formula for using the levels of two hormones, estradiol and follicle stimulating hormone (abbreviated FSH), to make this estimate. This “new method for predicting a woman’s last menstrual cycle could have broader implications for menopausal women’s health”. Since “in the year leading up to the final menstrual period, women are met with faster bone loss and a greater risk of heart disease”, if the end of menstruation could be predicted, medical monitoring and interventions would become possibilities. The research was also reported as news on the medical website Medscape.

Research results are often reported as news stories, as though these results are facts. However, “dog bites man” and “man bites dog” are facts, but research results are not facts in the same way. They are “evidence” that most often must be evaluated, understood, and put into the context of many other studies. There could very well be disagreement about whether a study’s methods really did accurately make a point, or whether the conclusions the researchers drew from their work were justified. Sadly, it happens all too often that research does not make the point that the headlines claim.

Photo by clarita // morgueFile

Here, we have a study by a respected researcher at a major institution, UCLA, funded by a grant from the National Institutes of Health and other prestigious grantors. However, we do not have the information with which to understand what the researchers actually did. UCLA issued a press release which states that the study “suggests” a way to predict the final period. The Medscape article states that “A new model MAY [my emphasis] help physicians determine how far a woman is from her final menstrual period”.

Suggests? May? I have no idea what this means. As a researcher, I want to look at the published article to see what was actually done. However, the publisher does not make a free copy of the article available. Anyone who wants to look at the published article—a researcher or an informed consumer—would need to pay the publisher $37.00 to access this 20-page article for one day. Predicting the last menstrual period from hormone levels, which is what is claimed, is something other researchers have tried but failed to do, so how these researchers worked with the difficult problems is an important question.

Assume for a moment that the model was a big success, and it did predict the last menstrual period. The idea that this has important implications for women’s health is stated as though it were another fact. However, this is not a fact; this is a complicated and controversial area. Bone density does decrease in the years surrounding menopause, but professionals disagree about how big an effect this has on bone disease. For example, current guidelines recommend testing bone density beginning at age 65, 15 years after the average age of menopause, because this is when the fracture rate has significantly increased. Heart disease risk factors may increase on average in the years surrounding menopause, but professionals disagree about whether menopause is important compared with other factors associated with aging.

Assume for a moment that bone disease really is an important negative health consequence of menopause. Whether interventions would be found that must be started in the year or two before menopause is another speculation. Such interventions might be found or might not. Predicting the last menstrual period, even if the claim is valid that a method to do so has been found, is a long way from preventing disease.

The medical satirist Andrew Vickers wrote an article called “News On Cancer Drug Fails to Raise False Hopes”, which begins: “A recent article on a novel cancer therapy has rocked the newspaper industry by giving a balanced and cautious review of an early-phase trial”. Satirists make extreme statements to make a point. Media reports are often written to sound definite and to portray a study as really important. A cautious approach to medical news is to withhold judgment unless the methodology of the study is clear and the context of the study is understood.

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Posted in Health Care, Hormones, Media, Menopause, New Research | No Comments »

House of (Menopausal) Cards

March 26th, 2013 by David Linton

(Spoiler alert: if you haven’t finished or intend to watch the show discussed here, you might wait to read this post until later.)

The premises of the much-discussed new series House of Cards hosted on Netflix, are that no one in the world of politics can be trusted, that alliances are fragile, and that disaster looms at every moment. Beneath the surface of beautiful buildings, attractive people, glamorous receptions, and rousing rhetoric lie depths of deception and betrayal.

At the heart of the intrigue are the central power couple, US Congressman Frank Underwood and his wife, Claire, who heads a non-profit NGO dedicated to providing clean water to impoverished African villages. They appear to be well matched and unified in their ambitions for both personal power and their pet projects while expressing benign neglect toward each other’s outside sexual pursuits.

All is well in the Underwood cacoon until perimenopause makes its destabilizing entrance. There’s a concept that’s sometimes referred to as “Chekhof’s Gun” that goes something like this, “If you show a shotgun on the wall in an early scene, someone better use it before the play is over.” Well, the menstrual shotgun first appears in an early episode when Claire is seen standing before an open refrigerator door and she’s not looking for a quart of milk. Frank notices, says little, and the moment passes. Four or five episodes later Claire makes a deal to accomplish one of her goals, knowing it will undercut a grand scheme he is working on. When he learns of the betrayal, he employs the deadly menstrual shotgun, “Is it the hot flashes?” Whereupon she throws him out of her office and departs for New York to be with a long-time lover.

But this is only the first season of what promises to be an ongoing saga, so following yet another political crisis, she returns to Washington. But something has changed. She has been having dreams about saving a child who is being choked by vines and, in a final scene, visits an ob/gyn to discuss having a baby, despite the fact that she has had three prior abortions. Perimenopause has suddenly altered her perspective. As viewers have already learned that her husband hates children, the set up for next season’s drama is well established.

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Posted in Independent Film, Perimenopause, Television | No Comments »

Medicating the Postmenopausal Vagina

March 4th, 2013 by Paula Derry

On February 26, 2013, the Food and Drug Administration issued a news release saying that it had approved a medication called Osphena to treat a problem called postmenopausal dyspareunia (pain during sexual intercourse associated with changes in the vagina after menopause). The medical website Medscape reported that the news release had been issued. How to read these announcements? It seems as though FDA approval should be enough to know that a medication is safe and effective.   However, what are some guidelines in reading and evaluating this announcement?

First, some background: After menopause, when estrogen levels decline, tissues (cells) of the vaginal lining can become thinner, drier (thus providing less lubrication during intercourse), and less elastic or flexible.

This can result in pain during intercourse, feelings of burning or soreness, inflammation, and irritation.

Andreyeva by Ilya Repin // Public Domain via Wikimedia Commons

There are a variety of solutions for dealing with this.  Regular sexual stimulation (intercourse, masturbation) is recommended to keep vaginal tissues healthy.  Water-based lubricants can help reduce discomfort during intercourse.  Expanded views of sexual pleasure that don’t include intercourse might work around the problem. Leaving enough time to become aroused during intercourse (extended foreplay), communication between partners about when sex is painful and when not, can also help. Herbs like dong quai and black cohosh are recommended, especially by complementary/alternative practitioners, although the herbs  lack a research base. A low-dose estrogen applied to the vaginal area (as a cream, tablet, etc.), is effective. Local application minimizes estrogen being absorbed into the bloodstream, traveling through the body, and having effects, some of them potentially negative, distant to the vagina. There is, however, controversy about some estrogen being absorbed.

Now, to the FDA announcement:  The FDA requires proof of a medication’s safety and effectiveness before it is approved.  According to the news release: “Osphena’s safety and effectiveness were established in three clinical studies of 1,889 postmenopausal women with symptoms of vulvar and vaginal atrophy. Women were randomly assigned to receive Osphena or a placebo. After 12 weeks of treatment, results from the first two trials showed a statistically significant improvement of dyspareunia in Osphena-treated women compared with women receiving placebo. Results from the third study support Osphena’s long-term safety in treating dyspareunia.”

Notice, first, that the drug’s effectiveness was tested for 12 weeks. This is not an unusual amount of time for such a study, but it is not very much time. Notice also that women treated with Osphena had a “statistically significant” improvement. As I discussed in a previous post, “statistically significant” means “unlikely to have occurred by chance.” In other words, there was evidence that Osphena  really did have an effect, but we don’t know how big an effect—it might be very large or very small.

Safety was established by studying the experiences of women for one year: however, one year is not a long time for side effects to develop. Osphena is a systemic medication. That means it is not applied locally in the vaginal area, it is ingested as a pill so that it travels to all parts of the body in the bloodstream. It is a selective estrogen-receptor modulator, or SERM. SERMs act like estrogen in some places in the body while not in others. The idea is that a SERM like Osphena would act like estrogen in keeping vaginal cells healthy while not acting like estrogen to increase health risks like certain cancers. However, more time than a year might be needed for health problems to show up. Indeed, the FDA news release stated that “Osphena is being approved with a boxed warning alerting women and health care professionals that the drug, which acts like estrogen on vaginal tissues, has shown it can stimulate the lining of the uterus (endometrium) and cause it to thicken…. Women should see their health care professional if they experience any unusual bleeding as it may be a sign of endometrial cancer or a condition that can lead to it.” The FDA announcement also stated that “Common side effects reported during clinical trials included hot flush/flashes, vaginal discharge, muscle spasms, genital discharge and excessive sweating” and that Osphena should be prescribed for the “shortest duration consistent with treatment goals and risks for the individual woman.”  Continue reading...

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Posted in Menopause, Pharmaceutical, Sex | 4 Comments »

Menopausal Junk

February 28th, 2013 by Heather Dillaway

In response to my last blog entry about Helena Bonham Carter, Paula Derry commented that we treat menopause as a “junk category,” tossing in any symptom we can’t explain or don’t want to attribute to anything else. So true. In fact, Anne Fausto-Sterling said this long ago about menopause – that tons of symptoms were attributed to menopause when in fact only hot flashes really had a link to this life stage. BUT, we keep on attributing anything and everything to menopause.

    Photo by Flickr user Caterina // Creative Commons 2.0

  • Gaining weight at midlife? Must be menopause.
  • Sad or angry at midlife? Must be menopause.
  • Hairy at midlife? Must be menopause.
  • Dry at midlife? Must be menopause.
  • Blurry eyes at midlife? Must be menopause.
  • Headaches at midlife? Must be menopause.
  • Big boobs at midlife? Must be menopause.
  • Constipated at midlife? Must be menopause.
  • Have a symptom you can’t explain at midlife? Must be menopause.
  • Turned 50? Must be menopause. (Yes, see, it’s ridiculous.)

And the list goes on. And on. And on.

Okay, so, yes, menopause is a junk category because symptoms (junk) are just thrown in and declared “menopausal” (“perimenopausal”) at every turn. Just like when women go to the doctor and are given pregnancy tests no matter what their symptoms (“must be pregnant”). Ah, the fun of the reproductive life course.

BUT, I would say that there is another kind of “junk” that I see at menopause. I’ve interviewed menopausal women for 12 years now, and one of the hardest things is separating out menopause from all the other things (junk) going on in women’s lives as they make this transition. It is so hard to figure out what menopause really is and what it really means for women because it is surrounded by so much other “junk” at midlife. When you ask women about how they feel about menopause, they tell you but they also contextualize how they feel by telling you about:

  • their kids (the kids that live with them and the ones that have left)
  • their partners (current ones, ex-partners, and ones they wish they had)
  • their jobs (the ones they hate and the ones they care about)
  • their friends (the ones who support them and the ones who don’t)
  • their aging parents (and how hard it is to take care of them)
  • their worries about future aging
  • their doctors (good and bad)
  • their youth
  • their aches and pains
  • their bodies (the parts they like and don’t like)
  • their history of menstruation and other reproductive experiences…

You get the picture.
You have to wade through all of this to understand menopause. Sometimes it feels like junk clogging up their lives and clogging up the path to figuring out what menopause is really like. At the end of the day menopause is such a narrow part of most middle-aged women’s lives, but it is tied in with so much other midlife stuff that it’s hard to separate out. When you ask women about menopause, it’s sort of like asking someone, “How are you?”, on one of their busiest days. The answer you get back is surrounded and dictated by the junk in their lives and, unless you understand that going in, it might seem like menopause itself is a junk-filled process. But maybe it’s not. Despite all the news articles that predict new symptoms and conditions at menopause, and despite all of the midlife contexts that surround menopause, maybe menopause itself is very simple if we can weed out everything that’s not really menopause… What do YOU think?  Continue reading...

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Posted in Menopause, Perimenopause | 4 Comments »

Big Breasts, Menopause, and Helena Bonham Carter

January 31st, 2013 by Heather Dillaway


Another sign of menopause to add to the list: big breasts. Or so Helena Bonham Carter suggests in a recent interview. She suggests that she did not have big breasts until menopause and that it is “the one benefit of menopause.” But before this comment, she said that she wished they “didn’t stick out as much.” Apparently menopause and big breasts are a mixed blessing.

I’m fascinated by celebrities mentioning menopause these days. Actresses from the UK recently seem to be much more outgoing about their menopausal statuses than actresses from the US (see my previous post about Sinead O’Connor), at least from my followings of celebrity gossip (which, admittedly, is not very thorough). The idea that they are talking about it in passing, in simple conversation, is illustrative of the fact that menopause is not as hidden as it once was.

On the other hand, in this particular case, reading between the lines, Helena Bonham Carter says very directly that larger breasts are “the one benefit” of menopause, inferring that there are many more negatives. Further, the idea that the only benefit is appearance-based is not only interesting but also problematic in its reaffirmation of gendered norms about the necessity for women to look good for others. Finally, it is also clear from her comment that having big breasts – something that is often sought after in our highly sexualized, male-dominated culture – is maybe uncomfortable for women in public and that women’s bodies are indeed on display and women know it. Sure, she could have said that she wished her breasts didn’t stick out as much because they got in the way of her physical movement through space, but I doubt it. I think she made this comment more because of her discomfort with others’ gazes upon her body.

So, what does this all say about menopause? Or about big breasts? I think Helena Bonham Carter’s comments confirm the following: First, menopausal women are definitely still thinking (for better or worse) about their appearances. Second, women are intimately aware of the size of their breasts and understand that they are for public viewing (whether they like it or not). Third, big breasts are seemingly better than small ones, at least according to our various and intersecting gender norms. Fourth, Helena Bonham Carter doesn’t think there are any other benefits to menopause (a dismal thought), and we know she’s not the only one. (But aren’t there plenty of benefits? Come on….Sinead O’Connor thinks so…) Fifth, and despite some of the above conclusions, women aren’t necessarily hiding their menopausal status anymore.

I know, I’ve taken two sentences out of Helena Bonham Carter’s mouth and inferred lots of things, but am I that off base? I don’t think so, but feel free to comment!

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Posted in Celebrities, Communication, Menopause | 10 Comments »

Bored by Research Updates and News Headlines

January 3rd, 2013 by Heather Dillaway

"— Allons, à ton tour, ma petite... vas-y ! — Non, Papa ; si on devient si vilaine que ça en un an, j'aime mieux pas entrer".

By Achille Lemot (1846-1909) [Public domain], via Wikimedia Commons

Sometimes I think biomedical researchers and media spokespersons are just searching to find the pathology in our lives. Not that we don’t know this already, especially when it comes to women’s health. Because of how medicalization works, of course anything that veers from the defined “norm” for women (here, a young woman who menstruates every 28 days like clockwork) is pathological. Thus, menopausal women are pathological by definition. But, sometimes this gets pretty depressing, and really, it’s not very accurate considering that the vast majority of women go through menopause at some point during the midlife (so doesn’t that make menopause pretty normal and non-pathological?). In my Google alerts last week, here were the “menopause” headlines:

Diet, Exercise Post Menopause Help Reduce Risk of Breast Cancer
Medical Daily

Menopause linked to higher brain aneurysm risk
abc7.com

Healthy lifestyle during menopause may decrease breast cancer risk later on
Medical Xpress

Weight-y menopause
The Star Online

Diet To Overcome Menopause Problems
BoldSky

I do understand that there are many more health risks in middle age and beyond, and that changing/waning hormone levels at menopause induces different concerns/risks than women might have faced before menopause. Researchers, doctors, and media spokespersons have made it crystal clear over the past few decades that this is the case. But, as feminist and social science researchers have urged us to get beyond the “menopause as death” or “menopause as problem” perspectives, it seems that we’re not making much progress in thinking differently or more broadly about this transition. As I read the articles on menopause leading to more breast cancer risk, risk of brain aneurysm, and risk of weight gain, it is reaffirmed in my mind that we’ve made very little progress in broadening the dialogue (at least the published and mainstream dialogue) on this important life stage.

Sure, this life stage is filled with problems, risks, and interesting situations, but what life stage isn’t? Isn’t there published research coming out on ANYTHING ELSE about menopause? I want to read about something different! Readers, feel free to comment about any other interesting stuff you’ve read about menopause recently because I for one am searching for new takes on menopause. Seriously, people, was there nothing else new last week on menopause? As we head into 2013 I’m hoping for something new.

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Posted in Communication, Media, Menopause, Menstruation, New Research | 7 Comments »

We’re Ripe for the Third Talk, Actually!!

December 20th, 2012 by Ashley Ross

No question – Poise’s Second Talk Campaign is undeniably courageous, taking on Menopause, the Previously Unmentionable. Call me impatient and unappreciative, but I just can’t help mourning the missed opportunity to REALLY empower women, instead of aligning with those unrelenting forces bent on squeezing the Mojo from the second half of our lives.

Seeped as I am in the journey of menopause, (my own, and as co-creator of the Menopausal Mojo Teleseminar program), my curiosity was cautiously piqued when I opened the Poise link in this blog post  last month. (Cautious because, after all, Poise is an incontinence product and the association is not only anxiety provoking but inadvertently quantizes my experience into a demeaning and unimaginative metaphor — something like shame meets discouragement meets insult. Sorry, that’s just how it feels to me. Let it be known, I am not in denial here – it has been a while since I could safely jump on a trampoline with anything in my bladder.)

Nevertheless — someone is talking publicly about menopause. And I am certainly curious to see what aspect of this rich, challenging and potentially transformative experience they are choosing to highlight.

The first thing we see: “8 in 10 women agree, it’s time to change the way we think about menopause”.

YES!!! What we’ve been saying all along, my wonderful co-conspirator, Karen Clothier (creator of the body-mind-spirit focused and unexpectedly successful Menopause the Magical Telesummit) and me. We find ourselves coming back again and again to feeling the urgent need to rebrand menopause. We clearly do want another way to understand peri/menopause. After hundreds of years of agents of the male paradigm systematically dismantling our authority of our experience, using shame to silence our inherent collaborative tendencies, we have lost the language to talk about the transformative experience of our 40’s and 50’s – as we move from fertile women to mature women, from “child bearer’s to bearers of wisdom” (Kristi Meisenbach Boylan The Seven Sacred Rites of Menopause).

Clearly the difficulty begins with the term “menopause” itself. The term was coined in 1812 by the French physician de Gardanne and is defined as (a moment in time) 12 months after the last menstrual period. A little hard to acknowledge a rite of passage when its beginning, middle and end are as elusive, instantaneous and vague as that. But that’s not all, that’s simply the scientific use of the word. Our everyday use of it also describes perimenopause (the 5-10 year period before the Moment-In-Time) as well as post-menopause (an unspecified period after the Moment-In-Time). Confused yet?

Small wonder that we need new, updated language, imagery, descriptions, mythology and role-models — a full-spectrum, holographic map to describe the physical, emotional and spiritual terrain of our midlife experience.

Wait, I’m getting a little ahead of myself. Back to the Poise menopause page, and how it misleads women by reducing this remarkable transition into … yes, you got it … SYMPTOMS. As if symptoms are the menopausal experience. And the successful management of said symptoms is all there is to this phase of our life cycle. Tragically reductionist, when seen from the perspective of how insidiously the media molds our reality. This is brilliantly elucidated in Jennifer Siebel Newsom’s movie Miss Representation, which shows “the media’s limited and often disparaging portrayals of women and girls, which make it difficult for women … to feel powerful.”

“Disparaging”. Hold that thought while we listen to Dr. Jennifer Berman, Poise’s menopause and intimacy expert, describing mood swings. In the clip  “What’s the DEAL with my moodswings”*, does she validate our experience and perhaps suggest that our emotions might be valuable indicators of our experience? Does she acknowledge the virtually universal need of women at this stage to retreat (I would venture to say the developmental milestone in the female psyche to withdraw and self-reflect), and then acknowledge how at odds with our externally driven, production oriented culture this urge is? Perhaps she suggests that THAT might be the reason WHY our moods are swinging – that our emotions are accurately reflecting the environmental imbalance of the whole paradigm? Wouldn’t it be the moment for Poise, and all those interested in empowering women, to ask this crucial question: why are we making menopause all about what’s wrong with us?

Here’s what the good doctor says:   “Moodswings are very common during the perimenopause and menopause.  Women will describe symptoms of feeling more irritable and short fused, more weepy and depressed, more (uh) anxious and sort of, (uh) difficulty concentrating …and that’s very common during perimenopause, and it tends to level out, to some degree, as women approach menopause.”

Firstly, is it just me or is her tone patronizing? Is she explaining anything new here and offering solutions as promised? Is she even answering the question: “What’s the DEAL with my moodswings”?!

Now of course I see what a masterful campaign Poise have created here. They’ve captured an untapped market, have obviously paid close attention to the terms used by women in their focus group and have echoed the aspirations of menopausal women to save us from our Symptoms.

How much more interesting would it be if they used the global reach and collective power of the internet to invite us to create new language and ways to define our midlife experience that go beyond complaining about hot flashes (see “personal stories” on the site)? Ladies, instead of letting them reduce our experience to managing our symptoms, let’s demand inspiring stories about how we are stepping into the second half of our lives with the Mojo that comes from accessing our collective wisdom, our wizened humor and our well-earned self-respect. Now that’s a branding campaign worth following.

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Posted in Advertising, Communication, Media, Menopause, Perimenopause | 3 Comments »

Getting from the Average to the Individual When Reading Reports of Research

December 10th, 2012 by Paula Derry

We are unique individuals. Or, we are like everyone else. Which is it? For menstrual periods and the menopausal transition, as perhaps for most things, we’re a little bit of both. For me, keeping in mind that both are somehow true, and understanding the ways in which each is true, is a crucial but tricky business. Scientific findings are often reported as though they are universal truths. “The normal menstrual cycle is regular and occurs every 28 days.” “Depression is more likely during the transition to menopause.” However, research most typically examines groups of people, and results are most often average findings. A discrepancy between the average and the range of real experience isn’t surprising.

Take, for example, a study of the transition to menopause. This was longitudinal research—that is, the same group of women was studied for many years, and the patterns of change in their menstrual cycles over time could be documented. The authors conclude that there are three stages in the transition to menopause. At first women experience, perhaps beginning in their thirties, subtle changes in menstrual flow (like periods becoming heavier or lighter) without cycle length becoming irregular. Next, periods become irregular. Finally, women skip periods in the run-up to menopause. The stages are based on what, in the authors’ words, occurs “most frequently”; the average or frequent result is the basis for understanding the underlying pattern. Yet there is also a lot of variation. As reported in the article, only 39% of the women progressed in a forward manner through the three stages. Almost half seesawed back and forth. In addition, it is known that a significant minority of women report that they have gone from regular cycle lengths straight to menopause without a time of menstrual irregularity. I remember that when I first read this study I felt a certain comfort that changes in my body, like lighter periods and other changes, were predictable and fit into a pattern that other women experience. Yet, on the other hand, the findings can’t be used as a blueprint for what is supposed to happen. We share experiences with others, but we’re also unique individuals.

The average menstrual cycle is said to be 28 days—well, I don’t know many women with a 28-day cycle, and while some women describe themselves as “regular as clockwork” other women are bewildered that anyone could think that the cycle was regular. Rates of depression have been found in many studies to increase during the menopausal transition. However, the great majority of women do not become depressed (the “relative risk” has increased, but the “absolute risk” remains low). Knowing that the rate increases might suggest to a woman that she consider this possibility, but does not answer the question of whether she will become depressed, or, if she does, whether her depression is related to perimenopause or something else.

In trying to use scientific facts to understand ourselves or the world around us, the difference between the particular and the general, the predictable and the unpredictable, is important. Our individual behavior and physiology aren’t random or without form, but neither are they completely predictable.

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Posted in Menopause, Menstruation, New Research | 2 Comments »

Useful Gifts to Buy this Holiday Season

December 6th, 2012 by Heather Dillaway

The other day a Huffington Post article crossed my desk, titled, “Gift Guide 2012: What To Get The Menopausal Women In Your Life.” According to this article, here are some of the things menopausal women (read: perimenopausal women) might want this December:

  1. Coldfront cooling palm packs (to relieve sweaty palms)
  2. A personal desk fan (for those hot flashes at work)
  3. A “menopause gift basket” filled with healthy treats and goodies, maybe also including vitamins, and alternative remedies for relief, “to stabilize mood and help the body adjust to hormonal changes.”
  4. A Feel Cooler Cooling Mattress Pad or Cooling Pillow that interacts with your nightly body temperatures to cool you down (for night sweats)
  5. Cool Sensations Moisture Wicking Bed Sheets (reportedly for those floods of night sweats you might get)
  6. Hot Girls Pearls – cooling beads to wear around your neck (for hot flashes) – apparently these have even made it onto Oprah’s Show
  7. Tickets to Menopause the Musical
  8. Sweat-wicking pajamas (there are lots of different brands, again to deal with night sweats)

Clearly the theme here is that menopausal women get hot and need relief. Fair enough, for many menopausal women this would be true. But this list got me thinking: what might I add to this list? Here are some I thought of:

  1. Humorous gifts, such as books of jokes about menopause and aging?
  2. Books about menopause
  3. Cookbooks that specialize in natural eating?
  4. A yoga gift certificate? Or other exercise certificate?

I’d love to hear from readers about other ideas for menopause-related holiday gifts.
Then I got to thinking again: If my daughter had reached menarche already, what kinds of holiday gifts could I get her that relate to her life stage? Here are some of the ideas I thought of, and I definitely need help from readers to expand this list:

  1. Pretty reusable (washable) maxi pads (e.g., Lunapads)
  2. A cool bag to carry maxi-pads around in
  3. A cool tampon case (like the ones that Uncommon Goods sells)
  4. Cool new (extra) underwear
  5. A special calendar for her to use to track her periods
  6. New Moon Girls’ magazine (or just an online membership to New Moon Girls)
  7. The book, Our Bodies Ourselves, or other books on puberty and menstruation

So, readers, what else belongs on this list? Those of you already buying for Hannukah and Christmas might have some great ideas…..please chime in!

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Posted in Girls, Menarche, Menopause, Menstruation | 4 Comments »

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