WHEN OUR PERIODS STOP

After our periods have stopped coming regularly, our regular doctor's visit can turn into a prescribing opportunity for the physician or nurse-practitioner.  We may complaint to the doctor that we have experienced less lubrication when a penis is inserted into the vagina, or we may feel an itching and irritation at the vaginal opening.  Then, when the speculum is inserted, it may be painful. 

Voila!  "Here's a prescription for some cream that's going to make it all better" or "Here's some pills to take daily".

Even though the reason we had less lubrication might be:
        •that our partner hasn't waited for us to get sufficiently "wet", or
        •that we have douched excessively, or
        •that we haven't had much penis-vagina sex lately,
        •it is assumed that we are deficient in hormones because we no longer have a regular menstrual cycle. 

If we allow ourselves more time to get fully lubricated, or if we stop douching, or if we stimulate the vaginal walls with a dildo or a speculum, the problem of "dryness" may disappear.

But, the irony is that if we do use the cream or take the pills, the dryness does go away.  Doesn't that prove that we needed the drug?

No
.  The way that hormone-like drugs work is they stimulate our cells to work harder to do whatever each type of cell is supposed to do.  The cells of the vaginal lining are supposed to proliferate, that is, reproduce themselves rapidly, so the drugs cause our cells to grow rapidly, causing a thicker vaginal lining.  A thicker vaginal lining has more cells to push out fluid when we're sexually stimulated, so therefore, more moisture. 

Very often, we have no complaints at all, but when the speculum is put in, it hurts.  It is not uncommon for the insertion of the speculum especially in we haven't had anything inserted into it for awhile to hurt a little.  We found out that if you insert the speculum the next day, it hurts less - the next day it is much less or doesn't hurt at all.  In other words, our vagina stretches and accommodates the speculum just fine.

If a woman starts an intimate relationship with a man after a long period of abstinence, it helps to avoid this initial discomfort by inserting a finger or speculum every day a few days ahead of resuming penis-vagina sex. 

Lorraine Rothman and Marcia Wexler wrote an excellent small book to explode all those "Myths of Menopause".  The myths are stated here with a summary of the facts, but if you are having any problems after menopause, this whole book is a must-read!

MYTH 1:

Science has all the answers.

FACT:

They don't.  Faulty studies are accepted by the medical community and are absorbed into the broader culture.

MYTH 2:        

Menopause is a time of biologic imbalance that is best managed by medical professionals.

FACT:

Menopause is a natural transition that most women pass through with little of any discomfort.

MYTH 3:

There are male hormones and female hormones.

FACT:

All people make the same sex hormones.

MYTH 4:        

Our ovaries are our only source of estrogen and progesterone.

FACT:

Estrogen and progesterone are not made only in our ovaries but also in our adrenal glands and body fat.  We need these hormones throughout our lives for healthy normal body function.

MYTH 5:        

Post-menopausal women have estrogen levels that are either very low or non-existent.

FACT:

Our bodies make sufficient estrogen from the time we're embryos until the day we die.

MYTH 6:        

At menopause women's ovaries shut down and doctors are correct in calling this "ovarian failure".

FACT:

Healthy women's ovaries do not cease to function after menopause.

MYTH 7:        

Estrogen levels always go down at menopause.

FACT:

Because of liver damage and/or exposure to certain chemicals, estrogen levels can go up in menopausal and aging women.  High levels of estrogen can stimulate cancer cells.

MYTH 8:        

Studies show that menopause is a disease.

FACT:

For many years, menopause studies focused on women with illnesses or unusual health conditions, which gave normal menopause an incorrect and disease-oriented definition.

MYTH 9:        

Decades of research into menopause support the importance of giving Hormone Replacement Therapy to aging women.

FACT:

Research has not been able to show that hormone drugs protect women against the degenerative diseases of aging, nor has research shown that taking the drugs is safe.

MYTH 10:

Hormone Replacement Therapy is a must for aging women.

FACT:

75% of aging women do not take Hormone Replacement Therapy, do not want to take these drugs, and, if they do start, generally stop taking them within a year.

MYTH 11:

Severe physical symptoms at menopause are due to low estrogen levels and require Hormone Replacement Therapy.

FACT:

Metabolic and chemical changes at menopause can exacerbate hidden health problems.  Doctors attribute many symptoms to menopause and don't look for the underlying causes.

MYTH l2:

Estrogen drugs can be taken in different ways; each tailored to fit the woman.

FACT:

Women can take the hormone drugs in different ways--pills, shots, vaginal creams, skin patches--but all have the same risks to life and health.

MYTH 13:

Lowering the dosage decreases the risk associated with hormone drugs.

FACT:

High or low dosage, the risks remain the same.

MYTH 14:

Most of the estrogen replacement hormones are natural hormones; those that are synthetic act as natural hormones.

FACT:

Estrogen replacement hormones are not natural to women's bodies.  So-called natural hormones are not part of the body's process of making hormones and have not had long-term large-scale studies to determine safety.

MYTH 15:

To counter progesterone deficiency at menopause, natural progesterone, developed from a wild yam, is like our body's hormone and therefore, safe and useful.

FACT:

Menopause does not cause a progesterone deficiency.  Furthermore, the wild yam does not contain progesterone; it has to undergo chemical alteration in the laboratory before its molecules are exactly like our own progesterone.

MYTH 16:

Drugs are the only choice to help a woman through the discomforts of menopause.

FACT:

If a woman is otherwise healthy, yet wants some help through her menopause, she can pick from a variety of choices that do not depend on drugs.

MYTH 17:

Hot flashes are inevitable at menopause, due to estrogen insufficiency, and are relieved with Hormone Replacement Therapy.

FACT:

Hot flashes are related more closely to lifestyle issues than to estrogen levels.  Although many women get relief when they take HRT, hot flashes often return once the drugs are stopped.

MYTH 18:

Vaginal dryness is very common at menopause, due to estrogen deficiency, and is relieved with estrogen cream.

FACT:

Sensations characterized as "vaginal dryness" can occur at any stages of a woman's life.  More attention has been placed around it around the menopause.  Although estrogen creams do relieve vaginal itching and the sensation of dryness, the synthetic hormone is absorbed into the blood stream and carries the same risks to health as pills and patches.

MYTH 19:

Taking HRT for depression and anxiety around the time of menopause solves the problems.

FACT:

Menopause has the knack of showing up at the worst time in a woman's life. The loss of a job, loss of a spouse, caring for aging relatives, children leaving home, or worse, moving back in, and the perceived loss of youthfulness are problems that cannot be treated with HRT.

MYTH 20:

Heart disease increases dramatically after menopause and women with heart disease catch up to their male counterparts.

FACT:

Heart disease is a degenerative condition of aging aggravated by western lifestyles.  Menopause does not increase a woman's susceptibility.

MYTH 21:

Mild bone loss in menopausal women indicates the onset of osteoporosis, which inevitably leads to fractures and death.  Mild bone loss should be treated immediately with estrogen to prevent further loss.

FACT:

Menopause does not cause osteoporosis.

MYTH 22:

Vitamins can't hurt but they aren't going to help much either.

FACT:

Hormones and vitamins act interdependently, meaning that hormones need vitamins to carry out their functions.

MYTH 23:

Doctors take lab tests to improve care.

FACT:

Doctors often request tests to satisfy themselves and the patient pays for it.

MYTH 24:

Laboratory tests can accurately measure a woman's hormone levels to determine if she is in menopause.

FACT:

We can't rely on laboratory tests to predict menopause.

MYTH 25:

The FDA oversees the safety of our food and drugs.

FACT:

The FDA has over bowed to the needs of corporations.

MYTH 26:

To date, there is no evidence that food additives and pesticides do any harm, and their benefits for our food supply outweigh the risks.

FACT:

Exposure to chemicals aggravates an already over-burdened body.  Some of these chemicals are also estrogen-imitators.

Excerpts from MENOPAUSE MYTHS & FACTS WHAT EVERY WOMEN SHOULD KNOW ABOUT HORMONE REPLACEMENT THERAPY BY Lorraine Rothman, MS, with Marcia Wexler, PhD