It is a topic that nobody wants to talk about: menopause and perimenopause. Mothers rarely talk to their daughters about it. Friends don’t bring it up in conversation.
Women have probably heard about symptoms like hot flashes and night sweats, but they might not think their dry skin, muscle aches, or weight gain is part of it. So many women suffer in silence, quietly trolling the Internet for answers or talking to a doctor who might just brush off their complaints.
But when Christina Shutter of Naples posted on Facebook about the horrendous symptoms she suffered from during perimenopause, women started replying, “Me too.”
The posts offered comradery and suggestions among strangers. It gave the long list of women posting the feeling that they were not alone.
“I am all about people talking about things,” Shutter stated. “We don’t talk about women’s health in general. Why is everyone struggling in silence? We are putting our feet down. There has to be a better way.”
Shutter began having hot flashes, weight gain, and mood swings at age 37. The average age of menopause is 52, and perimenopause can start about 8-10 years before that. Shutter went to her doctor, who prescribed an antidepressant.
“I took one dose, and it messed me up for three days,” Shutter described. “If your body doesn’t need that kind of medication, you should not take it for hot flashes. That tells us where we are at. It is just, ‘Give her an antidepressant, and it will help with hot flashes’.”
Her hot flashes increased. She never got more than three hours of sleep. Instead, she would wake up after a few hours drenched in sweat. Exhausted, gaining weight, and having horrible mood swings, Shutter kept going to doctors and trying an array of medications.
“I made another appointment at a well-known women’s specialty group,” Shutter continued. The doctor told her that hormone replacement therapy was the only treatment. “I wanted to look at other avenues. All they want to do is write a prescription. There has to be alternative care. It was just a horrible experience.”
Hormonal changes due to menopause cause these physical and emotional changes. It happens in three stages.
Perimenopause is when the ovaries gradually produce less estrogen. It usually starts when you are in your 40s and can last several months or many years. Symptoms can be irregular periods, hot flashes, and mood swings.
Menopause is when you no longer have menstrual periods. Your ovaries don’t release eggs, and your body doesn’t produce much estrogen. Menopause is when you have gone 12 months without your period.
Postmenopause is the time after menopause that you stay in for the rest of your life. You can have mild symptoms for a few years and become more at risk for osteoporosis and heart disease due to low estrogen levels.
Shutter says she is now in the menopause phase and still having some terrible symptoms. She felt alone on this journey.
“I think that it is generational,” Shutter explained. “When I started going through all of this, I reached out to my mother. She grew up in a very strict Catholic home. She said ‘We don’t talk about that’. Menstrual health in general, is not talked about.”
Reaching out on Facebook made her feel less alone. Nicol Sargent was one of the people who responded, and she illustrated how symptoms can vary.
“I don’t have the hot flashes. I don’t have the night sweats,” Sargent said. “That is what everybody talks about. “Insomnia, joint pain, and shoulder pain – those are my big issues.”
She shared Shutter’s complaint about doctors who just wanted to give her drugs.
“All the doctors wanted to do was throw narcotic-type drugs at me,” she described. “They worked for a few weeks and then stopped working. I had not had a good night’s sleep in nine years. A year and a half ago, I got my [medical marijuana] green card and got some marijuana gummies, and now I can sleep through the night, and it helps the joint pain.”
Other women responded on Facebook with similar stories.
“I feel like it was me writing this post,” wrote Lori Lefebvre. “Menopause affects my daily life in so many ways. The joint pain is so bad I can barely walk. I wish there were something that could help me.”
“I feel for you,” wrote Nicole Sotiropoulos. “I have no health insurance and am scared to do this alone, but the hot flashes have definitely started.”
The posts also offered suggestions on doctors and medications, pointing out some drugs work and some very knowledgeable doctors are in town.
Dr. Frances Romano of Shine Direct Primary Care in Bonita Springs and Naples is a certified menopause practitioner.
“Women have been struggling for a long time,” Romano began. “It is just so hard.”
Romano stresses education as part of the process. She wants her patients to understand what is going on in their bodies.
“I go through all the hormones and explain, ‘This is how you feel when your hormones are fine, and this is how you feel when your hormones are crappy’,” she described. “If you understand what is happening to your body, it will be a better transition into menopause.”
She pulls up charts and explains the cycles the body goes through and how that affects various symptoms. She orders blood tests just to make sure there is nothing else going on with the patient’s health. Then, she considers a variety of remedies to see which one best fits each patient.
“It is nutrition and exercise and hormone therapy,” she said. “Hormone therapy is very safe.”
Some patients take pills; others do better with a gel or spray.
“It is very customizable to what the patient needs,” Romano said. She explained that some patients just need estrogen, while others need
estrogen, progesterone, and testosterone.
Romano does not just focus on medication but also on diet and exercise.
“You have to take care of the person you are now, for your person in the future,” she stressed. “In your 30s, work for the person you are going to be in your 40s. In your 40s, work for the person you are going to be in your 50s.”
Romano said she has always been interested in women’s health. She has taken extensive courses and lectures about menopause and is certified by the Menopause Society.
“There are a lot of misconceptions about perimenopause and menopause, and there is a lot of suffering,” Romano said. “I believe menopause is part of taking care of a woman. We are always taught that we are so emotional. It makes us feel like we are crazy, and when I show these things to patients and say ‘This is why you feel this way’, they understand. Having a menstrual period is a super power, and we just need to use it to our advantage.”
For more information about the benefits and risks of hormone therapy, speak with your ob-gyn or visit acog.org.