I am often amazed at how many health care providers STILL don’t take us seriously when we begin asking questions about menopause.  It IS, after all, a pretty major life transition!  Maybe doctors just don’t have time any more for educating us.  Or maybe, it’s such old hat to them, they’re sick to death of it.  But even good ones can fall short on the most basic information.

We just want to KNOW what we’re up against, OK?  Carol Leonard has been practicing midwifery for over 25 years and is a passionate advocate for empowering women about their health.  Here is one more great article from her giving a nice overview of what menopause is all about,especially if you're into alternative treatments!

So this was it. My cycles had definitely become erratic and much shorter and I had to finally admit to myself that "it" was beginning. The menopause I had always thought about as "in the future" was, well … now. So, with much excitement and some trepidation, I began to gather all the information I could find to help me make informed decisions regarding my health and well-being during this confusing, transitional journey.

In addition to reading all I could get my hands on about mid-life transitioning (including some great stuff in the supermarket check-out aisles), I started to interview various types of health-care providers to see what they had to say. I resolved to keep an open mind, particularly when it came to drugs such as Hormone Replacement Therapy. Now, this was patently ridiculous. I am a quintessential Baby-Boomer. I am almost always passionately opinionated about everything. Also, I am a child of the 60's -- the pills we were supposed to take were never the more interesting way to go. Needless to say, my research took me from conventional, mainstream medicine to shamans. Oh well, so be it. The following is a couple of year’s worth of (blatantly biased) research on menopause in a nutshell:

At the turn of the century, the average life expectancy for women was 55; thus menopause coincided with women's final years. In the United States today, the average age at menopause is 52 and our life expectancy is 80! This means many of us will live a good 30 years after menopause. And yet, menopause is still viewed as a disease of the aging associated with disintegration and dying. Menopause is only the end of fertility, not the end of life or productivity. Now, with the approaching millennium, a Baby-Boomer turns 50 every seven minutes (an astounding statistic). There will be 50 million Women of Menopause by the year 2013. A planet full of Changing Women -- imagine the possibilities! It is up to us to de-pathologize this natural event and make our non-reproductive years the most powerful productive years of our lives.

It is ironic that fluctuating hormone levels have been blamed for supposed irrationality and instability, yet after menopause when our hormone levels are not longer cyclic, we are considered estrogen-deprived, and still abnormal. Has it never occurred to medical researchers to trust in our bodies' inherent wisdom, that perhaps women are supposed to have decreasing hormone levels at this phase of our lives? The medicalization of the menopause experience describes menopause as a "deficiency syndrome" or "ovarian failure" and teaches that something is lost or inadequate and needs to be replaced.

The reality is that ovarian estrogen is already declining after about age 25, and estrogen made by the adrenal glands has already begun to increase. Estriol made by the body's fatty tissue is mainly what supplements the remaining ovarian secretions after menopause. Other body sites make the same hormones as well; these include the liver, breasts, hair follicles and the pineal gland. With adrenal secretions, all these body sites together supply all the estrogen needed by a woman who will not be bearing a child. In the truest sense, for most women there is no "estrogen deficiency" after menopause.

So, despite the fact that some researchers point to the 50-year life expectancy common in the beginning of the 20th century and theorize that women simply weren't meant to live past menopause (oh, please…), some of us seem to have the audacity to be living past our natural life-spans. We need more information about the normalcy of menopause and clear instructions to guide us with self-care.

Normal Menopause

Normal menopause is just that - normal. It is a definite physiological milestone in a woman's life heralding the beginning of a powerful new phase of growth. It is a good idea to be well prepared for this journey. The following are definitions of the language used to define the menopause experience, to help you negotiate decisions regarding your health during this time.

Pre-Menopause - is the time of greatest hormonal fluctuation during the later reproductive years (can feel like horrendous PMS), when periods become irregular and other changes may begin to occur. The actual age at which menopausal change begins varies considerably from woman to woman; the norm is 45, with a normal range of 35 to 55. During the pre-menopausal years, menstrual periods may become noticeably different (closer together, further apart, scantier, more profuse). Changes in the menstrual cycle are often the first sign that menopause is approaching. Changes may be sudden and significant, or so gradual that they go almost unnoticed. Periods may be very different from what they once were. Menstrual cycle changes can affect cycle length and the amount of menstrual flow. Night sweats and/or hot flashes may come, if at all, only sporadically and are usually blamed on too many blankets, a sweaty partner, or a spicy meal.

Menopause - is the end of menstruation, defined after the fact, that is once 12 months have passed without a period. Meno (menstruation) pause (stops) is technically, the last menstrual flow of a woman's life. The menopausal climax years include the year or two before and a year or more after the very last menstruation. The average age of a woman in the midst of her climax is 51. During the 2-5 year climax period, the bones refuse to take in calcium (perhaps so we don't become too rigid in our resistance to change?) and bone scans will show lessening bone density; flashes, flushes and night sweats may be frequent; palpitations, emotional sensitivity and sleeplessness are common. Depending on the individual woman and her circumstances, other physical and emotional changes may occur with the climax. Or she may breeze right through. All symptoms are transient and correctable. However, it is currently the fashion for physicians to take blood samples and then diagnose "low" hormone levels in women whose hormone levels are perfectly normal for their age.

Post-menopause - the several years after the end of menstruation during which time the body completes its adaptation to its new stabilized hormonal state. After menopause, the ovaries continue to produce low levels of estrogen and androgens, as do the adrenal glands. Androgens can be converted to estrogen by fatty tissue. So, post-menopausal women have some, albeit lower, levels of estrogen present throughout the rest of their lives. Post-menopausal women who have not had their ovaries removed are not more estrogen deficient than are pre-pubertal girls. The post-menopausal years symbolically begin on the 13th new moon after the final menstruation, and continue -- obviously -- for the rest of the lifetime. Commitment to a healthy lifestyle in the postmenopausal years can halt and reverse the loss of bone density (the bones do accept calcium once again!) Being vigilantly health-conscious can prevent estrogen and progestone sensitive tissues in the vagina and bladder from weakening and drying out, and maintain a healthy, vigorous heart and circulatory system.

Surgical Menopause - is the menopause brought on by the surgical removal of a woman's ovaries or by radiation treatment or chemotherapy. If the woman has not already gone through a natural menopause when she has this surgery, radiation or chemotherapy, she will go through immediate menopause at that time and will skip the pre- and peri-menopausal stages.

Menopause is a very individual experience, but all women deserve accurate information about the normal changes of menopause, safe remedies for common discomforts, and medical intervention for the small minority whose discomforts are severe. The following information is a culmination of many years of working with women as their community midwife and practicing as an herbalist working with plant allies to create healthier living for women and their families. I offer simple common sense alternatives to conventional, allopathic medicines' drug-oriented approach. These natural treatments can be used as an alternative to HRT in all but the most severe cases. This drug-free approach preserves the time-honored knowledge of our grandmothers, as well as modern, alternative methods that work for alleviating and preventing symptoms of menopause.
 
Due to the constraints of time and space for this article, I will only focus attention on the two most common menopausal symptoms: hot flashes and vaginal changes . Other symptoms can include emotional instability, "fuzzy" thinking, insomnia, depression, stiffening joints, sore breasts, dry skin, and abdominal congestion (constipation, gas, bloating). I will cover self-care for menstrual cycle changes and lessening bone density in Part 2. All symptoms are transient and correctable. If you are experiencing any of these symptoms and would like more information on alternative therapies, call your local midwife, an herbalist skilled in botanical medicine, or nearest naturopathic physician for homeopathic remedies. They will refer you to the appropriate treatment

Carol Leonard, a “foremother of the modern midwifery movement,” is a New Hampshire certified midwife who has been practicing for over the last three decades. She is the author of her memoir as NH's first contemporary midwife, Lady's Hands, Lion's Heart: A Midwife's Saga, Bad Beaver Publishing, 2008. She is co-founder of the Midwives Alliance of North America (MANA), which represents all midwives in the United States, Canada, and Mexico, and served one term as its president. She is currently building a four-hundred-acre farm in Ellsworth, Maine, named Bad Beaver Farm.