Menopause – I don’t know who I am anymore… is this the way it is now?

Menopause – I don’t know who I am anymore… is this the way it is now?

I don’t know who I am anymore… is this the way it is now?

Perimenopause, Menopause and Post-menopause

10 tips to a comfortable menopause journey

So, we know that menopause is a process that happens to all women at some point. Many of us assume that the common symptoms of perimenopause including hot flushes, irritability and discomfort are a “normal” and inescapable part of the process. You may be surprised to know that this is not the case! As with puberty, while our bodies change, it is not a life sentence. It can just be a transition. It is true that many women suffer horribly. It is also true, that with a diet and lifestyle that supports our hormones to balance, including cortisol and DHEA as well as the more widely known oestrogen and progesterone, we can transition through this period of life, comfortably! Life after menopause can be lively, exciting and something to look forward to. A stage of life blessed with increased wisdom and being comfortable in your own skin. Travelling through your Golden years with ease and grace.

Symptoms

These tend to vary from person to person and some women hardly notice any. An incomplete list includes:

  • Hot flushes
  • Breast tenderness
  • Worse PMS
  • Lower Sex drive
  • Headaches and migraines
  • Fatigue
  • Depression
  • Irregular periods
  • Vaginal dryness
  • Discomfort during sex (due to dryness)
  • Urine leakage when coughing or sneezing
  • Urinary urgency
  • Mood swings and irritability
  • Trouble Sleeping

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Perimenopause is the transitional stage between regular monthly periods and reaching menopause (defined as the point in time when a woman has had 12 months since her last period). The stage after this is classified as post-menopause.

Pre-menopause is the stage of life between puberty and menopause. A stage where hormones tend not to fluctuate much, a woman tends not to suffer any symptoms associated with menopause and she is in her reproductive years.

Perimenopause begins when the oestrogen produced in the ovaries starts to reduce. Often resulting in several years of irregular periods due to the more sporadic release of oestrogen and progesterone (as well as cortisol and DHEA). Sometimes the hormonal fluctuations as so large or out of balance that we may experience symptoms such as depression, moodiness and irritability, weight gain, discomfort, reduced memory and concentration, muscle aches, as sense of being uncomfortable in our own skin, hot flushes, hair loss, breast tenderness, reduced libido and sexual pleasure and vaginal dryness, to name a few. This stage may begin sometime between the ages of 35 and 50 years and can last from as little as a few months, to as long as 15 years with the average, being around 4 years. In the final stage, oestrogen levels may decline sharply. Symptoms may be most pronounced at this time, expanding to include things like urinary urgency and frequency or even incontinence; depression and anxiety as well as night sweats, fatigue and skin dryness.

Menopause occurs when there is no longer enough oestrogen produced by the ovaries to trigger the uterine lining to build, the release of an egg or the shedding of the uterine lining. This is the point where fertility ceases. Contrary to what some of us thought, during the perimenopausal stage, conception is still possible.

Treatments:

Medications:

Doctors can prescribe

  • Oestrogen creams for vaginal dryness, pain and discomfort
  •  Progesterone creams for breast tenderness
  •  The pill or other hormone replacement therapies to try to minimise symptoms
  •  Creams or tablets to reduce bladder irritability

Look into the options and side effects for yourself before you decide

10 Natural Tips for a Comfortable Menopause Journey
  • Exercise
  • Stop smoking
  • Get more rest/sleep
  • Reduce alcohol intake
  • Be in a healthy weight range
  • Ensure you don’t have a vitamin or mineral deficiency (magnesium, vitamin D, vitamin C, omega 3, evening primrose oil [internal or topical])
  • Reduce foods that have the potential to alter hormone balance in the body => Processed, hydrogenated and trans-fats; Highly refined carbohydrates (especially sugars); Caffeine; Alcohol
  • Pelvic floor exercises to support the pelvic area and the bladder (as incontinence is a symptom of hormonal imbalance associated with perimenopause)
  • Using natural oils (jojoba, coconut, olive) as lubricants down there as a lubricant during sex, or during the day to allow more comfort
  • Add an anti-inflammatory, alkalising, plant rich diet

Always consult your doctor if you have strong pain, very heavy bleeding or bleeding for more than 7 days longer than your usual period

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Pelvic pain and dysfunction part 1: Shhh we can’t talk about that!

Pelvic pain and dysfunction part 1: Shhh we can’t talk about that!

Pelvic pain and dysfunction part 1: Shhh we can’t talk about that!

Do you suffer from:

  • incontinence (urinary or bowel)
  • urinary frequency; urgency
  • bowel or bladder irritation (with or without pain; can feel like a full sensation)
  • pain (electric shock like, shooting, aching, itching or a raw feeling) of your clitoris, vagina, labia (or penis, scrotum), urethra or perineum (space between your vagina [or scrotum] and your anus)
  • Pain around your sit bone(s) when you sit (especially for long periods)
  • Pain during sex (or afterwards)
  • Pain in your buttocks that may often or sometimes travel down your leg and foot (can be one sided or affect both legs).

Did you know that help is available?

In this three-part series, you’ll learn about the key symptoms and causes of pelvic dysfunction, pain and incontinence. We’ll touch on chronic pain and discuss the basis of an effective management and treatment program. We’ll also reveal 7 simple actions to help you take control of your health and improve your individual symptoms of pelvic pain and dysfunction.

This is a difficult and sensitive subject and often not discussed due to its private nature.

It’s important to realise that in many cases there is a lot that can be done to help – there is no need to suffer in silence!

Symptoms can be wide-ranging, and diagnosis can’t be confirmed with just one test. Instead it requires a look into your personal symptoms and a physical assessment of your pelvic structures to identify imbalances of the joints, ligaments and muscles (tightness, weakness etc) and locations where nerves can become irritated and “trapped”.

Symptoms:

Can include (but are not limited to)

  • pain in the buttocks around where you sit (sometimes in the legs and feet too)
  • sharp, electric type shooting pain around or even within the vagina in women and scrotum (or even shaft of the penis) in men
  • pain during (or after) sex
  • bladder or bowel irritation/discomfort/incontinence/frequency/urgency
  • Pain that can refer or radiate to include part of, or even the length of the leg (generally down the outside) and even go down into the bottom of the foot.

Causes:

There is no one cause, and generally multiple factors are involved

  • Pudendal nerve entrapment – including from
    • long periods of cycling
    • excessive physical exercise
    • straining (from heavy lifting or straining on the toilet)
    • stress
    • posture
    • previous pelvic or perineal trauma/injury
  • Musculoskeletal imbalances – including from
    • long periods of cycling
    • excessive physical exercise
    • straining (from heavy lifting or straining on the toilet)
    • stress
    • posture
    • previous pelvic or perineal trauma/injury
  • Neuropathic (nerve related) pain
  • Trauma – including from
    • difficult childbirth
  • gynaecological and/or colorectal surgery or issues (eg internal abdominal adhesions or uterine fibroids and the like)
  • Infection (including skin conditions).

If you’re suffering from any of the above issues, or some sort of dysfunction of the pelvic/lower abdominal area or genital region, it’s likely that an in-depth history and physical assessment plus a multi-pronged treatment approach can be of great assistance. So, talk to a primary health practitioner (pelvic physiotherapist, GP or Osteopath for example) and find out more. If the advice you receive does not seem logical or if you don’t receive the options that help you gain back control, we suggest you try another practitioner, until you get the support you need.

And remember, working with a combination of such practitioners to get an integrated and diverse treatment and home care plan is your best chance of success.

If you would like to chat about your situation, drop us an email, call, or book an appointment with Alexis.

Stay tuned for part 2, where we discuss chronic pain and its complicated nature as well as the basic idea behind effective treatment and management of pelvic pain and dysfunction.

Author: Dr Alexis Weidland(Osteopath)