Don’t Tell Your Girlfriend How to Do Menopause
My patients know this is my one unbreakable rule. Well it’s at least the rule with the fewest exceptions. We all eventually join the “Golden M” club, but our pathway there can be very different. For some women there are a few symptoms such as hot flashes or night sweats, sleep disruption, and obviously irregular menstrual periods. But the symptoms are mild, not very frequent, and tolerable. For other women the lack of sleep or the “foggy brain”, the drenching night sweats or the heavy bleeding add up and significantly impair their quality of life. And, yes, there are even some women for whom menstrual cycles simply stop without sign or symptom. This last group is the women for whom I really encourage the “keep quiet rule” but that’s for their own protection!
This variability is why each woman needs the chance to tell her story and to share decision making with her clinician. Care needs to be individualized to match her needs, to return her quality of life, and allow her to continue to meet her days with energy and efficacy. For the large majority of women there is no need to fear hormones in menopause transition appropriate doses. This is the gold standard treatment and there are many evidence based variations on use to minimize risk. For the women who should not use hormones or who still decide not to use them, there are effective alternatives. Yet I see women all the time who start the menopause transition care discussion from a point of helplessness and even shame because they feel they are not coping with this “natural” life stage as well as their friends.
We have a few clues as to why our experiences are so different, but we still have lots of questions too. One thing we do know, it is not about “coping” or “being strong.” Expecting a friend to feel as you do when her baseline experience may be very different can be hurtful. So what can you do for your girlfriend?
Listen to her.
Ask her questions about her good days and her bad days. Ask how you can help if you have a friend who is struggling. Support the informed decisions she makes, especially when those decisions are different than the choices that were best for you. Help her to find more information if you believe she is acting from fear or feeling helpless but still has unexplored options.
Ah, there’s that exception to the rule! It’s always okay to encourage getting more information. But how do you know you can trust the information you find? I’m privileged to sit on the Medical Advisory Boards of several patient information sites. WomenLivingBetter.org is directed specifically at the menopause transition, particularly the earlier stages. I’ll be blogging more about this site and my good friend the founder, Nina Coslov, in the future. A more general women’s health site for which I’m on the Advisory Council is HealthyWomen.org. Both of these sites are scrupulous in sharing real information based on evidence. Finally, the North American Menopause Society website Menopause.org has great information about all aspects of menopause.