Why advocating for yourself is critical in women's health
[Estimated reading time: 4 minutes, 48 seconds.]
NOTE: Please consult your medical team before taking any medications or starting a fitness/diet regimen.
Yesterday, President Biden signed an Executive Order on Advancing Women’s Health Research and Innovation. This follows first lady Jill Biden’s announcement last month of $100 million in funding for women’s health. While this is long overdue, it’s too early to say how this will actually translate into improved health outcomes for women.
Credit: Anna Moneymaker - Getty Images
What can you do today?
On a weekly basis, I hear from one or two people in my life struggling with symptoms that are likely perimenopause-related. They tend to brush those symptoms off as just being frazzled from “life”. So they think they need to just deal with them.
You don’t have to.
It’s about having a candid conversation with your doctor during your annual physical and ADVOCATING FOR YOURSELF! The most common symptoms of perimenopause tend to be caused by a decline in estrogen. To make things more fun, did you know you make 3 types of estrogen over the course of your life?
Estrone (E1): The weakest form of estrogen you make. It’s your primary form of estrogen once you are post-menopausal and is typically created from fat tissue in this form.
Estradiol (E2): The main female hormone you make over the course of your reproductive life. Once you start perimenopause (remember this starts in your early 40s, if not earlier), this hormone remains static and is the main reason for many of your symptoms listed below. It also is a big contributor to the increased risk for women with heart disease (women present different symptoms than men).
Estriol (E3): Your body increases production of this when you are pregnant. Otherwise you have miniscule amounts of this in your body.
The most prevalent symptoms of perimenopause are:
Irregular periods: They can indeed occur more frequently and become more pronounced as a woman progresses through the later stages of perimenopause. As estrogen levels decline, this leads to greater variability in menstrual patterns.
Hot flashes and night sweats: Hot flashes are sudden feelings of warmth, often accompanied by flushing of the face and sweating. Night sweats are similar but occur during sleep, leading to disrupted sleep patterns.
Vaginal dryness and discomfort: Declining estrogen levels during perimenopause can cause the vaginal tissues to become thinner, drier, and less elastic. This can lead to vaginal dryness, itching, irritation, pain during intercourse, and an increased risk of urinary tract infections.
Changes in libido: Some women may experience a decrease in sexual desire or changes in sexual function during perimenopause due to hormonal changes, vaginal dryness, and other physical or emotional factors.
Mood changes: Many women experience mood swings, irritability, anxiety, or mild depression during perimenopause. Hormonal fluctuations, sleep disturbances, and life changes associated with aging definitely play a role here.
Sleep disturbances: Hot flashes, night sweats, and hormonal fluctuations can disrupt sleep patterns, leading to insomnia or poor sleep quality. Lack of sleep can exacerbate other perimenopausal symptoms and affect overall well-being.
Fatigue and energy changes: Sleep disturbances, hormonal fluctuations, and emotional changes can contribute to feelings of fatigue or changes in energy levels.
Memory and concentration difficulties: Some women report experiencing memory lapses, difficulty concentrating, or "brain fog" during perimenopause. Hormonal changes, sleep disturbances, and stress may contribute to cognitive changes.
Irregular periods and hot flashes are the symptoms most people think of when they talk about perimenopause. These two symptoms, along with vaginal dryness and discomfort, tend to occur in the later stages. Not always, but generally.
The other symptoms are a bit sneakier and manifest themselves throughout the perimenopause transition in different ways.
So when you’re talking about changes in libido, trouble sleeping, mood swings, low energy and inability to remember details, society has taught us to blame ourselves. We tend to blame this on the "crazy” going on in our lives, which leads to….
There’s something wrong with us. We’re getting old so we’re not good enough. Past our prime (thanks, Don Lemon).
It’s more about your hormones have changed and you don’t have much control over that. What you do have control over is finding out your options in how to counteract your hormonal shifts.
You have agency in understanding that what fitness regimen worked for you in the past may not work for you now because your hormones have shifted. Your body has different needs and requires different stimuli to prevent the loss of both muscle mass and bone density.
Talking to your doctor
When talking to your doctor, it’s critical to walk in with a list of symptoms you are experiencing. Even if you don’t think it’s a “major” symptom, lots of smaller symptoms can add up as it relates to the appropriate treatment option for you.
Be candid around how these symptoms are impacting your quality of life.
Whether menopause hormone therapy (MHT) is a right for you, you need to discuss that with your doctor.
I’ll offer my own experience, which shouldn’t be taken as something that is necessarily applicable to you. I was struggling with my mental health awhile back. If I had been going to a therapist, I might have been prescribed anti-depressants and/or mood stabilizers. This would have treated the symptom and not the cause in my case.
I had an in-depth conversation with my doctor around where I was at, and she asked me about my thoughts on MHT. We discussed the stigma associated with it due to a now-debunked study from 20+ years ago. We also discussed:
Potential benefits and risks for me, given my health history (including current medications)
Alternative treatments or lifestyle modifications I could make
Understanding the different types of MHT, and how they differ
Expected duration l’d be taking MHT and how we’d monitor the effects of taking it
Known possible long-term effects of taking MHT
Where I could learn more on my own
Still confused? Want some help on how to have this chat with your doctor?