07: What No One Tells Us About Menopause with Sharon Depcinski, LMSW, CST (Part 1)

Summary:

In the swirling tapestry of a woman's life, menopause emerges as a defining chapter, signaling the culmination of her fertile years, often in the late 40's or early 50's. But this phase is not just about the physical metamorphosis; it is an intimate dance with changing desires and sexual vitality, demanding both comprehension and metamorphosis.

This isn't just a time of bodily changes—it's an invitation to redefine sensuality and connection. By understanding and embracing these evolutions, we open a gateway to holistic health during this transformational odyssey.

Today's episode plunges into the depths of the challenges that countless women grapple with during menopause: from the discomforts of dryness and pain to the ebbs of sexual longing, especially in a world where clear guidance on menopause is often scarce. We're thrilled to share the wisdom of Sharon Depcinski, a licensed clinical social worker and seasoned sex therapist with a rich experience of over 25 years, as she lights the path with her invaluable insights.

Menopause symptoms, hormone fluctuations and hormone therapy

Navigating the maze of menopause becomes even trickier for women using certain birth control methods like IUDs or hormonal implants. These methods can hide the usual signs, such as missed menstrual periods. For these women, the silent pause in their menstrual cycle might not necessarily ring the menopause bell, blurring the lines of when they truly cross that one-year threshold without a period, which is the official marker of menopause.

But before menopause sweeps in, there's the prelude: perimenopause. It's like the overture to a symphony, setting the stage with erratic hormonal melodies, potentially lasting for a dramatic decade. These hormonal swings play out in a medley of symptoms: hot flashes, mood roller coasters, restless nights, and evolving passions. Here's the twist: these signs might start serenading some women in their 30s, making it essential to recognize their early tunes.

However, simply checking hormone levels isn't enough to decipher this symphony. While hormone tests offer a glimpse of a specific moment, they might not capture the full, fluctuating crescendo of perimenopause. Just imagine: estrogen might peak during this prelude, potentially giving a false sense of where one stands in the menopausal journey if relying solely on that single note.

Listening to the body's entire symphony of symptoms – the rhythm of periods, mood tempos, sleep patterns, and other classic perimenopausal cues – provides a richer and more accurate understanding of where one stands on this transitional stage, rather than relying on just a fleeting snapshot from hormone tests.

Menopause symptoms and their impact on quality of life

It is important that your doctor is listening to your concerns and is genuinely caring about symptoms during the menopausal transition because the sad reality is that there are clinics prioritizing profit over understanding women's experiences, particularly regarding hormonal testing.

Perimenopause, the transitional phase leading to menopause, presents a spectrum of symptoms that fall into distinct categories: physical, cognitive, mood-related, and genital-urinary. Each of these categories highlights the diverse ways in which the body responds to hormonal fluctuations during this life stage. In fact, 50% of women experience sleep disturbances during menopause. And as we know, sleep disruptions have a far-reaching impact on overall well-being. There are also cognitive changes, such as brain fog and word-finding difficulties, common during perimenopause.

In addressing these symptoms, it becomes evident that maintaining a healthy lifestyle and prioritizing bone health are crucial strategies to lessen the overall impact of these changes. By focusing on a balanced diet, regular exercise—particularly weight-bearing exercises—and proper bone health practices, individuals can positively influence their experience during perimenopause. Building a strong foundation of health not only aids in alleviating physical discomfort but also contributes to an improved overall well-being throughout this transformative phase of life.

Menopause symptoms and their impact on sexual health and sexual desire

Menopause is a symphony of changes, and while many of its notes are distinctive, not all challenges faced during this time directly tie to this life stage.

Tackling depression during menopause often feels like walking a tightrope. One popular safety net is SSRIs (Selective Serotonin Reuptake Inhibitors) - a lifeline for many facing depression. Yet, there's a catch: these meds can unintentionally dampen sexual desire. Renowned for their depression-fighting prowess, SSRIs can also throw curveballs like reduced libido, challenges reaching climax, or even anorgasmia. For those already navigating the menopausal ebb in desire, it's like a double-edged sword. It's pivotal to walk hand in hand with medical experts, striking the right balance between mental resilience and preserving intimate vitality.

Here's a reality check: Almost a third of American women see their libido wane during menopause. And brace yourself - a staggering 50% to 84% of postmenopausal women face the trials of genital urinary syndrome of menopause.

If that wasn't enough, over 25% grapple with the pain of dyspareunia post-menopause. These are more than just stats; they're echoes of shared experiences, highlighting the pressing need for acknowledgment and understanding. The silver lining? These challenges, while common, can be addressed, paving the way for enhanced well-being and intimacy.

Yet, the heart sinks knowing fewer than a quarter of these women seek aid. The root lies deeper - a lack of comprehensive training in sexual health for many medical practitioners. It's high time we tune into these essential conversations, making them a part of mainstream medical discourse.

Links and Resources:

North American Menopause Society: www.menopause.org

Dr. Jen Gunter www.drjengunter.com; Dr. Gunter’s Blog is thevagenda.com

Dr Rachel Rubin Urologist and sexual medicine specialist: rachelrubinmd.com

Let’s Talk Menopause: https://www.letstalkmenopause.org/

Movie: Good Luck to You, Leo Grande

Books Mentioned:

The Menopause Manifesto by Dr. Jen Gunter

The Vagina Bible by Dr. Jen Gunter

What Fresh Hell is This? Perimenopause, Menopause, Other Indignities and You by Heather Corrin

Magnificent Sex: Lessons from Extraordinary Lovers by Peggy J. Kleinplatz PhD and A. Dana Ménard PhD

Come As You Are by Emily Nagoski

Connect with Dr. Heather England:

• Website
• LinkedIn
• Substack (A Midlife Reckoning)
• Workshops

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