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Working Through Menopause a Problem For Many Women

Thursday, September 26th, 2013

The prevalence of older women in the workplace is greater now than it has ever been before, but evidence collected through a survey of women in the United Kingdom has recently suggested that women of menopausal age feel that their workplace performance has been hindered by the changes in their body during this time. That is no surprise. Menopausal symptoms can range from irregular menstruation starting in the perimenopausal stage to hot flashes, agitation, and even joint soreness or pain.

Many women report that they feel they do not perform as well, and that changes in their body due to menopause affects their productivity and the quality of the work that they produce. However, most express an unwillingness to discuss these problems with their employers, in large part due to the fact that – for the most part – their employers are younger men. While this study took place in the UK, it is applicable to the United States as well.

While all aging employees will likely see some decrease in their workplace abilities as they grow older, the predicament of women going through menopause is a sensitive subject—however, it is one that must be touched on in order to find a solution that works for these women and that does not make them feel as if they are “rocking the boat”, so to speak.

The study in question found four areas of concern that needed to be addressed. The first was a greater awareness of menopause and menopausal symptoms among employers. Along with that was a need for a more flexible schedule and a more comfortable workplace. However, one of the more important areas that this study advised should be broadened was the amount of support that menopausal women in the workforce should be able to receive as they go through this transition.

While not every workplace will have these resources available for women, it is a good reminder of how important it is for any woman to have a good source of support on hand as she progresses through this stage of her life.

Whether her support is a sister, a close group of friends, or even anonymous strangers through an Internet forum – one of the greater benefits of living in the virtual age – these resources can not only help a woman approaching menopause know what to expect from the changes in her body, but the experience of others can be a great resource to help women uncover ways in which they can broach the subject of menopause with employers and adapt to the changes in her body. By determining what to expect as her body changes a woman will know what to ask for and the concessions that may need to be made in order to keep her active, healthy, and – most importantly – happy in the workplace.

– Yvonne S. Thornton, M. D., M. P. H.

Soy is the Secret to Hot Flash Reduction in Menopause

Monday, February 4th, 2013

There’s no sugar coating it – menopause is the pits. We become more and more irritable until our family members can’t take it, we wake up drenched in sweat in the middle of the night, and we can’t even sit through a movie without taking a few bathroom breaks. Many women would gladly take their periods back to avoid these uncomfortable menopause symptoms. While menopause is largely out of our control, a recent study shows that there is one symptom we can actually reduce by altering out diet.

Hot flashes and night sweats are both considered vasomotor symptoms. They’re caused by the reduction of hormones that are meant to regulate the dilation of your blood vessels. Menopause greatly decreases the levels of estrogen in your body, and your blood vessels will expand quickly for reasons unbeknownst to you in that moment. When the blood rushes through your body, you’ll feel as though you are suddenly sitting inside an oven, which is a hot flash. Night sweats occur for the same reason.

How can your diet control these symptoms? An adjustment in your dietary intake which includes decrease in caffeine intake and avoidance of hot, spicy spicy foods is an excellent start. Research shows that women who eat more soy in their diets experience fewer hot flashes and night sweats. Soy is one of the single best sources of phytoestrogens, which have been shown to have a modest effect on hot flashes, but there are no conclusive evidence-based or long-term studies. For that reason, younger women are advised against eating too much, as the human body can only take so much at a time. However, for women who are going through menopause and have less estrogen than ever before, soy may be the perfect solution. This could easily be the reason only 7% of Japanese women experience hot flashes during their menopause. Their diets are rich in tofu and natural bean ingredients. Considering 55% of American women suffer from vasomotor symptoms, it might be time to take the hint.

As if this news wasn’t good enough, adding more soy to your diet isn’t hard at all. Many of the foods that are rich in soy are also delicious and offer fun alternatives to the usual American diet. To get more soy, consider adding tofu, miso, soymilk, soy nuts, and soy sauce. However, I must admit that soy in these forms is an acquired taste.  I don’t want to be hypocritical, but my palate wasn’t too thrilled with soy intake.  Though it might take time to get used to these new tastes, if you’re not already used to them, they’ll all taste delicious when you consider the alternative.

 – Yvonne S. Thornton, M. D., M. P. H.

“Is it hot in here – or is it just me?”

Friday, June 12th, 2009

If you’ve ever gotten a hot flash, you know how odd it can feel. Usually, hot flashes don’t have a major impact on a woman’s life but some women suffer more than others. About 80 percent of women experience hot flashes and night sweats, which are short bursts of intense heat of the face and neck. Usually they begin in the early years of the transition to menopause and peak one or two years after the last menstrual period, remain for several years and then resolve over a period of time. I’ve had patients come in to see me feeling downright miserable due to pre-menopausal and menopausal symptoms. Some complain of waking up dripping wet at 2:00 a.m. with night sweats or feeling like tiny bugs are crawling all over them.

These symptoms will pass as your hormone levels adjust but what do you do in the meantime? Other than buying a small hand fan, there’s no single answer. Treatment has to be individualized for each woman. Avoidance of triggers, such as cigarette smoking, hot beverages, foods containing nitrites or sulphites, spicy foods and alcohol, may  help limit hot flashes. Blood pressure medications have been prescribed off-label with some success. SSRIs (selective serotonin reuptake inhibitors) such as Prozac® and Zoloft® or antidepressants such as Effexor® (venlafaxine) also offer relief.  Oral estrogens or transdermal estrogen patches have been found to be very effective in reducing the incidence and the intensity of hot flashes.  However, if estrogen is used, unless you have had a hysterectomy, an additional hormone, progesterone, must be added to the estrogen in order to decrease your risk of developing uterine cancer.  Relaxation techniques, such as deep slow breathing, may also help with hot flashes.

Some women think first of herbal remedies such as dong quai, evening primrose oil or red clover. However, I discourage my patients from using herbs as they’re often ineffective. Soy (a phytoestrogen or plant estrogen) has been touted as a remedy for hot flashes.  However, there is no conclusive evidence  for its benefit and there are no long-term safety studies. If you are convinced that you want to go the herbal route, I strongly urge you to discuss these remedies with your doctor beforehand. Don’t assume that because you get it over the counter, it’s safe. Herbs are not regulated through government health agencies and can have potent unintended effects, and may interfere with other medications or cause harmful interactions.

– Yvonne S. Thornton, MD, MPH