I was introduced to Dr. Eve Agee, two years ago by a mutual friend via email. We scheduled a call and allotted an hour. We talked for two, and could have gone on for several more. I am forever indebted to that mutual friend.
Because Friday, October 18th, is World Menopause Day, we couldn’t think of a better way to acknowledge it than by interviewing Eve about a topic she’s been studying her entire adult life and now experiencing it herself. We’d like you to know a little bit more about her before going into our Q&A about this normal transition in every woman’s life.
Dr. Eve Agee is an international bestselling author, medical anthropologist, certified life coach and motivational speaker. Her best-selling book, The Uterine Health Companion: A Holistic Guide to Lifelong Wellness (Random House), is the winner of the International Book Awards.
Eve has served as a White House expert, taught at the University of Virginia, and researched women’s healing through the world. She is the co-founder of the Hot Flash Mob and her work has been featured on the BBC, NBC, iTV, Fox and NPR. You can learn more about Dr. Eve’s programs and products and receive her free videos series on how to thrive naturally during menopause at http://www.eveagee.com/menopause.
“With all the negativity we hear about menopause, this quote always feels like a breath of fresh air to me. I’ve been blessed to have interviewed hundreds of menopausal women over the past 20 years and one of the best lessons I learned is that even though menopause can present some big challenges, it is also a time when we as women have the opportunity to draw on our life experiences and step into our personal power.
Now that I’m entering the menopausal transition myself, I’ve discovered that the more I find ways to focus positively on the aging process, the better I feel. That’s because forming a more positive mindset about midlife and menopause lowers stress and increases energy, which can alleviate and prevent symptoms.” – Dr. Eve Agee
Now to the Q&A…
Q: What is Menopause?
A: Menopause is a normal stage of life. It’s natural and despite the misinformation that was commonly believed during the 20th Century, women have been going through menopause for most of human history. In fact, anthropologists believe it was the skills, wisdom and energy of menopausal women that allowed early humans to prosper and thrive so our species was able to evolve as we have (this theory is called the Grandmother Hypothesis).
During menopause, menses stop and women can no longer become pregnant–this opens the opportunity to focus our energy in other areas. Many non-Western societies believe that menopause is a personal transformation process, during which women have the opportunity to become more connected to their inner wisdom, creativity, personal power and leadership abilities. From a medical standpoint, menopause is defined as one year with no menstruation following a woman’s last period. That technically means that you don’t know that you’re officially menopausal until after it’s already happened.
Western medicine divides the menopause transition into several stages. Post-menopause refers to the remainder of a woman’s life after her last menstrual period. Peri-menopause is the life stage immediately preceding menopause, when a woman experiences changes in her menstrual cycles. Premenopause describes the phase of a woman’s life from when she first begins her periods to menopause. Temporary menopause may also be caused by a variety of medications used for endometriosis, fibroids, or cancer that disrupt ovarian function and inhibit menstruation.
Menopause can also be surgically induced by removing both ovaries, in which case menopause begins immediately. If you’ve had a hysterectomy and kept your ovaries, menopause can be determined through blood tests that measure your levels of Follicle Stimulating Hormone, often referred to as FSH. High FSH levels can signify that ovulation has stopped–indicating menopause–but it does not measure your estrogen levels. FSH levels can vary significantly during peri-menopause, so it may not always be an accurate test if hormone levels are still in flux.
Q: What are the most common symptoms of menopause?
A: In the West, more than 80 percent of women experience symptoms during the menopause transition such as irregular periods, hot flashes, sleep disturbances, night sweats, decreased libido, vaginal dryness and thinning, depression, mood swings, migraines, forgetfulness, and difficulties concentrating. You certainly may not have any or all of these symptoms, but if you do experience any of them remember that these symptoms generally occur during peri-menopause and then gradually decrease after your periods have ceased permanently.
Western medicine associates over 30 symptoms with the menopause transition, however from medical anthropology research we know that women in some parts of the world experience no symptoms during menopause and others experience very few. For example, Mayan women in Mexico and Rajput women in India describe having no menopausal symptoms at all and women in societies as varied as Japan as well as some Native American cultures report rarely experiencing hot flashes and other symptoms we consider a normal part of menopause in the West.
This is really interesting because women in many of these non-Western societies report feeling better and having more energy and increased libido during menopause so the symptoms biomedicine attributes to menopause are most likely caused by other issues such as long-term hormonal balances rather than this natural change in women’s reproductive patterns.
Q: What are the most common misconceptions of menopause?
A: One misperception is that menopause happens at the end of life to really elderly women. However, menopause typically happens in midlife. The average age of menopause for women in the United States is fifty-one and in some indigenous societies women typically go through menopause in their late 30s. In the U.S., peri-menopause generally begins in the early to mid forties or late thirties for some women and can last from five to as long as 12 years. Often Western women who are in their late thirties or early to mid forties and are experiencing changes don’t know what’s happening to them because they think they are not old enough be entering into menopause.
Another common misperception is that you should dread menopause because you are going to feel awful, have lots of symptoms and fall apart during menopause. Although many women in the West do have a really hard time during menopause, others do not experience many changes except the cessation of menses. Additionally, women in many African, Asian and Native American societies welcome menopause into their lives because of the energy, wisdom, clarity and insight they believe it brings. Most women in traditional cultures report feeling good during menopause naturally without having to rely on pharmaceuticals that can increase health risks.
Another misconception is that sometimes what are considered menopausal symptoms may be caused by imbalances in the adrenal glands or thyroids. So it’s important to make sure that symptoms that are being designated as menopausal are not actually caused by other hormonal imbalances.
Q: How many women are currently living with menopause?
A: By 2020, one billion women will be menopausal and we are pretty close to that number now. Menopausal women are all around you!
Q: What has been the standard protocol for treating menopause?
A: During the past 60 years, the standard protocol for treating menopause in Western Medicine was using Hormone Replacement Therapy. However, this protocol was based on the incorrect assumption that started in the mid Twentieth Century that positioned menopause as an estrogen deficiency disease. This protocol was whole heartedly embraced by the medical establishment even though there was no long term research to show if it was safe or not. As soon as long-term research got underway, we found out that HRT carries many serious long-term health risks including increased risks of breast cancer, heart disease and stroke. In fact, the World Health Organization has declared hormone replacement therapy carcinogenic.
We now know that menopause is not a disease. It is a normal stage of women’s lives that does not have to be treated with anything. Because of the risks involved with hormone replacement therapy, including increased risks of stroke, heart attack, breast cancer, blood clots, Alzheimer’s, and dementia, if you are experiencing symptoms during peri-menopause, first see if less invasive options such as herbs, supplements, homeopathy, reflexology, acupuncture, deep breathing, exercise, or nutrition, can give you the results you want.
Women who do not get relief from more natural approaches, generally find that bio-identical hormones and hormone replacement therapy relieve hot flashes, night sweats, and sleep disturbances–however we know that HRT poses serious health risks. Natural and synthetic hormones can also be used as a topical cream to relieve vaginal dryness or thinning. Many health care providers believe that bio-identical hormones, which come from plants and are individually designed each woman to provide micro doses of estrogens and any other hormones needed, may be safer but there is no long-term research yet.
If you do choose to take hormone replacement therapy or bio-identical hormones, have your hormones tested first to determine which hormones and what levels are lacking. Then work with your health care provider to decide on the timing that’s best for you. Some research shows that hormone replacement carries more cardiovascular risks if it is used later in life or started five years or more after menopause. However, other research shows that starting hormone replacement therapy before or soon after menopause increases risks for breast cancer. So weigh your own personal risks to decide the timing that is best for you and limit your use to less than five years.
Q: What’s the latest innovation or research in the pipeline for the treatment of menopause?
A: In my opinion some of the best innovations are coming from menopausal women who are creating safe, non-invasive, low-risk products to help themselves and others cope with symptoms, such as coldfront®.
The research I believe will ultimately help women the most, are the studies that reveal why women in some parts of the world have few symptoms or do not have any health issues and actually thrive during the menopausal years. This research looks at the ways diet, lifestyle, stress, and reproductive patterns affect our bodies and our hormones as we age.
This body of research shows that women in non-Western cultures that don’t typically experience difficulties during menopause, generally eat mostly plant based diets and have lifestyles that are much more active than the sedentary lifestyles so common in the developed world. This helps balance their hormones. Even the ways they frequently sit, stand and move support the blood flow and the nerves in the pelvic region protecting the health of the ovaries & uterus and creating more hormonal balance. Since women in indigenous societies spend more time outside, they receive increased exposure to Vitamin D, compared to so many of us in Europe and North America who spend most of our time inside and are consequently at much greater risk of being deficient in Vitamin D, which also plays an important role in hormonal balance and strengthening our bones.
Additionally, many women in indigenous cultures have more pregnancies and breastfeed their children for longer periods of time, often 3-4 years per child. During these extended breastfeeding periods, estrogen levels are relatively low. Researchers believe this helps them more easily make the transition to menopause because their bodies are used to long periods of relatively low estrogen. Unlike our society where we often have artificially elevated estrogen levels from all the hormones we take in from our food supply, the environment and even our medicine.
In most non-Western societies, women have not had the high rates of hysterectomies and other biomedical procedures or pharmaceuticals typical for Western women that can actually cause hormonal imbalances. We also know that in cultures where women have fewer or no bothersome menopausal symptoms even without using hormones, menopause and menopausal women are traditionally held in high-esteem. In these cultures, people frequently honor menopausal women as wise and treat them with deep respect. Menopause and aging are actually celebrated and thus less stressful than in a youth obsessed culture such as the U.S.
Q: Why and how are hot flashes associated with menopause?
A: Even though the exact reason why many women experience hot flashes during menopause is not known, scientists believe that hormonal changes during menopause affect the hypothalamus, the body’s thermostat, which is located in the base of the brain and is part of the endocrine system. Researchers theorize that the hypothalamus produces too many brain chemicals that signal that the body is too hot and causes blood vessels to open and sweating and flushing to occur in an effort to cool the body.
This has often been stated to occur because of low estrogen levels, but many scientists dispute that low estrogen causes this since children, who have low levels of estrogen do not typically have hot flashes and neither do menopausal women in many areas of the world. Consequently, more research needs to be done to understand how and why changes during menopause cause hot flashes in many women.
Q: What preventative measures can a person take against menopausal symptoms?
A: Since research shows that in many non-Western cultures menopause does not actually cause many symptoms or problems, this suggests that the menopause transition has been made difficult by our modern lifestyles, including chronic stress, inactivity, diets full of processed food, toxins in our environment and food supply, societal prejudice against aging women as well as medical treatments and pharmaceuticals. This means that it is not necessary to take hormone replacement to make it through menopause. However, you will want to support your body through whole foods nutrition, stress reduction, exercise and a healthy mindset and lifestyle.
Physical activity and regular aerobic exercise decreases menopausal symptoms, lowers stress hormones and generates more feel good endorphins. Strength training builds muscle and produces testosterone, boosting libido and giving you more vitality. Strength training is essential for all women as we age, especially if you have used hormonal contraceptives which can weaken muscles even in young women.
To prevent hot flashes specifically, start to eliminate alcohol, cigarettes, spicy foods, and caffeine, including regular and decaf coffee, soft drinks, and chocolate as much as possible. Wear layers of clothes made of natural fabrics and use cold on your skin during a hot flash to cool yourself down. Eat whole foods such as green leafy vegetables, fruit, and hormone free animal products. Consume healthy fats such as walnuts, avocadoes, organic raw coconut oil, and reduce processed foods, sugars and refined oils. Supplementing with natural vitamin E, particularly at high levels such as 800 to 1,000 milligrams per day, can also help decrease hot flashes. Work with your doctor to find the correct vitamin E dose for you, particularly if you are diabetic.
Research shows that women who do deep breathing daily or visualize cool images during guided meditation have a dramatic decrease in hot flashes. Daily deep breathing, for as little as 10 minutes a day can reduce hot flash frequency and intensity. Studies also prove that with just 12 weeks of regular visualization adults can regulate hormone levels, improve mood and reduce depression, fatigue and stress hormones. This works because visualization engages all the senses and creates powerful instructions and memories for the body. I recommend combining deep breathing with visualization to help reduce hot flashes. To do this, find a quiet place to relax, close your eyes, breathe deeply and imagine cool soothing water flowing through you regulating your body temperature and bringing you peace.
Q: What resources do you recommend?
http://www.menopause.org/ is the website for the North American Menopause Society
http://www.mayoclinic.com/health/menopause/ is the website for the Mayo Clinic that has preventative strategies as well as biomedical treatment options
Q. What words of wisdom for those experiencing peri-menopause through post-menopause, and the people closest to them, can you give?
A: It helps to have a sense of humor during menopause. It really can be challenging when your body starts changing in all sorts of undesirable ways. We can take steps to reduce symptoms and strengthen our bodies, but many of those changes take time. So be kind to yourself and make small changes gradually over time to improve mood, increase physical activity and eat more whole foods.
Take advantage of the fact that menopause does provide an excellent opportunity for introspection and reflection on how we want to live the rest of our lives. Give yourself time to tap into the gifts that menopause can bring. And remember that the large body of menopause research in non-Western cultures shows that women in many parts of the world do not experience health challenges during menopause so there are ways we can feel better during this transition. Just like the bodies of women in traditional societies, your body knows how to make the changes that occur during menopause, but it does need ample nourishment and support to do it with as much ease as possible.
We thank Dr. Eve for sharing her vast experience and expertise with our community, and encourage you to ask any questions that come to mind. Remember: menopause is normal; and… you are not alone!