A renowned authority on women's health, Dr. Christiane Northrup anwers questions about the myths, realities, and possibilities that the "change of life" offers to women--physically, emotionally, mentally, and spiritually.

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energy boost growth HRT & spirituality celebrating age & depression supportive husband is HRT safe? teens relating sex diet herbal therapy the jitters spiritual retreats a touchy subject?

schubird123: What are the spiritual lessons I can learn from menopause? So far, it seems like only physical symptoms that need to be dealt with.

chris_northrup_md: Sometimes a few physical symptoms are the only challenges one will find at menopause. There is no need to look for spiritual challenges if all is well with your life.

ferretgirl75063: I had a mastectomy four months ago. No chemo, no radiation. I have not menstruated in three months. Menopause in my family is 50ish. Can a mastectomy cause early menopausal onset?

chris_northrup_md: A mastectomy itself will not cause early onset, but the physiologic stress associated with surgery could cause several months of missed periods which may mimic menopause. Chances are that your periods will restart.

speciallady43604: I've had a partial hysterectomy. I'm now 53 and don't know if I've gone through menopause. How will I know?

chris_northrup_md: Most people who have had their uterus removed but who retain their ovaries will experience things such as hot flashes. This may be the only symptom you will have. Others go through mood swings, insomnia, PMS-type symptoms. Each case is individual.

schubird123: You've spoken about the increase in energy that can come with menopause. Why do you think this happens?

chris_northrup_md: There is a kind of increase in life force available to us at menopause if we open to our spirits. New growth begins in the spring; menopause is the springtime of the second half of life.

At the same time, we have a heightened sense of our mortality, so we feel a certain urgency to get on with those things which we've always wanted to do but which we've kept putting off until later.

asimpkinson: Dr. Northrup's book "The Wisdom of Menopause" has recently been published by Bantam Books. For more information about Dr. Northrup's upcoming events, newsletter, workshops, etc., log on to www.drnorthrup.com.

w_coppock: How is menopause an opportunity for growth?

chris_northrup_md: For the same reason that menopause is associated with new energy or this midlife life force, it is also associated with a sense of dying to our old obsolete ways of being in the world. Oftentimes the beliefs and behavior that have served us well and helped us survive the first half of life must be revised or eliminated. If we don't change, we set ourselves up for disease and premature death.

Unlike in adolescence, when we were certain we were immortal, we've now lived long enough to witness all around us friends and family members.... So menopause becomes an opportunity to direct our lives on purpose and according to our inner needs.

Menopause is often seen as a time of raging hormones, mood swings, and erratic behavior. What's really important for people to understand is that hormonal fluctuations do not, by themselves, cause craziness. Instead they simply heighten unfinished business. When we can see our own irritability and craziness as labor pains, then we can understand and have patience with ourselves as we go through the process of transformation.

schubird123: My doctor has been suggesting estrogen for years. Will taking hormone replacement to relieve symptoms cover up the need for spiritual growth?

chris_northrup_md: Absolutely not! The spiritual piece of menopause is so imbedded in the process of menopause that there is almost no hormone or medication that can mask it. And that is truly exciting!

mottsmom: There is some controversy about taking hormones to help ease the symptoms of menopause. Are hormones safe?

chris_northrup_md: I've worked with all kinds of different hormonal preparations for years, and I've come to believe that in low doses, when the hormones are bio-identical--they match those found in the female human body--then they are generally safe and often very helpful. However, there are women who react to the slightest dose of hormones no matter what form it's in.

In general, I recommend that women going through a natural menopause try alternatives to hormones first; e.g., high-dose soy, exercise, supplements, and dietary change, and use hormones only if more natural means are unavailable or ineffective.

jtgarner99: Do you believe that progesterone cream helps bone growth and post-menopausal women? I have been using it for three months.

chris_northrup_md: Right now we don't have enough solid data on bone loss and 2% progesterone cream. However, in an ongoing study, it looks as though bone loss is halted with the cream at menopause, but the cream doesn't increase bone density. So many factors contribute to healthy bones that I think it's important that we get away from thinking that there is one thing that will take care of a process as complicated as bone metabolism.

asimpkinson: Don't forget to check out Dr. Northrup's new book, "The Wisdom of Menopause " and log on to her website--www.drnorthrup.com--for information about her activities, workshops, etc.

Lekvar_5: Do you think menopause should be celebrated in the same way some families celebrate a girl's first period?

chris_northrup_md: I have noticed that many, many women are doing just that! These celebrations range from conventional parties to full-blown croning ceremonies. I personally felt compelled to have a large 50th birthday party but wasn't at all interested in marking my 40th birthday. I think anything like this is a great idea.

Lekvar_5: My aunt claims she never went through menopause. Is this possible? And did she miss an important period (pardon the pun) of spiritual growth because of it?

chris_northrup_md: It's common to hear from women who never had any symptoms during the menopausal transition. One day, they just stopped having periods and went on with their lives. I have a feeling that this was more common in the '40s and '50s than it is now, and that's because nobody even wanted to talk about menopause until the last five to 10 years. So it's possible that there was some denial going on.

The spiritual rebirth of menopause is very compelling, but it certainly needn't wreck one's life. It can be a very gentle awakening.

schubird123: There is a sense of loss at menopause, that you're no longer fertile or youthful. How can you keep this loss from becoming depressing?

chris_northrup_md: The only parts of life that are eternally valuable and perennial are love, knowledge, and a connection with our souls. The more we dwell on summertime when the winds of autumn begin to blow, the more miserable we'll be. But if we use this time to connect with our deepest selves, we develop a sense of proportion, and a sense of humor that is delightful. Ultimately it's simply a choice we must make to accept the time of life we're in. There's no power on the planet that can make us 20 again.

I also suggest that we expand the concept of fertility. It is far more than the ability to bear a child. It's all about our ability to create with others, and that increases at menopause.

thammond64: My wife has been told that she is perimenopausal, and she's rather depressed about it. What can I do to help her feel better? I know it's not easy for a man to relate, but I want to try.

chris_northrup_md: Thank you so much for being willing to be of support. Back in the days when I delivered babies, men would ask how best to support their wives during labor--another process that they could not experience directly. My answer was the same as it is now: Your job is to love your wife.

Compliment her, tell her what parts of her are beautiful. The woman you married has the same spirit she always had. Let her know that you fell in love with her essence, not her hormone levels.

I also think you can get her the book "The Wisdom of Menopause." :- )

shell_mabelle: Can you tell me, in this day and age with young girls starting their periods earlier, whether menopause starts earlier?

chris_northrup_md: No, it actually means that menopause may start later, and this has to do with the factors that bring on a menstrual period early, like body weight, percentage of body fat, diet, etc. These are the same factors that cause a woman to menstruate later in life.

Lekvar_5: I've heard that women in their 20s can be perimenopausal. Is this really bad news for them?

chris_northrup_md: Same goes for women in their 30s. It doesn't have to be bad news, but the body should not go for long periods with subnormal levels [of hormones] while in your 20s and 30s. This can lead to early osteoporosis and other problems. I always recommend hormone replacement whenever possible in these situations.

fluffyone2002: How safe is hormone replacement therapy?

chris_northrup_md: Hormone replacement therapy should be prescribed in individualized doses that match as nearly as possible those hormones that a woman's body may be lacking. Hormone replacement refers to three different hormone groups: estrogen, progesterone, and androgen.

Too often, people believe that hormone replacement means Premarin. Premarin is the most popular form of estrogen but probably the most dangerous. It is made from the urine of pregnant horses and its metabolic breakdown products in the body are biologically stronger than the parent compound. There are several disturbing studies showing that Premarin does DNA damage in breast tissue.

Premarin is the main ingredient in Prempro and Premphase, two very widely prescribed forms of hormone replacement. Better choices are patches such as Climara and Estraderm. When it comes to progesterone, the best choice is bio-identical progesterone, which is available in capsules as a 2% skin cream known as Prometrium and a vaginal gel called Crinone.

Unfortunately the most widely prescribed progesterones are synthetic, such as Provera. This [progesterone] is also the ingredient in Prempro. This type of synthetic hormone has been associated with narrowing of coronary arteries. I believe that it may be dangerous in some women.

As you can see, the question "Is hormone therapy safe?" depends on the person, the type of hormone, the dose, and the period of time over which it's used. We now know that estrogen replacement increases the risk of breast cancer and ovarian cancer. Unfortunately, the vast majority of studies which show this association have used Premarin and Provera hormones that are not natural to the female body.

mackie37: How can teen daughters relate to their menopausal moms better? I know when I was a teen, my mom was menopausal, and with all of the hormones flying around, our house was a war zone!

chris_northrup_md: You must give each other lots of space because you're both individuating from the expectations of others. My next book will tackle this issue in depth because I have two teenage daughters. :-)

schubird123: Sexuality seems to change at menopause. Have you noticed that women want sex less, because it's uncomfortable, or more, because there's no need for birth control?

chris_northrup_md: Both things, depending on the woman. Some women want sex more than ever because of the increased energy flowing through them. But you can't make a blanket statement about sexuality at menopause.

I want to stress that no woman should suffer from painful intercourse, because there are so many safe and effective means to cure that problem.

mr_brown_the_dog: Are there particular foods I should be eating as I go through the change? I'm avoiding the hormone replacement therapy my doctor suggests, and I'd like to tackle this thing holistically. Any ideas about diet?

chris_northrup_md: The diet that will help the most is a diet that contains Omega 3 fats, like those found in salmon and flaxseed. Also, a diet of whole foods is vitally important. It is very important that the diet keep insulin levels low. To give you a rundown of the diets out there that do that: the popular book "Sugar Busters," "Protein Power," and "The Sugar Addicts Total Recovery Program." All contain valuable information.

It's essential that you get enough protein and enough healthy fat but cut way back on all refined carbohydrates, such as alcohol, sugary foods, and starchy foods like French bread.

chiwawa51: What about herbal therapies?

chris_northrup_md: Herbs have been used to help menopausal women for millennia! Though far more research has been done on hormones than on herbs in the United States, herbal remedies such as black cohosh are the most popular menopause treatments in Europe.

For those who would really like to delve into how to take herbs, I recommend Susan Weed's "Wise Woman's Way Through Menopause."

mr_brown_the_dog: Is short-term memory loss associated with menopause? I can't tell if it's my hormones, my age, or my imagination...

chris_northrup_md: There is this phenomenon called fuzzy thinking that is very common at menopause. It is not so much memory loss as it is a change in one's attention. Attention is turned inward, so you may be apt to put the cell phone in the refrigerator. This is not a sign of early Alzheimer's!

weeweeber715_00: Why am i going through menopause at 38?

chris_northrup_md: Thirty-eight is a bit early for menopause, but it is not uncommon. The most likely reason is autoimmune problems in the ovaries. That means that the body makes antibodies against your ovaries. In a case like yours, I would recommend acupuncture and traditional Chinese medicine. Many times, I've seen this halt the process and restore balance.

smilingreeneyes_12: Is it normal to have more "jitters" during this time?

chris_northrup_md: It is not normal to have jitters, but it is common, and that's because menopause is associated with anxiety when fears we've been carrying for years come closer to the surface. It's difficult to know whether a person needs therapy, St. John's Wort, DHA and Omega 3 fats, or exercise. All of these can help with the jitters. I would read the brain section in my book "The Wisdom of Menopause." There is a whole chapter on this topic.

sweetsus419: I was wondering if there is one contraceptive pill that works better than others for women that suffer from migraines during the onset of their period? I know there is one that works well if you have acne, and I was curious if one works better for migraines. Also, I am perimenopausal and on Loestrin.

chris_northrup_md: A progesterone-only pill may be helpful in this case; an example is Micronor. I would also recommend a 2% progesterone skin cream daily, 4-5 days before you're likely to have a migraine.

schubird123: Are there any spiritual places or retreats where women can go to celebrate the advent of menopause?

chris_northrup_md: You could really go anywhere. You could go to a spa like Canyon Ranch if you wanted to do a high-end spa or a place with hot springs.... Any retreat center would be perfect. It depends on your temperament. The most fun is to go somewhere where you can nourish your soul but also have your body taken care of really well, with massage, good food, etc.

Lekvar_5: Do you think my mother would be insulted if I gave her your book, even though she hasn't formally told me that she's entered menopause?

chris_northrup_md: I loved that you asked that, and the reason is because so many people have asked me the same thing.... How do I slide this book into the house without getting hit by someone over the head. :-)

I would talk about the places in the book that you could relate to as a woman or as a man and just say you thought she might enjoy it, regardless of whether or not she is in menopause. In fact, many women in their 30s and early 40s are enjoying the book because it gives them a way to prepare for an inevitable stage of life. Approach her as though she is 39 and simply might want to prepare. :-)

asimpkinson: Thank you, Dr. Northrup, for a very informative, interesting evening. And thank you all for participating in this chat. Good night.

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