| February, 2010

Will Your Marriage Survive Menopause?

Opposite Sides Argument 2Over 60 percent of divorces are initiated by women in their 40s, 50s or 60s — the menopause years — according to a recent survey conducted by AARP Magazine. Why are women running away from marriage?

I wasn’t even married when I slammed into menopause months before my wedding day at the age of 47. Despite being completely in love, I almost ran away and my fiance almost married bridezella!

Experts say the number one reason for divorce is lack of communication. My response from the ladies corner, “When everything you know to be normal is being kidnapped by changing hormones, communication may be last on the list. Throw in lifestyle changes, health and aging issues, and you are left in a small evaporating puddle of low self-esteem feeling hopeless.”

Many men blame lack of sex as the leading reason for midlife divorce. But is it? AARP poled 1,682 adults ages 45 and older on the importance of sex. Two-thirds of men (66 percent) and about half of women (48 percent) agreed that a satisfying sex life was important to their quality of life. That is only an 18 percent difference. So is it lack of sex, or a breakdown in communication chasing the women away?

Navigating a course in uncharted territory can test any relationship emotionally and sexually. It can also bring a couple closer — it did for me.

Purchasing midlife marriage insurance can help combat the unforeseen hazards during the menopause transition. How do you qualify for this love insurance? The first step is to understand how menopause can affect your love life.

Ladies first.

Menopause is a life transition that can affect you physically and emotionally. Your body is experiencing fluctuating hormones that can cause hot flashes, night sweats, itchy skin, migraine headaches, breast tenderness, vaginal dryness and irregular periods. Eighty percent of women will experience uncomfortable symptoms, and the majority struggle with midlife weight gain.

Many women feel unattractive going through so many uninvited changes. Some suffer from exhaustion, depression and moodiness leaving them feeling isolated and confused.

During menopause a woman’s brain also goes through changes. Dr. Louann Brizendine (author of The Female Brain) says, “The mommy brain unplugs. Menopause means the end of the hormones that have boosted communication circuits, emotion circuits, the drive to tend and care, and the urge to avoid conflict at all costs.”
There are additional factors on top of fluctuating hormones that may contribute to a lack of communication and interest in sex.

Dr. Wendy Klein, co-author of The Menopause Makeover and leading menopause expert, informed me, “If a woman is taking medications, such as antidepressants, mood stabilizers, contraceptive drugs, antihistamines, sedatives, antihypertensives and/or medications for blood pressure, this can also decrease sexual desire.”

Midlife stresses brought on by career change, the loss of a loved one, empty nest syndrome or caring for elderly parents can contribute to a declining libido.

Throw in aging issues and the last thing on a menopausal woman’s mind is communicating. This woman is in self-survival mode, and may be in no mood to connect or make whoopi.

If she is in an unsupported relationship while managing this collection of changes, leaving the marriage may appear like her only salvation.

Gentlemen — your turn.

How many factors listed above is your partner experiencing? It is no surprise why men are afraid of menopause. His woman is changing in front of his eyes.

Women are not alone suffering from changes. Men also have midlife challenges, both physically and emotionally. Declining testosterone can affect libido, moods and sexual performance. Generally a man’s hormones change gradually compared to the woman’s experience during menopause, so it may not be obvious to the man that he too is changing. Some of these unwelcomed changes may include midlife stress, as well as health and aging issues. If both partners are experiencing change, the relationship may be on an emotional roller coaster.

Approximately 47 percent of women experience sexual difficulties with a decrease of sexual desire being the most common, according to the National Health and Social Survey and the Global Study of Sexual Attitudes and Behaviors.

It is no surprise that most men associate menopause with having less sex. But, it does not have to be this way. The man can actually help save a shaky midlife marriage with some handy tools to power charge the relationship. Women who have a supportive partner often have a smoother transition through menopause. When she is happy, he is happy.

Acquiring midlife marriage insurance takes action to make a difference.

Midlife Marriage Insurance For Him
1. Listen to her; don’t criticize or try to fix her.
2. Go with the flow; be prepared for mood swings.
3. Be compassionate, and validate her experience (that means agree with her, don’t try to fix her).
4. Be romantic. Bring her flowers for no reason. Make her dinner. Give her a massage. Make it about HER.
5. Cuddle more. Tell her you love her and that she is beautiful. You may just get lucky. If not, do not take it personally.
6. If YOU are not in the mood, keep her company shopping, she will love the company ;)
7. Support healthy eating and exercise choices. Join her for a walk or go on a hunting expedition at the grocery store to find new healthy foods.
8. Don’t ignore her menopause symptoms. Talk about it. Ask her what she needs to feel better.
9. Offer support if she needs to visit her healthcare provider to discuss menopause symptoms, a low libido or depression.
10. If numbers one through nine fail – disappear for a while. She may be seriously cranky and need space to focus on herself.

Success depends on going through this transition as a team! Both partners must contribute to have a successful marriage.

Midlife Marriage Insurance For Her
1. Track menopause symptoms and discuss treatment options with your healthcare provider.
2. Make a commitment to a healthy lifestyle. Exercise most days of the week. Eat nutritious meals. Watch portions.
3. Update your beauty regimen.
4. Build a support group.
5. Communicate with your partner. Don’t shut him out – let him know what you need. Understand he may be confused by your changes.
6. If you are not happy in your current relationship, discuss counseling.
7. Be receptive to creative adjustments in lovemaking activities.
8. If your libido is low and/or you are suffering from vaginal dryness, discuss your treatment options with your healthcare practitioner. There are hormone and non-hormone options available.
9. Pamper yourself.
10. Try to stay positive.

Communicate, support each other’s needs, get counseling if needed, add romance, adjust lovemaking activities, and your odds increase that your marriage will survive menopause. Being on the same team will nourish a healthy, loving relationship that can last a lifetime.

Life is constantly changing, and marriage is no different. Have real expectations, and acknowledge that your relationship goes through transitions. This will help you weather difficult times.

Midlife is an opportunity for both men and women. If you are prepared, informed and willing, your marriage can survive menopause. A loving relationship supported with good communication can strengthen your love life at any age.

This menopausal bride made it down the aisle of love. Both my partner and I said “I do” to communication and romance during menopause. We are still happily married five years later and ready to leap over the seven-year itch together.

References
Montenegro, X. The Divorce Experience: A Study of Divorce at Midlife and Beyond. AARP, May 2004.
Brizendine, L. The Female Brain. New York: Broadway Books; 2006.
Jonekos, S. and W. Klein. The Menopause Makeover. Ontario, Canada: Harlequin Enterprises; 2009.

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Irregular Periods During Perimenopause

Wendy Klein MD150One of the first symptoms you may notice during perimenopause is irregular periods.

I was on birth control pills so I did not experience irregular periods. But for those of you not on birth control pills, noticing a change in your period may be an indication you are perimenopausal.

___________________

Interview with Dr. Wendy Klein, leading menopause expert and co-author of The Menopause Makeover

Staness: What is one of the first symptoms of perimenopause?

Dr. Klein: The hallmark of perimenopause, which is the phase prior to menopause, is irregularity. We all grow up thinking that when you enter the change of life and become menopausal, your periods just stop. That is not the case.

What happens is your periods start to become irregular. You can have too many periods, you can have too few, you may skip a period and then get regular again, and you may skip a few periods. You may think, “oh my, I am in menopause,” and suddenly your period comes back again.

Staness: Why does this happen?

Dr. Klein: Prior to menopause your periods are usually very regular. The amount of hormone that you are producing is very regular and predictable. However, as you approach menopause, entering the perimenopausal phase, the ovaries are unpredictable. You will have months when you don’t ovulate, and that causes irregular bleeding.

Staness: How long does period irregularity last?

Dr. Klein: How long that lasts is highly individual. Could be a year, could be two years, could be three years and that is all normal variation. I like to say that the ovaries are stuttering. You don’t always ovulate and your previous hormonal milieu begins to change.

Eventually you will experience fewer periods and finally your periods will stop. You are not officially in menopause until you have skipped 12 consecutive periods.

Staness: How does a woman know her periods are irregular?

Dr. Klein: You may get too many periods. You may get too few. You may skip them. The bleeding may become heavier, or it can become lighter.

Staness: What should a perimenopausal woman with irregular periods do?

Dr. Klein: Well the easiest thing to do is keep track of your periods. Write them down in the your calendar and track them. Keep a record of when you are having your periods and what your symptoms are, so when you visit your clinician you can discuss the changes using actual dates.

If you are troubled by irregular periods, you can discuss the option of low dose birth control pills. This can help with regulation, with excessive flow, and also with contraception.

One of the issues of which you should be aware is that even in perimenopause you can still become pregnant and since your periods are not regular you have an increased risk of unintended pregnancy. Birth control is still necessary as long as you continue to ovulate, even if you are irregular.

______________________

Menopause is a normal and natural part of a woman’s life. Arm yourself with knowledge, build a strong relationship with your clinician and manage your menopause empowered.

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Finding balance — your secret weapon to good health and happiness

Businesswoman jugglingConstantly Cranky in North Carolina

Dear Crabby,

I had a total hysterectomy April 2008 at the age of 30 for endometriosis and a tumor on my right ovary. I was put on birth control pills, but decided I didn’t like the side effects and got off November 2009. After stopping the birth control pill I tried to go on my own, however I found myself hysterical. I was having so many emotions that I really thought I was having a mental breakdown. I was forced into seeing a therapist from my employer because they thought I was “stressed.” I don’t think that fits. I think psychotic fit’s better.

I am now on estrogen therapy (Premarin 0.625mg). After two weeks of being on this, I was forced to take a two-week stress-free vacation, I am actually feeling somewhat better.

I’m not married and therefore the lack of sexual desire doesn’t really bother me but the mood swings do. I feel like a 50 year-old in a 32 year-old body that is 5’2” at 186 pounds. How do I get past the happy one-minute and foaming at the mouth the next? I’m tired all the time and working 40 to 50 hours per week that makes me want to sleep all weekend. It’s a good thing I’m not married and have no children, because at the end of the day I’m exhausted.

Constantly Cranky in North Carolina

Dear Constantly Cranky,

You have a reoccurring theme in your quest for answers – the need for balance. As a busy woman, balance can be hard to find. Balance with your body, mind and spirit is a necessary step to being happy.

Step #1: Body, discuss your ET dose with your doctor

Per Dr. Klein, leading menopause expert and co-author of The Menopause Makeover, “after abrupt surgical menopause, it is generally necessary to start with a higher dose of HT, and taper down as tolerated.” Estrogen alone is prescribed for postmenopausal women who have had a total hysterectomy. This is because, without a uterus, the risk of uterine cancer is essentially absent, so there is no need for the uterine protection of progesterone.

Based on this information, I am not surprised you did not like the effects of being on the birth control pill that usually has progesterone and estrogen. Going off the birth control pill no doubt sent your hormones into chaos possibly contributing to feeling “hysterical.” Now that you feel better being on estrogen therapy (ET), you may wish to discuss your dose with your healthcare provider.

The hormone ups and downs you have experienced may be contributing to other imbalances, including moodiness.

Once you and your doctor manage hormone levels you will start to feel better.

Step #2: Make a commitment to lose weight

Being 5’2” at 186 pounds puts you in an unhealthy category according to the BMI chart. Your BMI is 34, anything over 30 is considered obese.

It is time to make a commitment to your health with weight loss being a major focus. Carrying extra weight can put you at risk of type 2 diabetes and heart disease.

Start eating five to six mini-meals a day to jumpstart your metabolism and reduce those blood sugar crashes that may be contributing to mood swings. Include lean proteins, low glycemic carbohydrates and healthy fats. Reduce your calorie intake. Use the calculators on the homepage. Take the full body analysis to determine your calorie intake for your ideal weight.

Start exercising at least 30 minutes four to five days a week. Forcing yourself to find time for exercise will help you find balance with work. Pamper yourself.

Join a dance class. Start moving for FUN. You will meet great people, and socializing will help you find balance too.

Step #3: Mind and spirit, find balance in your life

You are working long hours, and you wonder why you are tired on the weekend? You are living a stressful lifestyle that is not helping your health situation. It is time to also find balance in your LIFE. Making time for exercise and fun activities can help bring balance.

I invite you to join the Menopause Makeover online community at eharlequin.com. It is a group of supportive women who will cheer you on, share recipes and ideas. You are not alone.

Finding balance is your secret weapon to good health and happiness

Signed,
A balanced Dear Crabby

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"After twelve weeks on The Menopause Makeover, I not only lost weight, but I feel a lifting of my spirits. I am more vibrant and energetic and have a more positive outlook on life"

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