Wellness Wired: Not Your Mother’s Menopause

By Kerry Brophy Lloyd

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I recently went hiking with my friend Beth, who is older than me and has already entered the phase of life known as “second spring” in Chinese medicine. I like this term much better than “menopause,” a far less inspiring description for the end of a woman’s reproductive years, when the body’s hormones make radical shifts that leave many of us feeling, well, different. 

Beth shared that she felt pretty alone on her path to menopause, unable to get answers or find someone to treat her mystical symptoms. I told her that’s been my experience, too, as I feel like Dorothy traveling down the yellow brick road, not knowing what’s real or just a scary vision. Is the Emerald City truly my final destination? 

Menopause and its precursor, perimenopause, can be confusing, with countless physiological and psychological changes. Adding fuel to the fire, it happens when today’s women are juggling complex and stressful life events, from caring for aging parents to parenting teens to becoming empty nesters for the first time.  

Go Ahead, Blame It on Hormones

Hidden from sight, estrogen and progesterone play a major role in a woman’s reproductive years, from our first period until our last (menopause officially begins when you’ve gone exactly 12 months without a period). As our ovaries begin to retire, changing levels of hormones impact our weight (ugh!), energy levels, mood, sex drive, digestion, sleep … and more.

“Confusion and frustration are the words I would use for what many of my patients experience through perimenopause and menopause,” says Whitney Fessler, a licensed acupuncturist and owner of Grand Teton Acupuncture. “Perimenopause can last from two to 10 years, which is insane to me because that’s a huge chunk of a woman’s life. And it’s different for everyone and really unpredictable. You don’t know what to expect or how long it will last.” 

Bio-individuality, the concept that each person has unique biological and physiological characteristics that influence their health, truly dictates each woman’s journey to menopause. Still, Fessler says that anxiety and insomnia are two of the most common symptoms she sees in her practice. 

“It’s such a huge shock to the system, whether it happens gradually or overnight. We have so much support through our fertile years, but once that’s over, you kind of feel alone,” she explains.

Finding Hope and Help 

Dr. Charlie Echeverria, an osteopathic physician in Jackson, is noticing encouraging trends when it comes to treating perimenopause and menopause. 

“More and more women are being proactive about this phase of life,” she says. “They’re much more informed than women were 10 years ago.” 

Dr. Charlie uses a holistic approach that incorporates the mind, body, and spirit to alleviate symptoms. She has several treatment protocols to treat both peri- and menopause, including advanced lab work and pharmaceuticals, but her treatments are always looked at through the lens of helping patients detoxify, reduce inflammation, and improve gut health and liver metabolism.

“The body is smarter than our brains will ever be,” she says. “It has so many self-healing and self-regulating properties that we can tap into.” 

Hormone Replacement Therapy (HRT) is one of the ways Dr. Charlie helps her patients balance hormone levels, an approach that she says is far from the experience of our mothers and grandmothers. Back in the 1950s, when HRT was first used, women experiencing menopause symptoms were put on a drug called Premarin, made from the urine of pregnant horses. In the 1990s, a series of clinical trials raised alarms about this drug’s potential risks, including cancer, making it unpopular with healthcare professionals.

In recent years, however, bioidentical hormone replacement therapy (BHRT) — hormones engineered in labs, so they are chemically identical to what our bodies produce naturally — has entered the arena as a safer method. 

Kristin Coburn, a family nurse practitioner with Teton Valley Health, only prescribes BHRT to patients when it’s the “right fit” (sometimes family history and cancer risk factors make women ineligible for BHRT). A former labor and delivery nurse, Coburn has been practicing for 31 years and sees women in all stages of life.

“The pendulum has really swung in terms of HRT,” says Coburn. “When we weren’t giving women back their hormones, we saw more heart-related diseases, more osteoporosis, and an overall increase in poor health among women. When we give back estrogen, we see heart, breast, bone, and brain protection.”

“My goal with BHRT is to do it safely and start when symptoms begin, instead of waiting until you’re 60 or older. Women have quite a few options now: pills, patches, vaginal rings, creams — one size doesn’t fit all.” 

For women in perimenopause, BHRT can often be just a boosted dosage of progesterone, whereas in menopause, once the ovaries have shut down, it’s a full-on replacement of estrogen.

Choosing Your Guides 

An exciting trend in treating peri- and menopausal hormonal imbalances involves the blending of different medical fields — an “East-meets-West” approach that Erin Borbet, a traditional Chinese medicine practitioner and acupuncturist in Victor, says can yield great results.

“I can layer in acupuncture and herbs with BHRT that a woman is receiving from another healthcare provider,” says Borbet. “It’s a nice way to help women holistically by finding things that work and blending them.” 

Fessler agrees, saying she often uses acupuncture in combination with what her patients are doing with other medical providers.

“What I’ve noticed is that perimenopause and menopause are moving targets,” says Borbet. “At some point, symptoms switch, and so the treatment needs to shift. This can be the biggest struggle for women, finding something that works, and then a few months later it all changes again.”

For this reason, it can be helpful to have different practitioners by your side as you go through perimenopause and reach the other side post menopause. (There’s no reason to be alone on the yellow brick road.)

“When you find providers you trust, it’s a relationship, so it should have all of those good qualities: communication, listening, and working together,” says Coburn. “If you don’t get the right answer, go to someone else who will listen. Interview different providers and see who feels like the right fit.”

Your Body Knows Best 

As for my own journey towards menopause, I find it strangely comforting to know that my body is doing this for a reason. Humans are the only species that live decades past our reproductive years, a gift of more time on this earth that also comes with sometimes bizarre changes.

“It’s a biological process,” says Borbet, “and the more you can trust your body, the more answers will come to you. As women, we have more access to our well-being than we often remember. Remind yourself, and each other, of the strengths we have.”

Dr. Charlie says to slow down. “I see so many patients trying to do too much during this time in life,” she says. “Then they feel frustrated because they don’t feel well, and that adds fuel to the fire.”

So off I go into the land of menopause, with friends by my side who have traveled this path before, and healthcare professionals I trust to give me safe options along the way. One step at a time, I believe I will guide my body where it wants to go.

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Lotions, Potions and Pills, Oh My!
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James Blackburn, compounding pharmacist and CEO of Blackburn Drug in Jackson, mixes up hormonal remedies and outlines below some of the more common delivery methods. He encourages women to work closely with healthcare providers to find the best fit and be wary of products sold online that may not use quality ingredients or offer dosing that meets your personal needs.

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