Dr. Carolyn Chambers Clark, Award-Winning Author and Wellness Nurse Practitioner

Home, Dr. Carolyn Chambers Clark, Author and Nurse Practitioner
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Menopause - Living Well with Menopause excerpts


Introduction -  Chapter 1

If you're reading this book because you're about to (or already have) begun menopause, congratulations! You've taken an important step toward understanding the challenges of menopause and acting positively to enter this new phase of life. You've also decided that you want to seize control and take steps to be the happy person you know you can be.
Menopause is one of the most important journeys in your life. It will be thought-provoking, frustrating, confusing, and growth enhancing. You may start to hate your partner, your kids, your job, your boss, your hair and even your furniture.
This is normal--- upsetting but normal.
The idea is to keep in mind that you're not losing control.
You're not losing your memory or your mind. Hormonal and other challenging changes are occurring, and as a result, your body, mind, and spirit are reacting. An imbalance has presented you with the opportunity to learn how to weather the effects.
My Personal Menopause Journey
I know what you're going through. In my late 30s I started to react with anger and frustration to situations that never used to bother me. In my 40s I began to have trouble sleeping through the night, and I had short periods of panic for no reason at all. My heart would pound as my worries increased. At first I didn't realize that these emotional changes and insomnia were tip-offs that hot flashes, dry skin, thinning hair, and achy joints would soon arrive. As a nurse, I should have known menopause was on its way, but maybe I didn't want to acknowledge it.
As a holistic and wellness practitioner, I didn't even consider taking hormones as my periods waned to a halt. I figured that women had come through menopause for thousands of years before hormone therapy, and they must have discovered ways to manage the changes. 
I began to notice I perspired much more and had to wear layers of clothes so that I could peel them off during heat flashes. Having had menstrual cramps, heavy bleeding, bloating, and fatigue for many years, I was secretly happy to turn the page on that phase of my life.
Little did I know that the changes were just beginning. My normal thin and glossy hair grew even thinner and dull, and I began to find clumps of it on my bathroom floor. My skin felt dry and itchy despite putting on body lotion. I was gaining weight even though I ate healthy foods. My joints and muscles ached more frequently, and I started to notice short episodes of dizziness. I stopped sleeping through the night, and sometimes it didn't seem as if I slept at all. I would prowl the halls, clicking the TV on and off, hoping to find something to soothe me to sleep. I began to resent the fact that everyone, including my husband, was fast asleep and I wasn't.
I had no idea what to do. The information available at the time was primarily from medical sources and touted taking hormones, which I'd already decided to forego. I knew from my physiology courses what potent substances hormones were, and I didn't want to subject myself to the yet unknown long-term effects.
The prospect of going through this experience alone with no helpful information propelled me into action. I started collecting herb books, holistic books and anything I could find that even mentioned menopause. It amazed me that no one had collected both the medical and holistic information into one volume. Worse, I could only find a page or two on hot flashes in each source, with only a few suggestions, many of which I'd already discovered or had found didn't work. I constantly shuffled between studies I'd downloaded from the Internet or copied from journals, books, and notes

I'd scribbled on pieces of paper. Added to the mix were my clients, many of whom were entering or already in the throes of menopause and clamoring for information about what to do. They shared their stories with me, and I shared what I was learning from my daily searches for new information.

I had become a vegetarian years earlier, but the beans and rice that had once calmed me now seemed to provoke hot flashes. Ditto the frozen yogurt I'd grown to love. I'd always enjoyed a glass of wine with our Sunday dinner of pasta but found the alcohol now set off horrendous hot flashes.

That's when I knew that even though my lifestyle was healthy, menopause would force me to change the way I lived if I wanted to be more comfortable and more joyful. I changed what I ate, the vitamins, minerals, herbs and supplements I took, found a new exercise program that worked for me, and began to seek out other holistic practitioners to find what worked for them.
When I talked to my friends and colleagues, I realized I wasn't the only one in the dark. Menopause was not talked about among women the way giving birth and parenting were. It was a dark, secret path all women eventually took, but one not discussed by our mothers, our health care providers, or our friends.
That's when I looked around for ways to connect with more than just the hundreds of women who had come to me for holistic and wellness education. I found bellaonline.com and became the editor for their menopause Web site. As I accumulated articles and brought more and more women to the Web site each month, it sunk in that there are thousands or maybe millions of women out there who could benefit from what I'd learned in my own menopause process and through counseling other women with theirs. That's why I wrote Living Well with Menopause. Women deserve to know more about the menopause process and how to cope.
Why This Book is Needed
Although we all go through a similar process, there are individual variations. Not everyone walks around every night for a year, unable to sleep. Not every woman struggles with hair thinning. Not everyone has short periods of dizziness or achy joints and muscles.
There is no way to know which women will suffer from which symptoms. That's why it's important for you to develop your own personal menopause plan.
The medical way is to provide hormones. The root causes of menopause changes are rarely, if ever, explained or addressed. That means millions of women, including you, may ultimately feel alone and unsure about how to proceed.
Now that the World Health Organization has proclaimed that hormone replacement therapy is not good for women and research has identified the primarily negative effects of hormones, many doctors are unsure of what to recommend. Some simply shrug or prescribe an antidepressant. But some research has shown that antidepressants may be no better than a placebo (sugar pill) and may increase the risk of suicide.
To top it off, many doctors may not have an answer when you ask, "How can I prevent the conditions that might follow menopause---heart conditions, osteoporosis, breast cancer?" The unknown can lead to fear. It can make you think you won't be able to recapture your youthful ways, that there is no way to even slow the aging process. You may conclude there are no answers to menopause changes except locking yourself away from life and its joys.
But there are answers. It's just that a typical physician may not have them. Most are too busy to read the holistic and alternative research studies. They're rushing through dozens of patients a day and may barely keep up with their own specialty treatments. They just don't have the time to learn about new approaches except for the new drugs that salespeople bring to their offices.
Even physicians and nurse practitioners who consider themselves experts in women's health rarely venture into the uncharted territory of the menopause process. They don't have the time to really listen to their patients' complaints and try to find a unique program each of them deserves.       Studies have shown that women are given inconsistent and incomplete information about menopause. If that isn't bad enough, even female doctors don't have accurate menopause information. One study of 925 female doctors in the Chicago area revealed that only 18% of those surveyed correctly answered seven key questions about menopause. Least knowledgeable were family physicians. The researcher concluded that "physicians may not be an accurate source of information and that there is still a lot of confusion about menopause."
For most women, a holistic and wellness approach is needed. This framework not only deals with symptoms, but with the root causes of symptoms. It provides realistic approaches so you can develop a full-fledged plan that works for you.
Yet, when you go to your health care practitioner, the hormone approach might still be pushed, despite the fact research has shown the possible frightening effects of this route. The media rarely focuses on women's health. You hear information about risk factors related to smoking, being overweight, and drinking, but how often do you hear about new approaches to menopause?
You could make the point that menopause is not of interest to that many people. But more than half of the population is facing, has faced, or will one day face menopause.
In a way, the lack of media play is to be expected because menopause isn't a disease like cancer or heart disease. Menopause is a completely normal, natural process, even if the medical community has labeled it a "deficiency of estrogen disease" or "ovary failure disease."  Menopause is not a disease, but it does present plenty of challenges.
To make your way through menopause and have a successful life postmenopause, you need an approach that makes you feel good and lets you know that menopause is not the end of life---it's only the beginning. There's no reason to be wrinkled and old, without energy or joy, in pain and depressed. You need to know that menopause is not the dreaded curse of aging.
It can be the beginning of your most sexually passionate, creative and productive phase of life. With the right nutrition, exercise, and attitude, you can look forward to a resurgence of energy and an unexpected opportunity for personal growth.
Trusting your own intuition is really the first step toward conquering your fear of success.  Don't be like Jill, who couldn't believe she could seize control and develop her own menopause program. She convinced her primary care physician to give her an antidepressant. Although she knew it wasn't working right, she kept taking it, hoping to feel better. When she nearly died from an overdose, she finally realized it was up to her to take a long look at her life and decide on a self-care plan that would work for her.
Here's what she said: "I knew I was going down, down, into a spiral of depression, but I trusted my doctor to save me. Unfortunately, he was away the weekend I took too much. Luckily my husband came home early and found me. Later on I read the research that antidepressants can lead to suicide. That made me face the fact that I'd been abused as a child and needed counseling to get me past that and have a successful menopause."
Finding a practitioner who listens and treats you as an individual with legitimate ideas and concerns is another important step. I get hundreds of e-mails a week from women with questions about how to deal with hot flashes or anxiety or what type of exercise program will help. They tell me their physicians don't have time to listen to them and they're not sure why they're taking some of the prescribed drugs they've been given.
Many of these women have been told they're overreacting when they complain about gaining weight or having hot flashes and are sent home by physicians with prescriptions for antidepressants, pain pills, antianxiety medications, and/or estrogen replacement with no discussion of whether these drugs---all of which have secondary effects that could be harmful---are the best choice, what the underlying causes of the symptoms might be, and what those causes might mean.
Candace gained a lot of weight while taking hormone replacement after menopause. She stopped exercising and having sex with her husband. He eventually left her for another woman and Candace fell into a deep depression.
She told me: "I thought I didn't have anything to live for anymore. Something stopped me from just hanging it up. Maybe I realized it was worth staying alive. I started working with a holistic nurse. She helped me see how my feelings of wanting to be loved outweighed everything else in my life and how I was sabotaging myself. Once I realized that, we developed my own plan for getting me better, and I knew I was on the right track."
Megan had her own set of menopause problems. After the birth of her second child, she was told by her physician that she must have a total hysterectomy, although there was no life-threatening reason for her to do so. As Nancy Lonsdorf, M.D, Veronica Butler, M.D. and Melanie Brown, PhD., have written in their book, Women's Best Medicine: Health, Happiness, and Long Life Through Ayur-Veda, modern medicine is not serving women well.
"The "art-by-part" system of medicine has led to a number of inappropriate treatments for women...27 percent of the hysterectomies were deemed not needed...several times the rate of hysterectomies performed in European
countries...Endometriosis, fibroid tumors, prolapsed uterus, even severe menstrual pain are often "solved" by hysterectomy, even though there are safer, less invasive (and less expensive) treatments available."
Megan hadn't asked for a second opinion about her condition, and she had the surgery. Because of her risk factors for breast cancer, hormone therapy was definitely not an option. Totally unprepared for menopause, went home to take care of her two young children. She told me:
"I had hot flashes and anxiety attacks, and I was up all night, unable to sleep.

I was so tired, I didn't see how I was going to cope with the kids. One of them started acting up in school and the teacher forced us to put him on Ritalin for ADHD. My husband started working overtime and I think he was having an
affair. I didn't know what to do until I forced myself to take charge of my life."
Why You May Need This Book and What You'll Learn
I wrote this book for women like Megan, Candace and Jill---women who deserve to live well with menopause. I hope this book will help you seize control of your life, and find a holistic practitioner you can work with, so you can continue growing and learning.
You need this book if you:

*   Are going through menopause and feel terrible
*   Are going through menopause and haven't even tried to control your symptoms
*   Are going through menopause and are trying various methods of
     symptom control that aren't working
*   Have finished with menopause and are losing bone density
*   Have finished with menopause and are worried about breast cancer
*   Have finished with menopause, have heart disease in your family, and
     want to take preventive action           
*   Know you should quit smoking but haven't been able to
*   Are an open-minded health care practitioner who wants to understand and help women going through menopause
Living Well with Menopause will help you go beyond treatments that merely manage symptoms, to discover cutting edge self-care actions that will not only make you feel better, but will help you chart your path for the future and prevent chronic conditions from developing.
What You'll Learn from Reading This Book
After reading Living Well with Menopause you will:
*  Have a tool to assess your menopause symptoms
*  Discover whether hormonal replacement is for you
*  Develop skills to reduce your menopause symptoms
*  Identify underlying causes that could be affecting your
    menopause symptoms and preventing self-growth
*  Discover resources that can help you
*  Devise a personalized menopause plan that will work for you
About This Book
Living Well with Menopause is different from many other books. This is your book, written by a woman who is not only a holistic practitioner, but has been through menopause and understands the confusion and frustrations, as well as the joys and potentials. 
Living Well with Menopause  provides the information about menopause you probably won't find out from your doctor, pharmacy, patient organizations, or in other books on menopause.
It provides invaluable insights I've learned from working with clients in my 35 years as a nurse as well as what I've learned from my own menopause. The book includes everything you need to know to live well with menopause---the information, tools, and resources you need to develop a menopause plan and become the best person you can be.
This book gives you what your doctor won't tell you about risks, drugs, and conventional and alternative treatments---what works and what doesn't and the research that explains them. You'll hear the voice of real women who've struggled to pass through menopause and come out whole and happy. Each person in this book wanted to share her own story, ideas and obstacles with you. I know you will recognize portions of their stories that are familiar, that touch you, that move you to take action yourself. Above all, you'll be convinced you are not alone in your struggle.
My Disclaimer
I hope that what you learn from this book will help you decide what menopause plan is best for you and how to find a holistic practitioner to help you implement your plan. Although I've been a nurse since 1964, I am still learning. I seek out information from perimenopausal women and the Internet, speak to health care practitioners and keep up with the latest research findings. I don't try to go it alone and neither should you. So go find the conventional, alternative, complementary, and holistic practitioners to partner with you in wellness. Don't forget to bring this book along and share it with them.
About the Internet
Throughout this book you'll find references to Web sites, articles and Internet-based resources. If you have access to the Internet, either through your own computer or by visiting your local library and using their free services, visit this book's Web site, at http://menopause.bellaonline.com/. The site features a free newsletter, discussion forum, and updated articles based on the latest breaking research. Don't put off your visit to this Web site. It can help you know you're not alone. There are resources and people out there to help you. By choosing to be proactive, you'll feel a surge of personal power and delight. You will be in charge of you.
Challenging the Conventional Approach
This book is not meant to stand in opposition to the traditional medical approach. It is the one system that works best in emergencies. Many physicians are caring, able and healing professionals. They listen to their patients, they seek out new information to better their practices, and they collaborate with holistic practitioners to provide the best possible care. Without medical care, millions of people would die, but the system is not equipped, nor are most of its practitioners, to assist with normal life processes like menopause. For that, you need a holistic, self-care approach fueled by valid information and supported by certified holistic practitioners.
I've worked with many wonderful physicians who keep up-to-date on the latest research and respect the work of complementary and holistic practitioners. I respect them totally.
But not all physicians are like them. Some think that only conventional treatments for menopause are effective, and that they learned everything they need to know about menopause in medical school. They may carry stereotypes about women and may not take your complaints seriously. This type of physician scares me and should scare you, too. Remember that health care providers work for you and that you're paying them to carefully listen to your ideas, explain all possible treatments available and support you in your health care decisions. If they don't listen, explain, and support, you would be well-advised to find another medical practitioner who respects you and your opinion.
As you read on, you'll discover that not all medical decisions are based on research. One that wasn't based on good science is hormone replacement therapy, which was once thought to be the perfect answer to menopause.
Hormones are now coming under fire as a possible cause of cancer, heart disease, blood clots, gallbladder problems, and liver tumors.
Louise, a 49-year-old CEO of her own construction company, entered perimenopause and asked me: Why doesn't my doctor listen to me when I ask questions? I know he's busy, but I have concerns about what's happening to me and I need answers. I answer my client's questions.
I can't speak for her physician or yours, but in this book I try to answer the questions women have raised at my menopause Web site, as clients in my practice, or in the research I've conducted. The opinions of mainstream physicians are well represented in the other books, patient-oriented pamphlets, and Web sites on menopause. Now it's time that the millions of women passing through this natural process called menopause have a chance to be heard and learn how to live well. 
Copyright 2005, 2117m  Carolyn Chambers Clark. Excerpted from LIVING WELL WITH MENOPAUSE: WHAT YOUR DOCTOR DOESN'T TELL YOU...THAT YOU NEED TO KNOW.
For more information about the book, click on the cover at the top of the page.

Live well and be well. 

Think positive and you'll be positive!

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