Martie Nightingale is a certified nurse midwife who also holds certification in menopause, lifestyle medicine and perinatal mental health at Intermountain Health
(PRUnderground) December 9th, 2024
Women may hear friends, sisters or mom talk about menopause as the time in life when a woman’s body naturally stops having menstrual periods. It’s a time of transition and there are some positives and some there could be some negatives, but mostly it’s a time with a lot of questions about what is normal!
Menopause happens when the ovaries stop making estrogen. Estrogen is a hormone that helps control the menstrual cycle. Menopause marks the end of the childbearing years. The average age that women go through menopause is 51 years.
The years leading up to menopause are called perimenopause. Beginning in a woman’s 30s and 40s, the amount of estrogen produced by the ovaries begins to fluctuate. A common sign of perimenopause is a change in their menstrual cycle. Cycles may become longer than usual or become shorter. Cycles may begin to skip periods.
The amount of flow may become lighter or heavier. Although changes in menstrual bleeding are normal during perimenopause, it’s best to discuss any changes with a trusted women’s health provider, since abnormal bleeding may be a sign of a problem. Generally, a woman may be in menopause if they have not had a period for one year.
See a provider with medical credentials
As you approach menopause it’s important to find or continue to see a trusted provider who has medical credentials in women’s health. This could be an OB-GYN, a midwife, or a nurse practitioner or an advanced practice provider who specializes in women’s health. Some of these providers also have a menopause certification.
The Menopause Society is the most reliable source for menopause information. Providers who pass their certification examination hold the credentials of MSCP (Menopause Society Certified Practitioner). The Menopause Society webpage has a database where you can find a menopause-certified provider near you.
Their website also provides patient information known as “MenoNotes” on a variety of key topics as well as a more comprehensive Menopause Guidebook.
Common symptoms of menopause
- Hot flashes and night sweats –The frequency and duration can vary greatly and can impact sleep.
- Brain fog – not being able to focus or difficulty with cognitive tasks
- Weight gain, especially around the abdomen
- Osteoporosis – loss of bone density which can make you more susceptible to bone fractures.
Menopause Health and Fitness
“The need for strength training, calcium-rich diets, and active lifestyles to combat bone density loss and injury is a growing conversation,” said Martie Nightingale, a certified nurse midwife at Intermountain Health, who also holds certifications in lifestyle medicine, menopause and perinatal mental health. She is also a plant-based endurance athlete. “There are lifestyle tips that can help ward off injury, strengthen bones, and combat effects of menopause.”
Lifestyle modifications that can help with menopause symptoms
- Diet – plant-based diets are associated with fewer vasomotor symptoms like hot flashes and night sweats. A plant-based or Mediterranean diet can help with weight gain.
- Physical activity - weight-bearing exercise helps with bone density and yoga helps with balance and preventing fractures. Also has mental health/mood benefits.
- Sleep - adequate sleep and prioritizing sleep helps prevent brain fog to maximize cognitive functioning.
- Stress reduction – and learning to manage stress helps with overall health.
- Social connection – helps you feel like you’re not alone in your menopause experience.
- Limit risky substances – smoking, vaping, alcohol, drugs. Smoking increases risk for osteoporosis, while alcohol intake increases breast cancer risk.
Mental Health and Menopause
“As menopause impacts mood and mental well-being, the focus on mental health support during this time is becoming a strong conversation point. There are things you can do to manage anxiety and mood swings,” said Nightingale.
Hormone Replacement Therapy
“Many women assume they’re not candidates for hormone replacement therapy, but the latest research shows there are very few absolutes, that rule out hormone replacement therapy,” said Nightingale. “The majority of women are candidates for hormone therapy, particularly if they begin taking it within 10 years of menopause and before age 60.”
According to The Menopause Society, the term “bioidentical” hormones is a marketing term, not a scientific term. Hormones that are custom-made at a compounding pharmacy and those produced by larger pharmaceutical companies contain the same hormones. However, those produced by larger pharmaceutical companies are considered safer because they have been scientifically tested and are government approved.
Despite marketing claims, custom-compounded hormone replacement therapy has the same risks as manufactured hormone therapy, even though those compounded medications are not required by law to include a package insert of possible risks and side effects.
The right dose of hormones for women who have a uterus is the lowest dose of estrogen that treats your menopause symptoms, combined with enough progestogen to protect your uterus from cancer.
“A variety of medications and treatments have been found to be helpful for menopausal symptoms. For vasomotor symptoms: in addition to medications, other therapies include: hypnosis, cognitive behavioral therapy, weight loss, and a plant-based diet have been found to reduce symptoms,” said Nightingale. “Anti-depressants such as selective serotonin reuptake inhibitors (SSRIs) can also help with menopause symptoms.”
It’s best to speak to a certified menopause practitioner who can review your medical history and go over the risks and benefits of treatment options to create an individualized treatment plan to match your specific concerns. Some over the counter treatments are not researched and some are not evidence based.
To find a women’s health provider visit the women’s health page at Intermountainhealth.org. To find a certified menopause provider visit menopause.org.
About Intermountain Health
Headquartered in Utah with locations in six states and additional operations across the western U.S., Intermountain Health is a not-for-profit system of 34 hospitals, approximately 400 clinics, medical groups with some 4,600 employed physicians and advanced care providers, a health plans division called Select Health with more than one million members, and other health services. Helping people live the healthiest lives possible, Intermountain is committed to improving community health and is widely recognized as a leader in transforming healthcare by using evidence-based best practices to consistently deliver high-quality outcomes at sustainable costs. For up-to-date information and announcements, please see the Intermountain Health newsroom at https://intermountainhealthcare.org/news.
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