HEALTH CARE OPTIONS for MENOPAUSE
by Joanna Poppink, MFCC
In ancient times, human beings believed that
because a woman did not bleed As millions of American baby boomers approach
mid-life, "menopause talk," no longer a whispered secret or a knowing
look, is growing louder and more articulate. It's also politically and
Amid the clamor of conflicting positions, women
are asked to make medical decisions that determine the quality and length of
their lives. In order to make the best choice for herself, a woman needs
confidence, self respect and accurate, relevant information. Some women lack
HRT or Not
The most life-challenging decision for a woman approaching menopause concerns
osteoporosis, cardiovascular disease and cancer. The bottom-line choice
for a woman is usually presented like this:
Take HRT (Hormone Replacement
Therapy) and reduce risk for osteoporosis and cardiovascular disease
but also increase the odds for contracting cancer of the breast and
uterus lining. Do not take HRT and reduce the cancer risk but increase
the odds for developing osteoporosis, heart attack or stroke.
estrogen straight and chances for ovarian cancer go up. Take estrogen
with progesterone and chances for ovarian cancer go down.
to Consider in Making Choices
There are at least five realms of
information for mid-life women to consider in making health care choices:
medical information, personal history, family history, cultural influences,
and personal principles.
1. A woman needs to prepared to get
second, third and even fourth medical opinions before embarking on any
drastic physical intervention. Taking hormones for years or the rest
of your life is a drastic intervention.
She should question the source
of information being presented to her. Were the studies large enough
to have valid results? For example, oft cited early studies on the progesterone
factor in decreasing ovarian cancer risk were small and exploratory.
Were they studies of women? Many NIH studies through 1990 excluded
women out of concern that women's hormones would affect results.
Evaluating her past and present general health provides important information.
For example, HRT is not recommended if a woman has any history of cancer
or acute liver disease.
3. Knowing the female healthy history
in the family is useful. However, even when the information is grim,
she can factor in the life styles and environmental influences which
may have affected her mother, aunts, grandmothers, and cousins. They
may have been exposed to asbestos, eaten diets heavy in meat, fat and
sugar, not exercised, smoked or had insufficient calcium.
troubled now at 77 with osteoporosis, said "If I had known smoking
depleted calcium in my body and would make osteoporosis twice as difficult
for me, I would have quit years ago."
4. Cultural influences
need to be considered. Our culture sells ideas, people and products
through media images. The profit mentality perceives the large number
of women entering mid-life as potential consumers of numerous menopausal
products. Traditional advertising may focus on maintaining a youth appearance,
freedom from inconvenient sensations or powerful health benefits. It
plays down the lack of information, or faulty information, based on
medical studies which have excluded women.
5. Finally, a woman's
personal principles are a most important consideration. She must honor
her deepest self if she is to live well with her decisions.
Support and Guidelines
A woman's best equipment to care for herself
during and after menopause includes an appreciation of a woman's life stages. A
growing ability to listen, read and recognize her changing body sensations is
Supportive and trustworthy friends and family
are valuable, plus new friends and associates who bring a fresh and responsive
view to the woman's developing feelings and perceptions. We all need to
acknowledge emotional shifts which are similar yet different from the challenges
which have always accompanied women's cyclical rhythms.
Perhaps most important, a woman needs more than
ever the woman's ability to be respectfully attentive to new feelings and
perceptions emerging from her developing changing self. These small but
continually growing and developing aspects of her authentic self become her true
guides in her journey through the stages of being a woman.
With confidence and self-respect women can
question the validity of available information and educate themselves concerning
their bodily process, general health care, new research, source, quality and
side effects of various recommended drugs and hormones. Then they can make
informed choices which support the highest possible quality of life.
Lastly, we need to remember, menopause is part
of the natural feminine cycle. It's part of the wonder of being a woman.
licensed by the State of California in 1980, is a Marriage, Family, Child
Counselor (License #15563). She has a private practice in Los Angeles
where she works with adult individuals and couples. She specializes in
working with people with eating disorders and with people who are trying
to understand and help a loved on who has an eating disorder.
10573 West Pico Blvd. Suite 20
Los Angeles, CA 90064
(310) 474-4165 phone
(310) 474-7248 fax