Menopause Archives - Tanya Mark - Nutrition & Wellness Coach

Prompting 3,000 comments and ranking as one of the most read stories of 2023, the New York Times article Women Have Been Misled About Menopause by Susan Dominus made it clear that people going through menopause — about half the population, want to talk about it and want to be taken seriously.

Instead of the doom and gloom, invisibility narrative of aging, the sweaty menopause jokes and just suck it up and deal with it (it’s not really that bad) attitude, we deserve a comprehensive, anti-shame, pro-embodiment approach.

We want evidence-based facts, not information from a 32-year-old Insta-influencer. We want options to treat symptoms that may profoundly affect the quality of our lives. We want support with every facet of our wellbeing so that we emerge boldly from our reproductive years, sharing our wisdom with zest and, most importantly, so that we may thrive.

As a 55-year-old, post-menopausal woman, that’s the conversation I needed more than ten years ago when I started experiencing perimenopausal symptoms – hot flashes, night sweats that led to poor sleep and fatigue, anxiety, joint pain, forgetting what I was saying mid-sentence. Those are just some of 34 plus symptoms cited by the North American Menopause Society (NAMS). I didn’t know that those signs were signaling the beginning of my transition toward menopause and that for me, they’d last more than a decade.

Desperate to ease my discomfort I dove down the rabbit hole of Dr. Google and loads of misinformation and in particular, DIY hormone programs promising to fix my “broken” hormones. Let me spare you the time, money, energy, and years that I spent on those restrictive food plans. No, they did not relieve my symptoms. And honestly, I bet the stress from food restriction and under fueling my exercise aggravated my symptoms and perhaps contributed to my osteopenia diagnosis after a recent DEXA scan for bone density.

My menopause experience could have been much different.

Menopause support

In Dominus’s article, she shares the history of menopausal hormone therapy and how it used to be the most prescribed treatment in the United States. But in 2002, a single study, The Women’s Health Initiative, imperfect in its design, found links between hormone therapy and elevated health risks for women of all ages. Panic set in and prescriptions plummeted.

Hormone therapy carries risks, to be sure, as do many medications that people take to relieve serious discomfort, but dozens of studies since 2002 have provided reassurance that for many people the benefits of taking hormones outweigh the risks says Dominus.

That being said, hormones are not a cure-all. ‘Hormone therapy is not a fountain of youth and shouldn’t be used for that purpose,” says medical director of the NAMS, Dr. Stephanie Faubion.

Today, you have a range of options for symptom relief that may include hormone-therapy, non-hormonal drugs, and recommendations like cognitive behavior therapy for hot flashes, based on your health history and risk factors. Find a menopause informed healthcare provider to support you and screen for health conditions that you’re more vulnerable to such as cardiovascular disease, diabetes, dementia. Discuss medication options if needed and give your attention to modifiable behaviors to reduce your risk.

Expanding the menopause conversation

An empowered approach to menopause includes exploring all facets of your wellbeing. Learn strategies to regulate your emotions and manage stress such as journaling, calling a friend who’s a good listener or scheduling time with a mental health professional. Reap the many benefits of physical activity like supporting your heart and bone health. Nurture your relationships, social connections, spiritual wellbeing and prioritize joy and fun.

And let’s talk nutrition. There are many strategies to support menopausal health such as adding in fiber-filled whole grains to lower your cholesterol and blood sugar levels versus eliminating and restricting foods. Don’t get sidelined by diet culture nonsense that promises to fix your hormones and body.

Normalize menopause body changes

We deserve shame-free conversations about midlife body changes. As an exercise coach in my early perimenopausal years, I couldn’t imagine the menopausal reality of gaining weight and not having a flat stomach in the future. Even with no changes to your diet or exercise, it’s normal and natural to find yourself sizing up. Clothes weren’t designed to fit post menopause bodies where hormonal changes contribute to the re-distribution of body fat from our thighs and hips to our abdomens. Move beyond the scale and outward appearance. Approach your aging, changing body with this comprehensive pro-embodiment approach to your wellbeing.

We’re not less of ourselves on the other side of menopause, were more.

More powerful beyond menopause

“There’s a veritable legion of people post menopause who feel even more like themselves – even better, more at home in their bodies,” says author Heather Corinna in her book “What Fresh Hell Is This: Perimenopause, Menopause, Other Indignities, And You.”

We’re more direct. “The force of the impulse to speak out will feel like driving a Maserati for the first time – it takes a little while to get used to the power,” says Dr. Louann Brizendine, author of “The Upgrade: How the Female Brain Gets Stronger and Better in Midlife and Beyond.

Consider that 80% of Forbes’ 100 most powerful women of 2024 are 50 plus and the No.1 woman is 65 years old. She’s Ursula von der Leyen, President of the European Commission.

“Post-menopausal people express big feelings of freedom, self-acceptance, confidence, connection, and deeper intimacy, of being able to find a clarity about their wants and feelings and a greater ability to express them,” says Corinna. “Margaret Freaking Mead talked about the power of this post-menopausal zest.”

Empowered conversations about menopause honor that knowledge is power — and that we can be more powerful beyond menopause.

(This article was originally published in the March 27, 2024 edition of the Jackson Hole News and Guide).

Body appreciation while aging is critical to your physical and mental health.

Yet it’s a challenge most women face.

Scrolling through my Facebook feed, I recently read a post by an over-50 woman lamenting that she could no longer eat pasta. Dozens of women commented below, offering low-carb recipe substitutions, commiserating with her on the unwelcome midlife “muffin top.”

That post represents how most older women feel about their aging bodies. According to a 2013 study, “Characteristics of women with body size satisfaction at midlife” in the Journal of Women and Aging, an alarming 88% of women age 50 and over reported body size dissatisfaction. And that statistic doesn’t merely point to body image challenges.

Body dissatisfaction is negatively related to health behaviors and quality of life.

According to Dr. Elayne Daniels, an anti-diet, trauma-informed clinical psychologist, negative body image has an increased risk of health problems, including eating disorders, gastrointestinal disorders and nutritional deficiencies. It can produce social withdrawal and avoidance of events and activities due to self-consciousness. Body dissatisfaction increases the pursuit of diet plans disguised as “wellness” plans and risky behaviors such as disordered eating to lose weight. Furthermore, how you feel about your body can lead to mental health challenges such as depression and anxiety.

And alarmingly, trying to avoid body shame may prevent women from seeking health care and preventive screenings, which can worsen health outcomes.

On the other hand, women who honor their changing bodies reported fewer dieting behaviors and fewer eating disorder symptoms, which are rapidly emerging as a major public health problem for women at and beyond midlife, according to Margo Maine, a clinical psychologist, in her 2019 article “Body Image, Eating Disorders, and Women at and Beyond Midlife: The Nine Truths.”

Yet even among the 12% of women who reported body satisfaction, 40% admitted that even a 5-pound weight gain would make them moderately to extremely upset. Weight and shape play a prominent role in how middle-age women feel about themselves, reports study co-author Cristin Runfola.

Body satisfaction is a critical piece to enhancing well-being and healthful aging for women over 50 and beyond. And let’s be clear, body satisfaction isn’t about liking the way you look.

“Rather, it’s about building up a solid sense of self so that our appearance isn’t something that can make or break us anymore” says body image coach Summer Innanen.

“Diet culture, the beauty industry, Hollywood, etc., have told us that our destiny is dependent on being attractive, so it’s not our fault that we’ve conflated our happiness (and health) with looking a certain way” says Innanen.

Appreciate your aging body

But how can midlife women ditch body shame for appreciation?

Culturally, we need to shift away from the negative narrative about weight gain that occurs in women’s bodies throughout the life cycles. When we have open dialogue about these natural shifts, the shame fades.

“We gain weight at menarche, with the birth of each child, and we gain weight at menopause, so we’re not going to have the same body size and shape at 50 as we had at 20. And if we don’t expect that, that would be a help” says Joan Chrisler, a professor of psychology at Connecticut College and researcher of weight and eating disorders in women.

Maine agrees: “Today, we criticize an adult woman because she no longer has the body of a 16- or 20-year-old. Although natural for the adult female body, all weight gain is considered wrong.”

When Maine shares information about the incredible natural resources of the female body, she says women slowly begin to appreciate its natural wisdom and are more likely to make changes in their attitudes and behaviors. In her article, she states compelling facts about the protective nature of body fat such as:

First, women’s bodies are designed for survival, hardwired to beat starvation. In a famine, only about 10% of women die while as many as 50% of men will. It’s body fat that protects women.

And did you know that before puberty, a girl’s body is about 12% body fat? After, it’s 17% in order to produce ovulation and menstruation. A mature woman’s body is about 22% body fat, “providing the energy necessary for an ovulating female to survive famine for nine months” says Maine. Thus, women’s bodies have the capacity to maintain the human race. That’s an empowering fact!

Maine also shares this important fact: the weight that women gain after puberty and menopause is protective. Yes, read that again! To preserve fertility, reproductive and feeding organs, women first gain fat in their breasts, buttocks, hips and thighs. During the transitional phase into menopause, weight gain of approximately 12 to 15 pounds along with about a 15% to 20% decrease in metabolism naturally occurs. These biologically programmed changes allow women to manage menopausal symptoms, maintain bone density and decrease the risk for osteoporosis. Maine says hormonal shifts during this transitional phase increase the size of fat cells surrounding our reproductive organs as these cells produce estrogen, offsetting the shutdown of the ovaries.

The harms of dieting in midlife

Furthermore, malnutrition and dieting in midlife and beyond can be particularly risky.

According to Maine’s research, depleted fat stores will likely increase menopausal symptoms, and muscle-wasting can reduce metabolic rate and hasten neuromuscular decline. She also found that cognitive impairment secondary to dieting may also be greater, and the mortality risk associated with low weight is greater as people age.

Research in the American Journal of Public Health study, “Associations Between Body Composition, Anthropometry, and Mortality in Women Aged 65 Years and Older” found that women with BMIs in the “overweight” category from 25 to 29.9 had the lowest mortality risk with the optimal value estimated as 29.2 kg/m².

Moderate weight gain in midlife is associated with longer life expectancy for women.

Finally, Maine shares that “most — even well-informed, resourceful women — don’t know these facts. The truth is that the female body simply knows how to take care of itself.”

Shifting the midlife body conversation

Thus it’s key to women’s whole health to elevate the conversation regarding midlife body changes as natural and protective, not something to be ashamed of, but appreciated.

With these facts, one of Maine’s clients, a 73-year old woman who battled her body for decades, moved from body shame to appreciation. She stated, “I used to see weight around my middle as my spare tire, and I hated it. Now I see it as my life preserver!”

So instead of berating your belly and eliminating pasta from your plate, make peace with and respect the wisdom of your body.

Want to read more about the importance of body appreciation while aging? Check out Maine’s book “Pursuing Perfection: Eating Disorders, Body Myths, and Women at Midlife and Beyond.”

(This article was originally published August 4, 2022 in the Jackson Hole News and Guide).

Tag: Menopause

Menopause myths stymie real growth