For many generations, menopause was as shrouded in mystery as anything else related to the female reproductive system -- even friends would dance around the topic while they offered a sympathetic ear.
Today, menopause is an afternoon on "Oprah," on the covers of popular women's magazines, even joked about in those cubicle printouts that proclaim, "It's not a hot flash, it's a power surge!"
"It was one of those things that people didn't look forward to, so they didn't talk about it," said Carol Penagos of Hailey. "Now we're opening up about the alternatives, and it's so much easier to go through."
She had a difficult time with menopause, often having five or 10 hot flashes every day that left her red-faced and dripping with sweat. She would get irritable, snapping at her husband when he didn't understand. "It was like, get away from me, I don't want to be around anybody. Your body's changing so much that there's pain, then there's seclusion, low self-esteem, all of that was going on."
Penagos, 51, used hormone replacement therapy for several years until the symptoms started easing. Jenny Stireman, a nurse practitioner in the OB/GYN department of St. Luke's Wood River Medical Center, said patients like Penagos have benefited from therapeutic advances showing that smaller doses of hormones are still effective, with fewer of the side effects associated with them in the past.
Stireman recently held a seminar called "Menopause and Marvelous" that encouraged women to look at their body changes as a natural progression to a new, exciting stage of life.
"I think of it like puberty, just at the other end of the spectrum," Stireman said. "In the media, it seems like women have always looked at menopause like, 'I'm getting old and it's the end of me.' Now that our life span runs into the 80s, I'm going to spend a third of my life in menopause. Women want good quality of life, they're more proactive about their health."
Many women of the baby boom generation have now passed through menopause -- the average age of onset, defined as having no
periods for a year, is 51, Stireman said -- and they're reporting back to their younger counterparts.
"More than 50 percent of women who are menopausal say this is the happiest time in their life," Stireman said, citing the results of a study published in a 1999 issue of the journal Menopause. Three-quarters reported making a healthy lifestyle change, in terms of diet, exercise or other factors.
Penagos said this has been true for her. She recently went back to school part time to get a nursing degree, and she frequently takes her two dogs on walks or bike rides just to enjoy being outdoors.
"It's a fresh beginning, I just have this new outlook on life," she said. "I feel young again; I'm not in my childbearing years anymore, I don't have to worry about that aspect."
Many women report decreases in libido as well as physical changes including thinner tissues and decreased natural lubrication that make sexual intimacy more difficult, despite no longer having to worry about contraception.
Penagos said that, just as talking about her symptoms with female friends and family members made it easier to go through, opening up to her husband about sexual difficulties made that easier as well. "I never thought I could do that, sit down and have that discussion with my husband," she said. "(Now) I could be one of those Cialis commercials."
All this frankness about menopause can be a double-edged sword, said Dr. Don Smith, an OB/GYN at St. Luke's Magic Valley Medical Center. Patients are more willing to talk about their symptoms, but they've also heard and read so much that some are less open to his advice.
"You can generally tell within two minutes of a consult whether you're going to make any difference or not," Smith said. And with more information available, women are comparing themselves with other women more.
Menopause is obviously a normal thing; there are a lot of women who pass through gracefully without a glitch," he said. But they can be unsympathetic to others whose symptoms have a greater impact on their lives. "They look at other women who struggle and have issues as 'weak sisters.'"
It's important to remember that each woman's experience is different, said both health care professionals.
Marian Lloyd of Hailey said she expected menopause to be much worse than it was for her.
"It's not necessarily as bad as people say it is, you just get hot every once in a while. You always feel like you want to take a shower," said Lloyd, 58, who began getting hot flashes four years ago.
She said she didn't hear much about her mother's experience -- that could have been connected to her mother's Southern attitude about talking about private matters -- but she has talked about menopause with her older sisters and friends. "You hear more about it, and then you learn more about it, and when you're more educated on a subject, you can handle it better. Knowing someone else is going through it makes it easier."
Jokes about power surges aside, knowledge and empathy have gone a long way toward making what once was whispered about behind closed doors into just another natural change that every woman can expect, even look forward to.
Ariel Hansen may be reached at 788-3475 or firstname.lastname@example.org.
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