
by Holly Osterman
If there’s one thing I’ve learned after seven years of interviewing experts, building a menopause forum and living through it myself, there’s just not a one-size-fits-all solution.
Menopause is complicated.
Our bodies are going through major changes. And if all of the physical menopause symptoms weren’t enough, there’s the emotional baggage that comes with it. You know, the way it changes your relationships with your family and friends.
Let’s face it. Menopause can be an exhausting and lonely place.
Here’s the biggest problem. We all experience menopause differently. Your best friend can fly through menopause with a few hot flashes and an occasional sleepless night. You, on the other hand, are an emotional train wreck. Your hair is thinning. Your anxiety is in overdrive. And you just yelled at your boss. For no reason. Not good.
But there IS hope.
You see, you can seek out every special menopause diet, supplement, or treatment option—and there are plenty—but it’s easy to get lost in the sea of information.
Frankly, it can be overwhelming. You can almost feel your anxiety getting a little worse.
And what works for everybody else may not work for you.
Imagine how much simpler your life would be, though, if you were able to understand your symptoms, make sense of the changes to your body, and find the right resources to better manage your journey. All in a normal, sane and logical order.
You can. And it starts with a plan. No doubt, there are plenty of “how-to” guides on managing menopause symptoms. Many of them are really good and packed with useful information. But you need a plan that’s specific to you and your unique needs.
Here are the six steps to creating your personal plan (and a whole bunch of links and resources to help you implement it):
Step One: Do Your Research
As badly as you want to feel good right away, it’s really important that you take the time to do your research first. Don’t skip this step.
Think about it. Big companies don’t spend millions of dollars to launch a new product without first doing exhaustive research. They want to understand their market, make sure there’s a need and create the right strategy.
Before you launch the “new you,” you’ll want to do the same thing. And because your plan absolutely needs to be different than anyone else’s, there’s no better place to start your research than with you.
Understand Yourself
Whatever the finish line looks like for you, you’ll need to take an inventory—or a snapshot—of where you are today. Right now. It’s really tough to measure your progress unless you know where you’re starting from.
What does that snapshot look like? Well, be careful not to start identifying your menopause symptoms or guessing on treatment plans just yet. Focus on three areas that can help you assess your current lifestyle: your health, your heredity and your habits.
Health. For most of us, menopause happens naturally. It’s a part of life. Our bodies start making less estrogen and progesterone, the frequency or our periods changes, and our fertility declines.
For other women, medical treatments, such as radiation and chemotherapy, can potentially trigger early menopause.
And even though other health conditions, like high blood pressure, heart disease or diabetes, may not directly cause or make menopause symptoms worse, how you’re treating those conditions may play a factor as you better manage your symptoms.
That’s why it’s so important that you assess your current health, understand how different conditions may be related, and consult with your doctor as you develop your plan.
Heredity. Your mother and sisters all started experiencing menopause symptoms in their early 40’s. Does that mean that you can safely predict that you’ll do the same?
Not necessarily. Again, even within our families, we all experience menopause differently.
But according to Marcelle Pick, OB/GYN and founder of Women to Women, those of us with a family history or premature menopause are 60% more likely to follow a similar pattern.
Nanette Santoro, MD and director at the University of Colorado-Denver School of Medicine, shared a similar view in a recent WebMD article. “Menopause is strongly genetically linked” says Santoro, “so you’re very likely to fall within a few years either way of the age your mother was at menopause.”
Habits. Are you an avid runner or did you spend the entire weekend binge-watching Gilmore Girls? Feel good because you just started experimenting with the The Fast Metabolism Diet by Haylie Pomroy? It can really work, BTW.
Or are you intimate friends with Ben and Jerry? No judging. I’ve got a soft spot for my Chubby Hubby.
Recognizing our habits, both good and bad, is an important step in taking a personal inventory. Why? Because our lifestyle choices can impact our overall health.
If you smoke two packs of cigarettes a day, for example, don’t be surprised if your road through menopause is a little bumpier. Margery Gass, Executive Director Emeritus of the North American Menopause Society, has said that heavy smokers can experience menopause as much as two years earlier and are more likely to have hot flashes more frequently than non-smokers.
And no, a healthy lifestyle isn’t a cure for menopause. But a balanced diet, regular exercise and even meditation have been known to help manage the effects of certain menopause symptoms.
I want to be really clear. This isn’t a pep talk. And I’m not trying to convince you to lose twenty pounds or start training for a local 5K. Good habits are hard to maintain and bad habits are even harder to break.
But if you want to create a plan to better manage your journey, and feel good again, you need to know where you’re starting from. So take a picture.
Understand the Road Ahead
This stage of your life may pass quickly or last for years. In either case, you need to take the time to understand and prepare for what’s in store.
Imagine planning a trip across the country without Google Maps or your handy navigation system. Will you eventually get to your destination? Sure. You could stop at every gas station along the way, ask for directions and take your chances.
But you’ll do it more comfortably and with a lot more peace of mind if you take the time to study the route, traffic trouble spots and weather conditions first.
Menopause isn’t all that different. The more you understand the road ahead, the better you’ll be equipped to handle those trouble spots.
The phrase “this is not your mother’s menopause” has become really common in menopause circles. And it’s true. In generations past, women rarely talked about “the menopause.” Resources were scarce and doctors were even trained to manage symptoms differently.
We’ve come a long way.
The good news is that there’s a LOT of information out there. It’s so easy to Google our menopause symptoms and find whatever we need quickly. There are hundreds of books, websites and videos dedicated to menopause. Women are talking more openly and, better yet, sharing their stories.
The bad news is that there’s a LOT of information out there. And it’s just as easy to become overwhelmed if you don’t know where to start.
You need to avoid “information overload.”
So unless your goal is to become a walking encyclopedia of menopause symptoms, keep it simple. Begin with a book. And here are four really comprehensive examples to get you started:
The Menopause Book by Pat Wingert and Barbara Kantrowitz
Pat and Barbara were both journalists and worked together at Newsweek for 20 years. As they personally struggled with their own menopause symptoms, they searched for the menopausal equivalent of What to Expect When You’re Expecting. They couldn’t find it. So they decided to write it themselves.
In my opinion, this book is ideal for any woman at the beginning stages of perimenopause who really does want to know what to expect. Even though they dive into a lot detail on conditions, it’s filled with case studies and “how to” articles.
The Wisdom of Menopause by Dr. Christiane Northrup
If you haven’t heard her name before, Dr. Northrup is a nationally-recognized “menopause guru.” She’s published several books, but this one is the classic. In addition to the more clinical aspects of menopause, Dr. Northrup shows women how they can emerge wiser and healthier.
Any woman who’s already started experiencing symptoms, wants to get a better handle on treatment options, and needs a little encouragement should pick up a copy.
Menopause Confidential by Dr. Tara Allmen
The newest and most current menopause guide is written by Dr. Tara Allmen, a New York-based gynecologist and nationally-recognized menopause practitioner. With her background, you’d expect that Dr. Allmen would address your changing hormones and physical symptoms of menopause. And she does. Really well. But her writing style is so clear and easy-to-understand, it’s like having a normal conversation with a doctor who gets it.
Menopause Confidential is an excellent starting point if you’re feeling a little lost and want to understand both the physical and emotional sides of menopause, but don’t want all of the medical jargon.
The Hormone Cure by Sara Gottfried, MD
Dr. Sara Gottfried is a Harvard-educated physician and board-certified gynecologist who shares a unique hormone-balancing program in her best-selling book, The Hormone Cure. Her methods have been used to help thousands of women reclaim wellness, verve and optimal health.
If you’re on the road through menopause and are comparing supplements, herbal therapies and bioidentical hormones, The Hormone Cure is an informative option.
A few things to keep in mind as you’re deciding on where to begin your research. First, just pick one. All four of these books are detailed and very comprehensive. It’s a matter of which writing style fits you best and where you are in your journey.
And as much as you should read any of these books from cover-to-cover, it’s OK to cheat initially. It’s likely that you won’t be experiencing all menopause symptoms described, so consider scanning the tables of contents and flipping through to find what’s most important to you right now. Then go back to make sure you understand the message.
Finally, it’s easy to start absorbing information and diagnosing your symptoms. Don’t. Knowledge is important, but it’s even more important to meet with your doctor, discuss your symptoms, and get the medical guidance you need.
Step Two: Get on the “Write” Track
Remember how important it is to recognize your habits so you can measure your progress? Well, another habit you’ll need to develop as you move forward is writing down and recording your symptoms and activity.
Yeah, I know. Taking the time to track every hot flash, migraine and anxiety attack can get old fast. Especially if you do it every day. But the time you invest can pay big dividends.
The most obvious benefit is that you’ll have a written history and talking points to share with your doctor. Together, you’ll be able to see the big picture and identify patterns and trends in your daily life.
Again, because we all experience and manage menopause differently, find the system that works best for you. You can make it as simple or as structured as you’d like. A spiral notebook or whitepad will work fine. Or you can Google the term “track menopause symptoms” and find a handful of fillable forms to help you log the most important details.
And if you’re a little more technology-savvy, you can even download symptom tracking apps for your smartphone.
Whatever system you choose, don’t make it complicated.
So what, specifically, should you track? Start with your symptoms. As you’ve done your research, you should have a really good handle on what you’re experiencing. Write down the symptom and make a note of when and how often it occurs (frequency) and how bad it is (intensity).
But don’t stop there. Depending on your health and lifestyle, it may be useful to track other things, as well:
Your menstrual cycle. You’ve been down this road before. And until you’ve actually reached menopause, the first question your doctor or nurse will ask is “When was your last period?” You kinda, sorta know. But don’t guess. Write it down.
Your diet. What and when we eat can obviously affect how we feel. Are you in a high-stress job and prone to skipping lunch? Or do you have food allergies or other dietary restrictions? It’s important for your doctor to know and for you to understand how your diet fits your overall plan.
Your exercise program. Even though an active workout may not directly make your symptoms more manageable, how you nurture your body and mind is an important piece of the menopause puzzle. Write down the types of exercise you do, how often and for how long. And don’t forget those Tuesday morning Hot Yoga and meditation classes, too.
Your medications. Even though your doctor will have a record of your medications, this is a good place to keep track of the prescription and non-prescription drugs you’re taking, as well as the dosages. Remember to include any vitamins or supplements.
Tracking your symptoms and lifestyle takes a lot of work. But the more accurately you’re able to do it, the better you and your doctor will be able to tailor a treatment plan.
And if you’re struggling with the emotional side of menopause—if you’re feeling overwhelmed, lonely or even a little anxious—it might be helpful to keep a menopause journal. Again, doesn’t have to be fancy. Pick up a blank diary at your local bookstore, grab a pen and write. Make it a daily habit. You’ll find that just getting your feelings and emotions on paper can make a big difference.
Psychiatrist Carole Lieberman, MD, MPH shared her thoughts in an interview with Everyday Health.
“A journal anchors you,” says Dr. Lieberman. “One of the challenges of menopause is to not think that you’re going crazy because of all the emotional and physical changes you’re going through. When you journal, you can look back and remind yourself of how you have managed to stay sane despite these new challenges.”
Step Three: Have a Meaningful Discussion with Your Doctor. Or Get a New One.
The single, most important relationship you should have during your menopause journey should be with your doctor. Only makes sense, right?
And because your journey is unique to you, your doctor should understand your specific symptoms, background and lifestyle. He or she should work closely with you to explore treatment options that are just as unique.
Does that describe your relationship? If not, it’s time for a talk.
How to Prepare for Your Visit
How many women leave their doctor’s office just as lost and confused as when they went in? Unfortunately, it’s pretty common.
Here’s the good news: all of the steps you’ve taken so far—understanding yourself, researching and tracking your menopause symptoms, and keeping a journal—will make your doctor’s visit much more meaningful. You’ll able to better describe your symptoms, discuss your goals and ask the right questions.
But that’s just the start.
If you really want to get more out of your visit, I’d recommend downloading a copy of Shirley Weir’s free ebook, Cracking Open the Conversation with Your Doctor. Shirley is the founder of Menopause Chicks and her guide will help you prepare for your doctor’s visit, tell your story and “show up as an empowered patient.”
What to Expect
According to Dr. Sara Gottfried, Harvard physician and author of The Hormone Cure, the average appointment with a doctor in the United States is seven minutes long.
Stop and think about that for a second. Menopause is complicated and can last for several years. How much talking (or listening) can take place over a few minutes?
The bottom line is that you should leave the office feeling that your doctor is listening, understands you, and is working with you to manage and treat your symptoms. And you should have a follow-up schedule in place, as well.
Your health and well-being are important. Don’t settle for less.
When It’s Just Not Working
So what if you don’t feel that connection with your doctor?
Dr. Tara Allmen has a pretty direct answer.
“The secret to midlife health and wellness is to find a healthcare professional who can partner with you to address your specific issues and symptoms,” she says.
“Most women learn the hard way that their beloved and trusted OB/GYN, the person who delivered all their babies, is no longer the right one to take them on this next confusing and difficult journey through perimenopause and menopause.”
It might be time for a break up.
At a minimum, and if you don’t feel you have that partnership, you should explore your options. Start with asking friends about their experiences with their doctors. If those experiences have been positive, they may be able to refer you.
Or you can search for a North American Menopause Society (NAMS) certified practitioner on their website. Just enter your zip code and you’ll get a list of providers who are certified and have specific expertise in this field.
Step Four: Launch Your Menopause Action Plan (MAP)™
Now you’ve got to put it all together. It’s time to take action.
Think about your road trip. You can spend weeks picking your dream destination, mapping your route and packing your bags. But until you get behind the wheel and start driving, you’ll never get to where you want to go.
It’s easy to get stuck in menopause. Even when we really want to change, life sometimes gets in the way.
You need to make a commitment. And it starts with a process. It starts with your Menopause Action Plan, or MAP.
First, begin with the end in mind. Where do you want to be in six months or a year? How about in five years? How do you want to feel? And what do you want your life to look like?
No, you may not feel exactly like you did before menopause, but why not use this opportunity to reinvent yourself?
You can.
There’s a formula that many marketing companies and organizations use for strategic planning. And strangely enough, it can work for you, too.
The formula is simple: Goals > Strategies > Actions.
Your Goal is what you ultimately want to achieve. And it’s usually what we concentrate on first.
For example, your goal might be “I want to lose 20 pounds in three months.”
Your Goals should be within reach, but not too easy. Challenge yourself. And be specific. How long will it take you to get there?
Your Strategy is how you’re going to achieve it.
If your Goal is to lose 20 pounds, your strategy could be “I’m going to start a diet and exercise program.”
Keep in mind, you may have more than one strategy. But they should all fit together to help you accomplish your Goal.
Finally, your Actions are the steps—or tactics—that you’re going to take every day, week or month in order to make your goal a reality.
So, as part of your diet and exercise program, you’re going to: 1) join Weight Watchers; 2) go to weekly meetings; and, 3) walk for 30 minutes after dinner four times per week.
Your Actions need to be really specific. And you need to start doing them right away.
You’re obviously going to have more than one Goal. Maybe you want to sleep better or learn a new language. So for each Goal, go back to the beginning, map out your Strategies and Actions, and bring them all together.
It’s as simple as “Lather. Rinse. Repeat.”
You now have a Menopause Action Plan. And the best part? It’s specific to you.
See, the problem is that most of what you read online and in many books is focused just on Actions. Anybody can give you advice and tell you how to lose weight. But if that advice isn’t part of a strategy that rolls up to your personal and very specific goal, you may just get frustrated and give up.
Remember to be flexible. If your plan isn’t working or if you’re not getting the results you want, try keeping your Goals and Strategies in place and changing your Actions.
Step Five: Nurture Your Relationships
Do things feel different?
No, I’m not talking about the fact that you feel like someone just cranked up your internal thermostat. That’s a physical symptom. And hopefully, you’re on track to work more closely with your doctor to figure it out.
But don’t ignore the emotional side of menopause. For some women, it’s even more difficult than the hot flashes.
Do you remember when you and your sister would sneak out of work early on Friday to drink martinis at the bar down the street? Or how much time you and your husband would spend carting the kids’ butts around to baseball games and band camp?
Now, just trying to get dinner on the table is a challenge. And you just snapped at your husband because he forgot to pick up the dry cleaning.
Things are different. And so are you.
Now, more than ever, your relationships are important. So take steps to nurture them.
Reconnect with your spouse or significant other. I don’t want to sound like Dr. Phil, but let’s face it. People drift apart. And when the things that brought us together—the kids, the new house, arguments with the in-laws—become less of a priority, you may find yourselves in a different place.
Take the time to find new interests. Start with something small. A dinner out and light conversation. Or find a new passion that you both can enjoy.
And when it makes sense, you can even share your MAP so they can help you reach your goals.
Understand their perspective. Sure you’re going through a lot. But they may be, as well. And even though your significant other may have no real idea how your body or hormones are changing, it’s always healthy to look at your relationship from their point-of-view.
Magnolia Miller, health writer and founder of The Perimenopause Blog, has done an entire series of posts on the importance of perspective in relationships. It works the other way, too. She has a special category on her site to help men understand why you sometimes behave the way you do. You need to check it out.
Learn to lean on friends and family for support. Have you ever felt that you’ve always needed to be the “strong one” in your household? The glue that holds the family together? That’s all too common. You spend so much time taking care of your family and being there for your friends that you get lost in the shuffle.
It’s time to change. It’s time to be selfish. It’s time for you.
That doesn’t mean that you drop everything, sell your car and travel around Europe to find yourself. It just means that it’s OK to focus on your needs for a change. It’s OK to be a little more vulnerable and it’s OK to ask for help.
You might be surprised at how the important people around you will welcome “the change.”
Step Six: Find Your Community
The reality is, even when you have a plan in place and support from your friends and family, menopause can sometimes be a lonely place. Not to sound like a broken record, but because we all experience menopause differently, it just doesn’t feel like anyone really understands us.
But you have to remember something really important: you’re NOT alone.
Every day, and all over the world, millions of women are facing many of the same challenges as you. And though menopause symptoms can be like snowflakes—we’re all different—you need to find your “tribe.” There are women out there who really do understand what you’re going through. Who can offer support, share their wisdom, and even lift you up on a bad day.
So where do you find these women?
Okay, time for a little commercial break.
In 2009, I started Menopause ChitChat. It’s a private, online (and free) community just for women in menopause. You need to be approved before you can join, but it’s a safe place to ask questions and lend your insight.
Since we launched, the community has grown. We now have over 6,500 members and 2,000 discussions on everything from anxiety to relationships. And I’ve been so fortunate to be part of community where women can ask just about anything and support one another on our journeys.
Here’s what our members are saying:
“I have made some wonderful friendships through this site. I feel a sense of community and general caring and support from all the ladies on this site. It has helped me through this menopause journey knowing there are other ladies out there experiencing the same things as me. It is a sisterhood that I value deeply.”
“The biggest challenge is knowing I’m not alone and being able to discuss with others who are going through the same thing. Menopause ChitChat has done wonders for my peace of mind.”
“I love Menopause ChitChat and feel very blessed to have all of these wonderful women in my life. Although I probably will never be able to meet them face to face, we all share a common “thread” and are helping each other get through this crazy period in our life, one symptom at a time. So thank you to everyone at Menopause ChitChat. You have all made a big difference in my life.”
“It’s been really helpful to see from all the posts that a lot of women have similar issues. Having early menopause means that my friends can’t understand what I’m going through and I lack a support network. Thanks for the help!”
“When I see my doctor, I’m made to feel isolated in my experiences and a hypochondriac. This site puts me in touch with others, illustrates how universal this experience is and helps me to cope, even when I have little support from the outside.”
You’re really not alone. You’re part of a community of women who can relate to your experiences and lend support when you’ve got questions, had a bad day or just need to vent.
So make sure to visit Menopause ChitChat and join the conversation today.
A Final Word
Menopause can be scary. But it’s also an opportunity to take charge, examine your lifestyle and even reinvent yourself. Being informed—and creating an action plan specific to you—are the first steps along a new and powerful path.
It starts with a plan. And it starts with you.
Holly
Your menopausal community should be grateful for this extensive, informative post. You offered many avenues of guidance in an easy format to follow. At a time of life when the simplest of tasks can seem monumental, due to our fluctuating/declining hormone levels wreaking havoc with our bodies & emotions, countless women will benefit from your contribution. Thank you.
Lisa-
Thank you for the kind words. Menopause can be a very difficult time for many women and it’s easy to feel lost. I’m glad you found our guide helpful and hope that others will as well.
Holly