Menopause equals loss. Over history, that formula has been hard-wired into our female brains. The loss of our femininity, our fertility, our youth, maybe even our sexual selves. This kind of thinking comes with a price, adding enormous stress and anxiety as we navigate the hormonal tides of menopause.
But what if menopause was a gain? What if we go through this transition because something more powerful was waiting for us on the other side? Wouldn’t that help us experience menopause as a metaphysical doorway, rather than a crushing hell hole?
In our recent virtual discussion on thriving through menopause and how we experience stress during this time, we talked about this other, more hopeful possibility, and one of our guests Darcey Steinke, who wrote Flash Count Diary: Menopause and the Vindication of Natural Life, gave evolutionary support to the theory of menopause as a boon. Based on a study of whales, the only other creature that goes through menopause, “scientists are starting think that’s why menopause was selected in humans as well,” she told us. “We were hunter and gatherers, and women got so smart around 50 that they were more important to the group as leaders than they were as mothers.”
Steinke and Dr. Valerie Callender, founder of Callender Dermatology and Cosmetic Center in Glenn Dale, Maryland, guided us through causes and solutions for internal sources of stress—our changing hormone levels—and the external kind, feeling isolated and sidelined by how we’re viewed in society. Steinke remembers what one women said to her during her book tour: “If menopause wasn’t treated like the end of the world, we wouldn’t be so depressed.”
NextTribe launched this series in partnership with Nutrafol, which produces a specially formulated supplement that helps menopausal women take control of their hair health, to encourage conversation and understanding around menopause, a condition that is too often ignored by the media and health professionals. Since its inception, NextTribe has been talking about menopause and encouraging women to share their stories of this universal experience in our Menopause Chronicles. We invite you to share yours too!
Viewers of the event were able to ask questions, and there were scores of them. What follows is an edited and condensed version of the conversation, which was moderated by NextTribe co-founder Jeannie Ralston. Five viewers who submitted questions were chosen to win three months’ worth of Nutrafol’s Women’s Balance. When you come to our event on fitness, energy and sleep, make sure to have your questions ready and you too could win.
What’s happening in our bodies that causes menopause to be such an emotional time?
Dr. Callender: When we’re in peri-menopause, menopause, and post menopause, we’re actually losing what makes us women. Estrogen and progesterone start to decline, and with that decline the male hormones, androgens, that we actually have in are bodies become unmasked. So now you have effects of androgens. Some of the physical signs that you’re in menopause—we all know about hot flashes, mood swings, headaches, breast tenderness, irregular menses. As a dermatologist I find that patient’s skin becomes a lot drier, plus vaginal dryness. As well as problems or concerns with our hair follicles. On our body we start to lose hair; our pubic hair and underarm hair start to diminish as well as hair on our scalp. On the flip side, we end up getting more hair where we don’t want hair. Mustache hair and other facial hair. Hair changes definitely occur.
Yes, facial hair can be stressful, for sure. Darcey, your trip through menopause led you to write your book. Can you tell us what your experience was like?
Darcey Steinke: I didn’t know much about the change. My mother hadn’t told me much. I remember that right around 52 I woke up completely drenched in sweat. Of course being a minister’s daughter my first thought was God is finally trying to contact me. But really it was a hot flash. I’m 58, and on the downside now, but I had them pretty severely.
I’m a writer so I understand the world through books. I looked around and there were a couple medical books, but there were a lot of really terrible books about menopause. I’m not against hormones, but these books always ended with the woman taking hormones and that was the end of the passage for that woman. I just don’t think that’s true; it’s a very meaningful passage. You just don’t cut it off by treating it with hormones. You’re still going through something spiritually and physically. I would argue even metaphysically. I thought I should write about this.
What really got me really started was reading about the whales. That human woman and whales are the only creatures that go through menopause. And I found out that the killer whales, once they go through menopause, around 48 or 50, they become leaders of their pods. They go through menopause so they can go into positions of leadership. It’s not seen as a loss; it’s seen as a gain. They can help the pod locate salmon are at time of scarcity. They can help with communication. Through them, scientists are starting think that’s why menopause was selected in humans as well. We were hunter and gatherers, and women got so smart around 50 that they were more important to the group as leaders than they were as mothers.
That was the first positive thing I found about menopause that I could really hold onto. That’s the thread that pulled me on the journey of my book.
You’ve researched the natural history of menopause, and in your book you talk about the way menopause is viewed in the culture. What kind of stress does that put on us?
Darcey Steinke: The culture has no interest in older women in general. There’s a lot of prejudice. I did a lot of readings for my book when it came out, and I was talking about menopause and depression and this one woman came to the mike. She said, “If menopause wasn’t treated like the end of the world, we wouldn’t be so depressed.” I thought that was really interesting. There may be some hormonal stuff going on, but also the incredibly negativity depresses you as well.
I interviewed 100 women for my book and for every single one of them, menopause was different. It wasn’t a one-size-fits-all. People act like it is. Some people have no hot flashes. Some people really suffer from symptoms. It’s really important to remember that.
How does stress affect the body?
Dr. Callender: If you think about stress in general, it affects every organ in the body. The symptoms are different for everyone. We’re definitely having a lot of stress right now, with the pandemic and the world changes. It can cause heart rate to go up, and the effect long chronic stress has on heart disease is well documented. It’s something that’s associated with worsening of any condition you have.
What can you do to manage stress, during menopause or any time?
Dr. Callender: Lifestyle changes definitely can help. You have to find something that brings you joy. I like to use dance as my way of reducing stress. But also we have to make sure we’re eating right and exercising.
Because I’m a dermatologist, hair loss tends to be the most common stress-related condition I see. And the more hair loss there is, the more the stress, in a cycle.
A lot of women don’t’ want to take Hormone Replacement Therapy ; they’d rather manage hormones and stress levels naturally, with botanicals. The active ingredients in Nutrafol really help. Ashwagandha is a botanical nutrient that modulates cortisone levels and helps to decrease stress. Curcumin helps with inflammation. Researchers are finding that inflammation plays a part in hair loss and hair thinning. Inflammation is stressful on the body, and all this is intertwined. Saw palmetto is a DHT (dihydrotestosterone) blocker; it prevents the conversion of androgen to DHT. We don’t want the androgens, we want estrogen.
If a woman goes into menopause with a negative attitude about the transition, do you think it makes her experience worse?
Darcey Steinke: I think it would. There needs to be a context shift. It’s a natural phase of life. Yes, there are things that are hard about it, and anyone having difficult symptoms should seek treatment, but it shouldn’t be seen as a disease. It’s not a disease. Just like puberty and birth, it’s a natural part of a woman’s life. That’s the thing that really bothered me. How medicalized it was and continues to be in a way.
During my research, I found that a lot of websites, even those for well-respected hospitals, listed menopause symptoms in the nastiest way. Senile ovaries. Vaginal atrophy. No one would ever talk about the male body like that. There’s a nicer way to say these thing. I think there’s a lot of internal misogyny built up. Even now. That really upset me. Particularly that all the symptoms seemed to be about male pleasure.
I went to this menopause conference in Amsterdam. This gynecologist got up to talk about how we can get the vagina back in shape. He started talking about dryness. I realized he was really thinking of a vagina as a penis holder. He wasn’t thinking about it as part of a female body. His descriptions were nothing like I feel about my body. I mean I’ve had some dryness, but it’s not a terrible tragedy. I must say, I got really depressed some times. I got mad a lot working on the book, but sometimes faced with a certain kind of medical misogyny I got really, really depressed.
How do we make peace with the transition we’re going through?
Darcey Steinke: For one thing, I think the model of sex has to move away from intercourse. If it doesn’t feel comfortable any more there are a lot of wonderful things to do. Lot of other things on the menu. Communication with your partner. Lube is amazing.
Instead of going around being miserable, and your husband’s mad because you’re not having sex like he wants. You have to have communication where you sort of reinvent yourself. I have not read or heard anyone talking about that kind of thing. A lot of women suffer in silence and in shame. And it’s just bull shit.
Look at menstruation; no one goes around saying that’s a problem that has to be cured. To me, it is misogyny.
What’s the chief concern of women you see, Dr. Callender, who are going through menopause?
Dr. Callender: Mainly for my patient population in their 40s, 50s, 60s and above, it’s hair loss. We know that hair loss and hair thinning associated with our appearance and impacts our quality of life like nothing you can compare. Some may think hair is frivolous, but women are really, really concerned about hteir hair and skin. Most women don’t want to do medical treatments for their hair loss, so natural alternatives are very helpful.
Darcey, you interviewed more than 100 women for your books, what were some common concerns?
Darcey Steinke: There wasn’t just one. I think a lot of women, maybe a third, felt less feminine in that old-fashioned way. They were happy and relieved about that. They were happy to go to a slightly different place as a woman. That surprised me and excited me. The thing that bothered them the most is people making fun of them, teasing at work, by their families, by their husbands, and by their children sometimes too.
No one makes fun of someone having seizures. Many women told me that being teased at work, about being hot or something. I’d say that was the most common complaint. It made them feel shame. I’ve found they’re slightly ahead of us in Great Britain. Some businesses have cold rooms where women who are having hot flash can go and sit down. They’re also having sensitivity training too. They’re definitely ahead of us as far as destigmitizing menopause.
Questions from viewers:
Susan: I take turmeric every day for inflammation. Is it OK to take along with Nutrafol?
Dr. Callender. Yes it’s fine. You can take it a long with Nutrafol. If you have any concerns, you can consult with your own doctor.
Kim: What about brain fog during menopause? I really feel like I am forgetting more and not quite as sharp.
Darcey Steinke: That was the menopause symptom I was most worried about, because I’m a writer. I really need my mind to make a living. I talked to about 10 scientists and there wasn’t anything that actually said menopause was linked to brain fog. Frankly, at least half the studies found that women who complained about brain fuzziness were actually doing better than those who didn’t complain about brain fuzziness. That was fascinating to me. There’s not really a link.
I forget things, but I also forget things in my 20s and being extremely spacey. I’m much less spacey than I was in my 20s. Not losing my keys and wallet every month. I wonder, maybe it’s attached to aging in general, but I found nothing to link it to menopause.
Susan: Did you find sugar or alcohol increased hot flashes either in the day or the night?
Darcey Steinke: Yes, some doctors say that, and some of the women I talked to said that especially if it was before bed, sugar and wine would keep them up. I don’t know if that’s directly menopausal. I found even before menopause, if I had a few glasses of wine found it hard to sleep. I’m not sure that all the things that people put onto menopause are actually menopausal. Some of them might be general aging things.
Jeannie: I sometimes wonder if things that are happening to me are caused by menopause or just natural. Like, am I menopausal or actually a bitch?
Darcey Steinke: I actually want to talk about being a bitch. I feel like that’s really not true. I think they’re standing up for themselves. I think they’re finding they didn’t like the way their lives were before. Hormones can make you a little docile. I tell my daughter that the days before her period when hormones drop and people say women are bitchy, I say, no. I think you actually get a real solid look at your life how it is. Sometimes you’re angry and you want to change things. I really stay away from this idea of bitchiness; they’re really…
Dr. Callender. They’re taking charge
Darcey Steinke: And that can upset your partner or people in your life. Don’t let your husband make fun of you. Set boundaries. Don’t let anyone call you a bitchy or crazy. Accept what we’re going through and appreciate the good parts that are happening, we can take charge of this time in our life.
Dr. Callender: That’s why talking is important. You’re not alone.
Janet: I would love to hear some advice about post-menopausal bone loss. It’s adding to my stress for sure.
Dr. Callender: Vitamin D and calcium are so important. A lot of time osteoporosis runs in families; so start early looking at your calcium and vitamin D intake and family history. You can actually monitor those levels with bone scans. Sometimes your primary care doctor can be helpful, but orthopedic doctors are good to consult because of your joints and the degenerative changes that can occur.
Marie: You talked about lube. What are your recommendations for lube?
Darcey Steinke: I talked about lube on NPR, and I got all these companies sending me lube in the mail. Lube with CBD oil. Lube with whatever. I actually like Astroglide. But there are a lot of specialty kinds. Lot of people making natural lube. Small batch lube.
Kim: I feel like I have a mix of menopausal and teenage skin. Could it be stress or something related to being post menopausal?
Dr. Callender: We definitely feel acne is hormonal. And of course the majority of teens and adolescents have acne because of hormonal change. We do have a condition called Adult Female Acne, or AFA, that usually develops along the jawline. We see it usually in pre-menopausal women in their 30s and 50s. If it occurs after that, we have to think of the androgens that are becoming unmasked. Androgens are associated with acne as well. The treatments are basically the same. Just see your dermatologist about that.
Patrice: Did you just look at Western women in your research, Darcey, or all women?
Darcey Steinke: I didn’t get to research women in other cultures as much as I wanted. But I read a lot. There are only a couple cultures where women’s lives are better after menopause. That’s mostly in cultures where menstruating women are considered unclean. After menstruation is done, the women got to come down with the men and smoke after dinner.
There is a place in Spain, where after menopause you don’t have to cook any more. Your daughters-in-law take over. A few places like that. Not that much sadly. Not as much as I was hoping.
Nancy: I had a good transition in general. I’m wondering what kind of health regimen I should be following now.
Darcey Steinke: I’m a little more careful with my diet. I try to do exercise I love. I’m a big open-water swimmer. I try to do things that give me a real thrill rather than just going to the gym and doing elliptical. I try to really focus on what I want to do with my life. If I’m lucky, I have what 30 years left. I keep my eye on that and it gives me more inspiration and energy and I do think that helps. If I’m inspired and enthusiastic, I’ll generally be healthier.
Dr. Callender: We all have to find ways to decrease your stress. That helps overall with your organs. Decrease caffeine and alcohol. Be around friends. Laugh, smile. All of that can really help.