Managing Menopause: A Real Conversation

We are finally talking openly about this natural shift in women—menopause. No longer dumbed down and diminished by naming it “the change of life,” or some other vague term, menopause is becoming normalized, and it’s a topic of lively conversation for women seeking support and solid information.

Myself? I wave the menopause-and-me flag with a personal experience similar to many women faced with the physiological, mental and emotional changes that align with our ovaries packing up and calling it a day. Ultimately, we stop producing eggs, and our hormones like estrogen and progesterone take a nosedive.

What does this translate to?

• Hot flashes (I was drenched and devastated when a client swooped in for a big hug once)
• Insomnia (the cycle of falling asleep, waking up, back to sleep, waking on repeat every night, all night)
• Brain fog (staring into the pantry—why did I come in here? When did I become my mother?)
• Bladder leaks (so many products, so many TV commercials. For good reason)
• Lowered libido (and exhaustion from lousy sleep doesn’t exactly stoke the sexy-time fires either)

More not-so-great news? After menopause, a woman’s risk for cardiovascular disease, dementia and osteoporosis increases. But there really is hope—and help.

I recently spoke with Dr. Bal Pawa of Westcoast Women’s Clinic, whom I first turned to some twenty years ago with undiagnosed perimenopause. She and Dr. Nishi Dhawan co-founded their Vancouver clinic back in 2002, and were “the pioneer integrative hormone clinic at a time when the WHI (Women’s Health Initiative) report came out in 2002, indicating that hormone replacement caused cancer,” says Pawa.

Pawa explains menopause like this: “Menopause is not something you go through. It’s technically a milestone you reach. What you go through is perimenopause, the eight to 10 years leading up to menopause. After the milestone is reached, everything beyond that is called post menopause.”

Many menopausal women are underserved when it comes to getting support from their primary care doctors, even though the doctors are doing their best with limited time, training and resources. That’s where private clinics like Westcoast Women’s can offer some support.

“We founded the clinic with a mission to ensure women made informed decisions about their health,” she continues. “From the very start, we took a holistic approach to women’s health care; we weren’t going to just write prescriptions. As a pharmacist, I was aware that any kind of oral estrogen or hormone replacement can pose a higher risk for blood clots. For proper patient assessments, we looked at their diet, lifestyle, sleep and genetics, and offer individualized analysis.”

And what of hormone replacement therapy? “It’s now called menopausal hormone therapy,” says Pawa. “As a treatment for menopause, you have to consider many factors: the severity of symptoms, genetics, lifestyle, timing and presence of other diseases. For example, is that particular woman at high risk for blood clots or breast cancer?  Is she diabetic or hypertensive? Currently, the research is saying that hormone therapy does not cause breast cancer but may increase its growth if already present. It does not start the fire but can fan the flames.”

Are there new advancements we should know about? “The most recent is that the FDA just took away the black box warning for estrogen, saying it does not cause cancer, but it took 25 years,” says Pawa. “The Canadian government has agreed to pay for hormone therapy, so that’s another good advancement, and the third is more in the biotech sector, and how biology and technology interface is so vital now. There are devices that women can wear to track their symptoms.”

That said, there are plenty of excellent Canadian products available to address and alleviate some of menopause’s meanest manifestations. Brands are stepping up with at-home support that makes things just a little easier for us women as we age.

Canadian Brands Offering Menopause Support

To Sip:

OURbody Balance Menopausal Support Tea contains shatavari root (an ayurvedic herb known for supporting hormonal balance), red clover, which is rich with phytoestrogens, and St. John’s wort, which helps with mood and sleep. A comforting wind-down-of-the-day drink.

Organic Traditions is celebrating 25 years in Canada as a certified organic superfoods brand. The new Lavender Latte is on repeat in my kitchen, a bedtime cup of calming lavender, tart cherry, adaptogens and probiotics to help with sleep.

To Soak in:

Canadian bath brand Bathorium has it nailed with their Menopause Collection, especially the Hinoki Magnesium Bath Flakes. If you’ve been taking magnesium bisglycinate capsules at bedtime for inspiring some shuteye, think of this as a “you’re soaking in it” nightly bath experience.

To Cool it:

Saje’s Solace Hot Flush Rescue Remedy is a roll-on from the B.C. brand you’ll want to keep handy—one in your bag on the go, and one by your bedside for midnight emergencies. When you feel your temperature rising and the sweat bursting through, dab this on your temples, throat and wrists for a cooling calm with grapefruit, clary sage and cypress.

To Moisturize:

Women lose moisture all over their bodies during menopause, which is not limited to skin and hair. Gynatrof deals with the moisture dip that happens vaginally too (and can be downright uncomfortable), with a non-hormonal product that is pH-balanced, oil and glycerine-free. You’ll feel more like yourself when this becomes part of your self-care.

To Take:

Women’s Everyday Probiotic from Orange Naturals contains two targeted strains to promote vaginal health. A healthy vagina contains Lactobacillus strains, which help to fend off and prevent the growth of harmful bacteria. The cranberry extract in this product helps with recurring UTIs, too.

 To Spray:

Love these natural, tasty sprays to deal with all the menopausal mayhem. I use the Can-i Sleep right when I tuck into whatever book is at my bedside, and one chapter in and I’m feeling drowsy. The Can-i Boost is perched on my desk for mid-afternoon energy slumps and Can-i Fresh helps me dial it back when I’m stressing with relaxing properties that don’t make me sleepy.

To Sleep Cooler:

Silk & Snow’s Flax Linen Bed Sheets are my “where have you been all my menopausal life?” latest bedding find. Waking up hot several times a night was getting very old, and with some research, I discovered that linen sheets have a looser, more breathable weave that keeps you cooler than cotton sheets through the night. Bonus? Gorgeous colour options too.

To Skip the Sweat:

Try Cat Lady Deodorant from Routine Natural Beauty. The name is perfect, alluding to that cringy menopausal lady stereotype I hope to avoid. A jar of this lasts a long time. Just use a pea-sized dab on your underarms to keep fresh and dry, complete with a bonus lymphatic drainage while you massage it in.

To Help Your Hair:

Mandy Robertson is an IAT certified trichologist specializing in diagnosing and treating hair loss during menopause and is the owner of Deeply Rooted Hair and Scalp Clinic in Vancouver. I asked her a few questions when I noticed some thinning of my already fine hair.

How common is menopausal hair loss?

Hair loss during the menopausal transition is very common. Several forms of alopecia are associated with hormonal changes at this stage, including telogen effluvium, a disruption of the normal hair growth cycle in which more hairs enter the resting phase prematurely; androgenetic alopecia (female pattern hair loss); and frontal fibrosing alopecia, an autoimmune condition that leads to scarring hair loss along the frontal hairline, eyebrows and sometimes other areas of the scalp or body. When these patterns are considered together, well over half of women experience some degree of menopause-related hair loss.

What should women look for to determine if it’s time for an analysis?

Women who are in perimenopause or menopause can look out for increased hair shedding, hair thinning (especially over the top of the scalp) or loss of hair in the frontal hairline and eyebrows.

How can menopausal hair loss be treated?

There are many treatment options for menopause related hair loss. Topical or low-dose oral minoxidil, oral spironolactone, topical or oral finasteride, low-level-laser-therapy, oral contraceptives (with low overall androgenic activity), Alma TED (trans epidermal delivery), peptide-based hair serums and platelet-rich plasma (PRP) are some of the options that can be explored.

To Laugh:

You have to find the humour in all this, right? Menopause is a lot, so a little laughter goes a long way. Watch CBC’s Small Achievable Goals starring the Baroness von Sketch Show’s Jennifer Whalen and Meredith MacNeill as two very different women smack dab in menopause, and producing a podcast.

Finally, an encouraging comment from Pawa: “In this age of information, it is an empowering time to be a woman. We have more choices, options and greater access to knowledge. There is a growing willingness to speak openly about our biology without shame. Women no longer want to compromise their quality of life. Instead, they are asserting autonomy, seeking informed options and engaging in shared decision-making with their healthcare providers.”