By Marleen M. Quint
Women’s Health Advocate
Menopause is medically defined as the cessation of menstrual activity, usually occurring between the ages of 35 to 58. It marks the end of a woman’s ability to reproduce. Doctors consider a woman having gone through menopause once her periods have ceased for one full year -- hardly brilliant science. The ability of the medical profession to accurately monitor, facilitate, predict and understand this passage in a woman’s life remains to be seen.
MYTH & MEDICINE
Many of the problems associated with menopause can be attributed to the undeniable overlapping of myth and medicine. A great deal can be understood regarding the type of myths attributed to female reproduction and its cessation when examining the societal shift from the matriarchal to the patriarchal. This shift affected how menopause was viewed both in society and in medicine. It also affected the subsequent terminology used to describe the menopausal process and the treatments developed to "correct" it.
In ancient times many traditional rituals involved the ingestion of menstrual blood to increase spiritual power. In ancient Greece, for example, spring festivals included the spreading of corn and menstrual blood on the ground to increase fertility.
The word "ritual" comes from "rtu" which means menses in Sanskrit. Blood from the womb was believed to have the power of life. Blood sacrifices at one time came from the "sacrificed" blood flow of a woman’s monthly cycle. This ritual was later corrupted into killing for sacrificial blood.
A woman’s bleeding was once considered a powerful cosmic event connected to the lunar cycles and the tides. This connection to the moon’s cycle was later distorted and the connection between the wisdom of women and the tides was denigrated. The word "lunacy" is the result of this denigration.
The word "menopause" (menespausie, in French) was first used in 1812 by a French physician named de Gardanne. At that time it was believed a woman’s mental state was directly linked to her reproductive organs. The uterus and ovaries were frequently removed as a treatment for symptoms as simple as irritability.
Another word connecting women and mental instability is the word "hysteria". It comes from the Greek word "hystera", meaning "uterus".
Both lunacy and hysteria are words rooted in the perversion of the natural female reproductive cycle and are both terms still listed in cyclopedia medical dictionaries (although the word lunacy is usually acknowledged as an outdated term).
By the 20th century menopause had become a medical disease to be dealt with rather than part of the natural aging process of a healthy woman. During the 1930’s a researcher named Dr. Serge Voronoff conducted hormonal therapy treatments involving grafting monkey ovaries in women resulting in several fatalities (I’d like to know who approved THAT study). By the 1940’s FDA approved the marketing of Premarin, a hormonal estrogen derived from pregnant mares urine (Yup, it‘s a well known fact; that‘s how it got its name). I bet that little piece of information wasn’t printed on the box! In the 1950’s we had lobotomies and female castration as a treatment for "mid-life crazies." The 1960’s brought us Feminine Forever, a book funded by the drug company Wyeth-Ayerst Laboratories, Inc. The book was written by a New York gynecologist named Dr. Robert Wilson. It characterized menopause as a disease rather than a natural phase of a woman’s life. It expounded the miracles of estrogen therapy as the cure for this disease and the answer to the fountain of youth.
The 21st century has hardly brought us the world of enlightenment for middle-aged women. The perceptions and politics that have twisted the view of menopause still prevails. The only recent productive piece of information we finally received confirmed research that both estrogen replacement therapy (ERT) and combination hormone replacement therapy (HRT) does much more harm than good. The Women’s Health Initiative (WHI) was the large government study that included over 161,000 healthy postmenopausal women which revealed the dangers of both ERT and HRT. Study results were published in 2002.
I make a point of mentioning the year of the study results because by 1975 it was already well-known in the medical community that women taking unopposed estrogen had an increase of uterine cancers. In fact, animal studies done in the 1950’s had already shown this. The debate on the safety and effectiveness of HRT has also been in contention for many years. This means our government has allowed the medical industry to use women as hormonal guinea pigs for over 50 years!
In spite of the clear medical bias existing around the subject of menopause, I would like to attempt to explain its process as simply and comprehensively as possible.
I was amazed to find out that the ovary doesn’t just shrivel up and die after menopause. The ovary has a much broader and longer function than previously thought. It’s not only an egg making factory. The ovary is also an endocrine organ that produces hormones all through a woman’s life.
A simplified explanation of how the ovary functions is to think of a woman’s life in 3 stages -- puberty, reproduction and menopause. Puberty is when reproduction hormones kick into gear, reproduction is the stage when childbearing occurs and menopause can be thought of as the reverse of puberty. The ovary goes from a reproductive to a maintenance stage during menopause. When women are younger, the ovary produces estrogen and progesterone. As women enter middle-age, the ovary begins to produce estrogen and androgens (male hormones). This means a woman has a little more testosterone and a little less estrogen but in a balance to maintain the non-reproductive stage of her life.
Menopause is a long and slow process. The actual physiological changes leading up to menopause can be a 15 to 20 year process. There is also a great deal of variability in the hormone levels generated during perimenopause (hormonal changes leading up to menopause) and postmenopause (after menopause has occurred). There are several factors that can effect hormone levels during the various stages of menopause.
FACTORS AFFECTING HORMONE LEVELS DURING MENOPAUSE
Obesity - This is defined as being at lease 20% over your ideal weight. This can be a major determinant of estrogen levels in postmenopausal women. The estrogen levels of obese women are 40% higher than those of non-obese women.
Physical Activity - Physically active women have higher levels of estrone (a form of estrogen). Those with more muscle mass have higher estrogen levels. This is probably connected to the large amount of an enzyme called aromatase found in muscle which accounts for the conversion of 25% to 30% of a woman’s androgens to estrogen.
Adrenal Gland - The adrenal gland produces a larger amount of androgens after menopause. These androgens can be converted into estrone through fat and muscle.
Other Organs - Other organs contributing to the conversion of androgens to estrogens include the brain (pituitary), skin, hair and bone marrow.
As you can see, the female endocrine system is very complicated yet adaptable. The ovaries don’t just dry up and stop working. They adjust to the different stages of a woman’s life just as other organs in her body makes various hormonal adjustments over a period of years to accommodate the changing needs of the aging female.
Up to this point, the menopause I’ve referred to has been part of the natural aging process. There are other forms of menopause resulting from direct, and often abrupt, human intervention.
MENOPAUSE THROUGH HUMAN INTERVENTION
Surgical Menopause - This involves the removal of both ovaries called a bilateral oopherectomy. This may be done independently or in conjunction with a hysterectomy (the surgical removal of the uterus). An oopherectomy will result in a immediate menopause. Although you lose most of your hormones after this procedure, various organs in the body supplement hormonal needs as previously mentioned. The adrenal gland produces some hormonal compensation which is adequate for some women but not for most. Many women require some form of hormone supplementation to compensate for sudden depletion. Data indicates that women who have had an oopherectomy are at greater risk for heart disease and osteoporosis even with hormone therapy.
Medical Menopause - Often women who have been given chemotherapy as a cancer treatment go into temporary or sometimes permanent menopause. Radiation for colon cancer can also induce menopause.
Drug treatments such as Lupron and Synarel (hormonal treatments) can put a woman into temporary menopause. These drugs are usually given to treat endometriosis or to shrink uterine fibroid tumors before surgical removal.
Environmental Toxins and Menopause - This subject is very close to my heart. I’ve been researching the effects of environmental toxins on the female endocrine system for the past 12 years. There are 3 major things I have learned.
1 - Environmental toxins are causing major hormonal disruptions in women’s reproductive and other endocrine functions.
2 - If we don’t clean up the environment and find more natural forms of hormonal nourishment for women, we will continue to see an increase in diseases associated with menopause and experience the menopausal process more and more as a disease process than as a natural passage in a woman’s life.
3 - Commercial industries and government agencies are both directly and indirectly responsible for man-made pollutants that permeate our environment with toxic and endocrine disrupting results. It is only when these institutions are made accountable for their actions that we will see any constructive research and regulations put into place. It is my opinion that this kind of reform will only take place when a massive grassroots movement, with women at the helm, forces a turn of the tides.
Smoking - This is one specific environmental toxin that can induce early menopause. Women who smoke have double the risk of early menopause.
There are many environmental stresses imposed on a woman throughout her life that can have a serious impact on the menopausal process. Sugar, fat and variety of chemical exposures contributes to a number of diseases and exacerbates many of the negative effects of menopause.
Baby-Boomers, who are the largest demographic group experiencing menopause at this time, were the first generation to be exposed to a sea of carcinogenic chemicals and radiation in utero (in the uterus). I’m talking about chemicals like DDT, a carcinogen that was not manufactured in large quantities until W.W.II. Radiation from nuclear fallout was unheard of before the war. Creating the atom bomb literally created new forms of radiation poisoning that never previously existed on earth.
Of the 85,000 commercial chemicals used in the United States, most have not been tested for basic human safety. Many of those chemicals that have been tested and have proven to be carcinogenic and/or endocrine disrupting are still allowed to be manufactured and legally sold in this country. These chemicals can be found in pesticides, cleaning products, cosmetics, food additives, drugs and most plastic containers used everyday to store and prepare food. This includes plastic baby bottles and plastic containers frequently microwaved.
NEVER microwave in any plastic containers - Many plastics contain chemicals called xenoestrogens (xeno = foreign or alien). When you heat food in plastic, chemicals can leach into your food and introduce synthetic estrogens that bind to your natural estrogens and can cause hormonal disruption. This can interfere with the menopausal process and can lead to cancer, thyroid disease, uterine disease and an array of autoimmune diseases.
SIGNS & SYMPTOMS OF MENOPAUSE
At this point I would like to address the various signs and symptoms of menopause. I would also like to mention that many of the unpleasant symptoms of menopause experienced by American women are not universal to all women. Severe symptoms by women in other countries are less frequent. Sometimes they experience a different set of symptoms or sometimes experience no noticeable symptoms at all. In Japan, for instance, women so rarely experience hot flashes that there is no specific term in the Japanese language for "hot flash".
* Menstrual Irregularity
* Hot Flashes or Flushes (sometimes followed by cold chills)
* Dizziness, Rapid Irregular Heartbeat
* Hypoglycemic Symptoms: suddenly feeling weak or shaky, breaking out in a cold sweat
* Atrophic Vaginitis: thinning and drying of vaginal canal lining due to lack of estrogen
* Indigestion, gas pains, flatulence, diarrhea, constipation
* Bladder & Urinary Infections
* Breast Tenderness
* Cold Hands & Feet
* Joint Pain
* Mood Changes
* Pronounced Tension & Anxiety
* Sleeping Difficulty
* Forgetfulness, Inability to Concentrate
* Depression or Melancholy & Fatigue
These are some of the most common symptoms experienced by many menopausal women but are certainly not the only symptoms. The variety of symptoms experienced are as different as the women who experience them.
The problems occurring in the various stages of a woman’s life can often be attributed to societal bias and human interference with the natural process. We humans have not yet learned that we are not the masters of the universe and that Mother Nature, who has been hard at work for millions of years, may actually know what she’s doing.
My own gynecologist recently told me that life after menopause was the result of the miracles of modern medicine allowing us to live longer than human beings were ever designed to live. Without missing a beat, I told her I didn’t believe that for a second. The human heart alone was designed to keep beating for at least 80 years. Many past societies dating back hundreds and even thousands of years spoke of elders who lived into their 90’s and even longer.
Part of the modern day misconception of menopause is the misinterpretation of the term "average life expectancy". This does not refer to the age at which people usually die. Average life expectancy is determined by adding together all ages of death and then dividing that figure by population. If you have a society with a high infant mortality rate, famines, wars and plagues, then the average life expectancy is going to be low. But, for those who survive past the age of 5 and all other life threatening environmental conditions, they often live into healthy old-age.
It appears menopause is part of nature’s life cycle for women and has been for a long time. Some historians have found references to menopause as far back as the biblical era. There is much evidence that women routinely lived past fertility and many years after that.
As long as society and medicine see menopause as the end of a women’s "productive" life and treat it as a disease, we will never fully understand the menopause process even if the answer is staring us in the face. Women will forever be trapped in a world between myth and medicine where we are the unwitting participants of a system that mutilates and poisons us "for our own good".
STEP-UP THE COMMUNICATION
It is important for women to step-up the communication lines between each other concerning menopause. I believe it is even more important to share our stories with each other than it is for us to share them with healthcare professionals because we need to do one before we can do the other. Women must reclaim the lost tradition of healing through oral history. We know our bodies and we innately want to share our stories with each other. We need to establish more formal ways of doing so. Once we have found the knowledge and confidence within ourselves and between each other, we will find more effective ways of communicating and asserting our needs to healthcare professionals and begin to make the much needed changes in the approach to studying the female endocrine system. Perhaps we can begin by revising our terminology when referring to menopause. We can replace the phrase "treat the disease" with "nurture the woman".
If you have any comments or experiences that you would like to relate to us regarding this subject, please contact Marleen at MQhealthpge@aol.com
REFERENCES AND RESOURCES
In The Blood: The Myths, Magic and Mystery of Moonflow, Spiraldancer www.menstruation.com.au/periodpages/moonflow.html
Awakening to the Goddess, Marguerite Rigoglioso www.aislingmagazine.com/aislingmagazine/articles/TAM25/Awakening.html
Dr. Susan Love’s Hormone Book, Susan M. Love, M.D., with Karen Lindsey
Natural Health Care Clinic http://home.xtra.co.NZ/hosts/arodsnathealth/woman1.html
Menopause, Natural Medicine Instructions for Patients www.harcourt-International.com/e-books/viewbook.cfm?ID=363
Women’s Health Initiative www.nhlbi.nih.gov/whi/
Seeking A Cure for Menopause www.geocities.com/menobeyond/cure.html
DR.EDDY'S CLINIC & AYURVEDA SCHOOL - Integrated Medical Clinic & Ayurveda School is a unique healthcare facility, combining the strengths and knowledge of both traditional western and alternative medicine in a holistic manner.
Marleen M. Quint
Originally from Hawaii, Marleen was also raised in Japan and Guam. Her background is extremely eclectic and ranges from working in the field of cartography to performing as a singer, dancer and actress.
In 1990, Marleen was diagnosed with thyroid disease followed by breast cancer less than two years later. She lost both breasts and her thyroid with no family history that would predispose her to either disease. After much research, Marleen is convinced that environmental pollution played a significant role in the development of her life-threatening diseases.
Since 1995, Marleen has dedicated herself as a women's health advocate. She has served as a consultant for several health organizations including the National Cancer Institute in Washington, DC and UCSF Mt. Zion Cancer Center in San Francisco.
Marleen has combined her skills to develop a women's health presentation which delves into the connections between the politics of gender bias and the level of morbidity suffered by women. Marleen is an active speaker in the San Francisco Bay Area.