Chapter 1: What is menopause and how is it defined?
Hello, everybody. Welcome to winter. And our next show today is on menopause and all the information around it. And there is a lot. And hopefully it'll be educational for all of you. We've got a wonderful guest with us. Dr. Robin Austin, who I'll introduce in just a second. So stay with us. We've got a great crew that helps us do all our great shows.
And I like to introduce them and make sure that they're recognized because not everybody listens to every show. So if you listen to just this one, you'll know that we have a great, great crew in the background that helps us. Maddie Levine-Wolf, Aaron Collins, Deandra Howard, Matthew Campbell, Sheridan Nygaard, are next to none.
They've been with us since day one, doing our background research, production, marketing, transcribing the shows, everything. They're a super, super group of colleagues. And so thank you to them a lot, a lot. Dr. Barry Baines is with us, our medical advisor, who gives us the medical twist. Clarence and I provide kind of the public health twist
to these shows and we thought that, wow, it's good to have a medical advisor on some of these shows as well. So we can talk medical ease and public health ease as we do these shows.
Chapter 2: What are the stages of menopause and their significance?
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And our website is HealthChatterPodcast.com where you can see all the different shows, all the research that we have for the shows, etc. So thank you again to everybody. All right, so Dr. Robin Austin is with us today to talk about everything around menopause. Associate Professor at the University of Minnesota School of Nursing and Director of the Center for Nursing Informatics.
She's a research mentee with the Menopause Society and a fellow of both the Academy of Nursing and American Medical Informatics Society. Her research integrates data science methods to address whole person needs with a focus on chronic pain, which is also another topic that we should maybe talk about at some point or another, and menopause in midlife women. So thank you.
It's really special to have you on this show. This is a good topic. And there are certainly variables that I believe, and you can probably talk to this, that affect women in menopause, maybe more today than yesterday. Okay, so, all right. So let's start out with a simple question. What is menopause?
Yeah, thank you so much for having me.
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Chapter 3: How does stress impact menopause symptoms?
I really appreciate it. It's an honor to be here. So, menopause is, you can think of it, it's actually when you think of, I think of it more of the trajectory. So, menopause transition. And so, perimetopause, what they're talking about, can really start in your 40s. I think a lot of women, myself, was not aware that this could happen. Perimetopause can last 7 to 10 years. Menopause itself...
is when you've had no period or no menses for at least 12 months. And so that's kind of diagnosed or quote unquote diagnosed retrospectively after you've not had a period for 12 months. And so I think there's a continuum of where you might fall in that space. So I think of perimetopause, And it can start earlier.
I've talked to women just since I've started some of this work that they were like, I just had a baby. How could I possibly be in perimetopause? And we'll talk about that potentially as well. But I think it's this long trajectory and everybody is very different. That's the one thing I think about menopause is that it's not a one size fits all.
What I may be experiencing is completely different from somebody else that is experiencing something. So keeping the, all of those variables in mind, it's a trajectory.
Chapter 4: What are the common symptoms associated with menopause?
And I think that we're starting to really understand and kind of get our arms around how do women approach this? How do we educate women? How do we fill a void that's been for a while, I think, longstanding around menopause? And how much it really affects our day-to-day life that we really haven't been so aware of? We know it's there, but we haven't necessarily had a voice to talk about it.
So menopause is that 12-month window where we just don't have a period anymore. And then you're considered post-metapause right after that. But the perimetapause part is what we're really trying to talk about. And I also want to point out that women, because we're living longer, is that women live in post-metapause for about a third of their life.
And I think that really wasn't necessarily brought to the forefront so much when we're talking about this whole entire menopause journey, that women do live in post-metapause for a large portion of their life. And so I think that's another piece that has implications for chronic disease and some other conditions and healthy longevity. So I'll stop there.
Yeah. So, you know, first of all, let me ask you what's magical. I think you kind of alluded to this, but what's magical about 12 months. Okay. In other words, okay, yes, you're in menopause if you haven't had a period for 12 months. What about 10 months? What about 15 months? Is that just a guideline?
That's my understanding is that it's just a guideline. It's really to understand that your ovaries are no longer producing. You're no longer having a period. But the tricky part is that some people can still have potential spotting. And so I guess it's really... what is happening for that woman's specific body.
And I think it can also be influenced by if you are on birth control or you are on an IUD, for example, you might not be getting a period, but how do you know you're going into menopause? And so there's lots of other factors than just that one
it's one kind of time point, but there's other things associated with it that your healthcare provider can really help you to walk through to really understand if you are in menopause, if you're still on menopause transition, or if you're now considered potentially post-menopause. It's just a, it's a timeframe and it's a guideline and it doesn't mean it's an absolute for sure.
And again, everybody is very, very different.
Yeah. You know, it seems that, and I've kind of alluded to this before the show started, There's a lot of stress in our society, frankly, worldwide now. So the question I have around this is, does stress have an effect on menopause or women going into menopause?
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Chapter 5: What treatment options are available for menopause symptoms?
Maybe you're going into transition earlier because it's of stress and or other environmental factors. So absolutely, I think that we know that stress is a huge factor. We know it's present at all times. And I would say that there's other factors that women deal with potentially looking at stress. some trauma potentially in their lives.
There was a study that was done by a colleague at the VA that looked at military women and sexual trauma. They had more pronounced menopause signs and symptoms, but also potentially earlier signs and symptoms than other women that did not have that potential trauma.
So I think there's lots of, of areas to further research and hopefully be able to guide women that have experienced more trauma or, or stressors in their lives to be on the lookout for. And I think it's just, it's precursors to understanding what might be coming for those individuals.
Yeah. Yeah. Well, Clarence is here.
Hi, Clarence. I'm raising my hand. Go ahead. Go ahead, Gary. Yeah. Because I want to just, you know, expand just a little bit. And I think what we'll wind up talking about most is not so much the signs of menopause, which is when
woman ceases to have menses, but it's the symptoms of menopause that seem to be front and foremost from a medical management thing is that a number of the symptoms, in particular these what's called the vasomotor symptoms.
I think most people know them as hot flashes, you know, overall, but they're, I think the other, the other piece that I just want to add to is not only is there this range, you know, Robin, as you pointed out, you know, 40 or earlier. And I can tell you from experience, not, not me, but that that, the symptoms can go beyond 70. It's just such a wide range.
In the same way, the symptoms have a very wide range. And the number of treatments to address some of those symptoms is a very, very long list. And so I think the takeaway for me is this is such an individual situation that needs to be understood. And I'm sort of, as a sidebar, interested to hear about the role that you've been able to play with the informatics piece and its impact on menopause.
So I'll just kind of plant a few stakes in the ground over there for some of our discussion, because I think that will... you know, help because I think there is a big lack of education about, about menopause, its meaning, its importance, its significance, et cetera. So with those, with those few thoughts, I'm going to be quiet again.
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Chapter 6: How can lifestyle changes alleviate menopause symptoms?
What should they know about menopause? I mean, because we just talked about the fact that there's so much uncertainty about it. What should I know?
Yeah, great question as well. Yep. Great question as well. And I think because it is so individualized, but I think it's just, I think a lot of women that I hear or I talk to feel very dismissed at times. And so whether that's from the health system or family members or partners.
And so I think it's just the active listening and being able to recognize that, yes, what you are experiencing is real. It's not in your head. I think it's reaffirming that we can, there are treatable methods now as well, that they're having more conversations about it. And figuring out what is right for you and going in to talk to a healthcare provider.
And if you're not getting answers from one person, it's okay to move to another healthcare provider. I think that that's definitely part of the conversation, but I think it's really just acknowledging that you are going through something. There is a transition. Sometimes it can feel day-to-day, quite honestly. And I think it's just being supportive.
And I think it's being able to say, I'm with you. If you want me to go to your appointment with you, if you want me to just download when you get home, What other resources can we help? It's a team effort. All of it is always a team effort. And so and say, I don't know what I don't know. And so let's figure it out together and we can dive into some of the resources together.
I think that would be the best. I'm thinking from personally as well, like what I what I need as far as support, just to acknowledge that, yes, you are going through something and we can figure it out. And I think it's, it's just, um, and what treatment might work this, this year may not, may need to be adjusted next year potentially. And that's, that's okay as well. So yeah, I hope that answers.
Yeah.
Yep. You know, the question I have, okay. It's like, obviously as you get older, you're, you're assuming other complications. Um, other diseases that you're dealing with, other sicknesses that you're dealing with. So let's talk a little bit about treatment. So like on one hand, you have all these complications that you're dealing with. Then on the other hand, menopause.
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Chapter 7: What role does community support play during menopause?
So how does this all link together as far as a physician helping a patient?
Yeah, I'll just speak from what I've experienced my own self, but then I'm not prescribing by any means. This is not necessarily taken as medical advice, but I think too, your provider can really help to tease out like what might, if you have a chronic condition, such as like a type two diabetes, or you're monitoring that or pre-diabetic, or there's family history of heart disease,
But then also if you're experiencing, like when you talked about the hot flashes, there is the sleep disturbances, whether it's sleep because of stress or it's a hormonal issue. I think it's mood swings. We've had a lot of women that I've talked to around their 40s all of a sudden diagnosed with like ADHD or they're having more anxiety, or they're having more depression.
And that's certainly hormonal potentially, but I think it's well, not necessarily, you don't have to grin and bear it per se and say, oh, this is just, this is what it is. This is my midlife. No, there are treatments available. And I think just having, exploring what those might be. So you don't feel like, I always think of it as you're holding onto the steering wheel so, so tight.
We don't have to do that. We can, there are other things to help us through this transition. So I think it's really trying to tease out what are your signs and symptoms that you're experiencing that might be new or different from what your baseline had been maybe a year ago, six months ago, in conjunction with what are some other components that you're talking about right now?
Maybe it is some other underlying condition and things like that. So I think it's And the other part that I, that's a big in discussion, you can see it in social media all the time is the women experiencing weight gain. Um, and how do we, what are the, the new kind of ways to, um, or can't read it.
It seems like you can't read Instagram without learning about, you need to eat your protein, you need to weight lift, you need to zone two training or whatever it might be. Yes, we all need to exercise. That is not, that has not changed. But I think too, metabolically women do go through a shift through the menopause. I think estrogen has a lot of
impacts that we haven't necessarily fully realized. And so being able to understand that there is a transition, but there is still things you can do about it as well. And so sifting through What you might see on TikTok or Instagram and being able to get sound advice that's going to work for you in conjunction with potential other underlying health conditions that you may have.
And I see there's a lot of Instagram on the quick fixes or the hacks for health, which it's kind of fun to read because it is kind of interesting. But it's also at the same time, you want to make sure you're getting sound advice.
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Chapter 8: How can healthcare providers better support women during menopause?
And we're also learning more specifically. I'm also concerned around bone health because women lose
up to 30 percent if not more through bone density through menopause transition and that's not necessarily talked about enough um only because i think of it as women aren't aren't scanned for a dexa scan quote unquote which is the scan for your body for bone density i don't think insurance covers it till they're 65 which in my opinion is way too late but i know that women and um
Asian populations also have a higher risk of osteoporosis. So why are we not scanning all women much earlier? So you could do something in your 30s and 40s around bone density. And that's where the weightlifting kind of conversation starts to come into play. But estrogen has all factors around bone density. osteoporosis, cardiovascular disease.
You can kind of go down the list, but there certainly are differences. And I think that those differences need to be addressed and talked about a lot more than what they are, just from the standpoint of risk identification and being able to then talk to your provider, like, hey, I might be experiencing more severe signs and symptoms.
And what can I do about it as far as versus just thinking, oh, this is just normal. I can just, you know, whatever, I'll just continue on. And it's not. And I think that there are things that we can do to really help through that transition. There's a really good book, and I had the honor of hearing her speak just recently this past fall as Dr. Sharon Malone.
And she wrote a really good book on menopause and kind of midlife health. And I love her quote. What it was is that menopause is inevitable, but suffering is not.
and so i think i really take that to heart to really say that there are things that we can do and it's just it's going in and having the conversation with a provider that you trust that will listen and that will and again it might not be just one appointment it might be a few um to really figure out what individually is going to work for you so long answer to your to your question but yes there are differences and i think that we need to do more research needs to be done around that specific um component and if i can continue on for just a second with that train of thought
And kind of going back to what Dr. Berry, you talked about is whereas informatics fit in for this. And so for me, a couple of years ago, I was like trying to obviously going through something midlife myself. And I was searching for information to realize that there was very little information out there and very little research.
And being a researcher within the School of Nursing, I have access to, you know, health care databases. And I was searching and I'm thinking, what the heck? Where is the information? Like, this is ridiculous. And I was complaining and kind of griping about it around my house. And my husband finally just said, I think you can do something about that. I was like, oh, yeah.
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