Navigating the complex journey of menopause doesn't have to be a solo expedition. As your guide and host, Maureen McGrath, a nurse continence advisor and sexual health educator, I'm here to walk you through the twists and turns of perimenopause, menopause, and postmenopause with the wisdom and warmth only an experienced healthcare professional can offer. This discussion isn't just about the what, but the how—how to communicate your experiences to doctors who may not fully grasp the nuances of these transitions and how to sift through the noise of unqualified advice that's all too common in today's digital age.
Join me as we traverse the landscape of menopause management, from the importance of bone health and essential nutrients to navigating the often delicate concerns surrounding sexual well-being. You'll learn why your gym sessions might just be the unsung heroes of menopause relief and how to find specialized care through trustworthy organizations. With the right knowledge and support, the path to managing menopause with confidence and grace is clear. Remember, menopause marks a natural and inevitable chapter in a woman's life, and with our conversation today, you'll be equipped to embrace it head-on.
Navigating the complex journey of menopause doesn't have to be a solo expedition. As your guide and host, Maureen McGrath, a nurse continence advisor and sexual health educator, I'm here to walk you through the twists and turns of perimenopause, menopause, and postmenopause with the wisdom and warmth only an experienced healthcare professional can offer. This discussion isn't just about the what, but the how—how to communicate your experiences to doctors who may not fully grasp the nuances of these transitions and how to sift through the noise of unqualified advice that's all too common in today's digital age.
Join me as we traverse the landscape of menopause management, from the importance of bone health and essential nutrients to navigating the often delicate concerns surrounding sexual well-being. You'll learn why your gym sessions might just be the unsung heroes of menopause relief and how to find specialized care through trustworthy organizations. With the right knowledge and support, the path to managing menopause with confidence and grace is clear. Remember, menopause marks a natural and inevitable chapter in a woman's life, and with our conversation today, you'll be equipped to embrace it head-on.
Speaker 1:
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This podcast is brought to you by Life360 Innovations, creators of the Contino urethral insert, a non-surgical, health Canada licensed medical device for men with stress urinary incontinence. Contino is easy to use and blocks the flow of urine without the need for adult diapers or pads. More than just a medical device, the Contino Care Program connects you with experienced medical professionals and creates a personalized treatment plan that provides ongoing support so you can get back to life. Go to MyContinocom to see if Contino is right for you and book your free continence assessment. Get bladder leakage control with Contino and get back to living. Remember, go to mycontinocom. That's M-Y-C-O-N-T-I-N-Ocom. Good evening and thank you so much for tuning in. It's so great to be with you, as always.
Speaker 1:
I'm Maureen McGrath. I'm a registered nurse. I'm a nurse continence advisor, sexual health educator, I have a particular interest in women's health. I have a clinical practice, both in person and online, where I talk to women, educate women and treat women who are experiencing issues, and lots of those issues happen at mid life and, you know, women don't have the language sometimes and they're nervous about talking about perimenopause or menopause, in particular, talking about perimenopause, menopause and postmenopause. They don't even know to call it that at midlife, but they're very, you know, nervous about talking to their doctors about it. In part, menopause is often treated as a taboo subject, but it really shouldn't be. They are normal parts of the life cycle for those people who have been assigned female at birth. And if we look at menopause, it's pretty much defined as the absence of menstrual cycles for 12 or more months, and perimenopause are the years leading up to the menopause, and that's oftentimes when women begin to get symptoms and they think I'm too young. I'm too young for menopause, but it's actually perimenopause that we need to raise awareness about.
Speaker 1:
It's important that you talk to your doctor about menopause and I see a lot of you know posts on social media that women are being dismissed by their doctors. There's social media influencers, marketers who just want to sell you products. They don't have any experience treating patients actually in person or even online, even though they might claim that they do, but they can't because they're social media influencers and marketers and they don't have medical training. And and healthcare is a regulated industry, and so really the only way to treat patients is to be a registered nurse, a nurse, contents advisor, a pelvic floor physiotherapist, a pharmacist can provide education, evidence-based education, and the physician, nurse practitioner, physician's assistant. So those are the roles, but anyone that is a coach or a counselor or a personal trainer, you know you really should not be taking any medical advice from them. You should speak to your doctor. But I hear a lot from them that you know. They say that women are being dismissed.
Speaker 1:
I often think, oh my gosh, if they only knew that doctors are actually in their offices, not online, treating patients because they don't have time. And so you know. You know that it's people are drumming up business, and something that I'm concerned about lately is a lot of doctors are going online and they are being. You know, they're pushing, they are prescribing, they are selling hormones, supplements and other devices and products that you know for you to make your life that much better and and you know what it's really for the elite and and that's really the problem that I have with it is because only the elite can afford it, which, um, you know, is kind of upsetting. What I'm trying to do with this podcast is to provide the information to everybody, um, so that at least you're a little bit more informed, and to help you to live the best life possible. You know, when you speak with your doctor, you can, you know, it can help you to learn what to expect.
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The other thing I want to say is, yes, I recognize that doctors only get about eight hours of menopause training in their medical school, and you know, and I've talked to doctors about that and where they really don't feel informed. But they're very willing to learn and attend presentations and attend conferences to learn more, because this is a big issue for women today, especially since we had the Women's Health Initiative and where pretty much the kibosh was put on hormone therapy and the fear of cancer, breast cancer, cardiovascular disease, dementia. All of that was associated with a study that was pretty much flawed, but it did have some information in it and I think we have to tread carefully in these hormonal waters. But anyway, it's important to have a good rapport with your doctor because they know your health history and they know your background in terms of and then they will know what your risks are, especially in terms of treating perimenopausal symptoms or menopausal symptoms or postmenopausal symptoms, and when's the best time to talk to your doctor about perimenopause menopause it's early and frequently have multiple conversations. This isn't the kind of thing that's going to be resolved in one visit, and it's important to get educated even much earlier than perimenopause, much earlier than when those symptoms may appear. For you, it's important to know what might come, especially as you hit the 40s, and so really in your 40s, you should start having that conversation with your doctor. If you're a doctor, you should start asking the female patients in your practice if they're experiencing any symptoms of perimenopause, and I reviewed a lot of the symptoms in a previous episode, so may I suggest you go back and look at that.
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The average age of menopause in the United States is 51 years of age, but some people go through natural menopause at an earlier or a later age, and it's not a bad idea to talk to your mother and sisters about it. I know that moms and sisters don't really talk about this. There's some sort of embarrassment, shame, stigma associated with perimenopause. But if a patient has a family history of premature female menopause, we want to keep careful track of that and if they go through early menopause, hormone therapy is often prescribed. When the ovaries stop functioning as they should before 40, this is known as premature ovarian failure and I don't really like that term failure. No woman likes the term failure to be associated with them, but this does. This is uncommon, but it does require additional testing and we do treat that with hormone therapy until the average age of menopause.
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There's other treatments and things that can occur that can cause early and sudden menopause, like surgical menopause, for example, after a hysterectomy. Chemotherapy can cause it. Radiation therapy on your ovaries or reproductive organs can cause sudden menopause. Surgical menopause is permanent, but chemotherapy or radiation-induced menopause can sometimes be temporary. It's a good idea to have a conversation about this with your doctor, but if you think you're experiencing any perimenopausal symptoms, let your doctor know because they can do a physical assessment. They can do the proper lab tests and I'm not suggesting hormone tests or saliva tests or any of that bunk for perimenopausal symptoms, because your hormones are fluctuating in your forties and you're not going to get an accurate reading. It can be high one day, two hours later even, or the next day it can be really low and plummet.
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So when patients start skipping periods and they start having symptoms of perimenopause, they may also be losing bone at that time. So bone density tests are very important and it's important to start taking calcium and vitamin D and start weight bearing. Weight bearing exercise is so important and that helps you to limit your bone loss and you know weight bearing exercise, you know, is extremely, extremely important, and you know lifting weights is very important as well in terms of those weight bearing exercise. So iron in the form of iron from the gym, okay.
Speaker 1:
So oftentimes, changes to your menstrual period are the first sign of menopause, but it can also be from fibroid, for example. So we have to do a differential diagnosis. But you may have excessive bleeding, for example, or they may be a little bit further apart, or you may not get one for six months, something like that. So it's something to watch out for and it's something to think about. Well, this may be the start of perimenopause and I've gone through the symptoms, so I'd really love you to go back and review that so I don't have to repeat that. But some of these symptoms that you can have, like reduced libido and vaginal dryness, hot flashes, night sweats, that kind of thing, headaches, anxiety those can occur in your 40s. But keep in mind that these can also be symptoms of other diseases as well.
Speaker 1:
It's not always perimenopause, or maybe it is, it could be, but that's why it's important that you have that conversation, you get the proper lab tests done to rule out some other issues that you may be having as well or other medical conditions, and you know what? There's always a fix for the symptoms that you are experiencing. Do not suffer in silence and you know, living a very healthy lifestyle, you know, cannot be overstated either. So, good nutrition, low glycemic index, cut out the alcohol, exercise, lift weights. You know there are some certain questions that you might want to talk to your doctor about when you go and see them, about perimenopause and menopause. And if you're going in there early, you know, prior to any of them, starting to say what are the kinds of symptoms that I should be looking out for? What might I develop in perimenopause? Or you know I'm having these particular symptoms. Write them down because you know brain fog and memory lapses. They're a symptom of perimenopause and menopause and post-menopause, but they're also a symptom of other conditions as well. But you know, could these symptoms be caused by perimenopause or menopause or another condition? Do I need to receive any tests to check for potential causes? And what do those tests involve? And you know, are they accurate? Is there controversy around them? Is there a cost to them? Will you be making any money if I take those tests? Because that is a conflict of interest. You know we shouldn't be fearing doctors these days and I really take issue with doctors who are pushing and prescribing the same thing I really do. I think it's a conflict of interest, I think it erodes the trust in the doctor-patient relationship and I think it demeans the profession as well.
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Speaker 1:
You know you may want to ask what are the conservative lifestyle changes that I can make to manage my symptoms? Are there medications or other treatments available to manage my treatments? And you know what are the benefits, what are the risks and what are the potential side effects or adverse events and what are the costs of each treatment approach. And you know, do you prefer a conservative approach first to a more invasive approach as time goes on and oftentimes doctors do. Can you get more information on this? If your doctor doesn't know the answer to something, can you ask them? Can we follow up on this? Could you find out you know some more information on this what happens if I do a treatment and I get a side effect? What should I do then? You know? Another great question to ask is about your bone health. Should I undergo bone density screening? And you know when and how often Should I get my calcium and vitamin D levels checked? Yes, how can I make sure that I'm getting enough calcium and vitamin D?
Speaker 1:
Another important vitamin to take is vitamin B12, especially as women age. It's neuroprotective and oftentimes women can be tired as well when their vitamin B12, especially as women age. It's neuroprotective and oftentimes women can be tired as well when their vitamin B12 levels are low. Or when their B12 levels are low, I should say, and how long should I take a treatment is really important, especially when it involves genitourinary syndrome of menopause or GSM, which is the vaginal dryness, painful sex, low sexual desire. Gsm, which is the vaginal dryness, painful sex, low sexual desire, recurrent urinary tract infections and urgency or leakage of urine. Because women don't realize that is lifelong therapy, ladies, and oftentimes I find doctors forget to say that to patients. Oftentimes patients think, well, I'll just take it until the symptoms are resolved, but what happens is they get significant rebound and it will come back, and it will come back with a vengeance.
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Always important to ask about side effects, as I mentioned, and you know what types of activities count as weight-bearing exercise. Should I see a bone specialist? Are there other steps I can take to manage my menopause and stay healthy as I get older? How about nutrition? What do you recommend for nutrition, you know?
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Another question is if you're having a particular symptom you know to say could this symptom be associated with perimenopause? Remember, menopause symptoms are common and they are treatable, whether it's conservative measures all the way to hormone therapy. But you have to assess your risk and only your doctor is able to do that for you. What if you don't have a doctor. Well, or if your doctor, you don't feel comfortable with them, or they don't feel like they have enough knowledge about perimenopause or menopause, well, look for a doctor that you feel comfortable with. You know, because you're going to feel more comfortable talking about menopause with certain doctors than other ones and you know you may find it easier to talk to a doctor that you know.
Speaker 1:
Well, I had a patient in my office the other day and I was talking to her about she actually had a yeast infection, but you know we wondered she was 57, if she was having GSM. You know, when you over-treat with estrogen in the vagina you are at risk for yeast infections, but anyway. So we talked about that. But we also talked about, you know, low sexual desire and you know her husband seemed there was a desire discrepancy very common in couples. And so she said you know, I didn't really want to talk to my doctor about this because our kids are at the same school and so I'm so glad to be able to talk to you about it. And so you know you may know somebody you know, cause you see them on the golf course and you don't want to talk to them, or they might see your husband on the golf course. Not to be sexist, I was talking about I might run into you on the golf course. I play golf, do you? Anyway, you know you may want to look up a NAMS national, the North American Menopause Society doctor people who are trained in menopause, doctors who are trained in menopause, or the American College of Obstetricians and Gynecologists as well. Obstetricians and gynecologists also have training in perimenopause, menopause and postmenopausal care. You might have heard differently on social media. They seem to limit it to the people that they refer patients to. But it's not just urogynes who can deal with menopause. It is actually obstetricians and gynecologists can as well.
Speaker 1:
Important to make a list of your concerns, which I mentioned. Be prepared before you go to that doctor. Doctors don't have a lot of time and that's one of the issues, so write down and check off each point that you want to bring up, whether it's about the symptoms or the treatment or side effects that you might be having. Do your research beforehand. Do your research about perimenopause and menopause. You know. If you feel more comfortable with a family friend or a family member or your partner by your side, ask them to accompany you. They may be able to take notes for you. I find that's a very important aspect because a lot of information can be given in 10 or 15 minutes.
Speaker 1:
You know, if you want to find a healthcare professional with menopause expertise, ask around. Do you have any friends? Attend conferences, get a referral, as I mentioned. Search that NAMS database North American Menopause Society. Look for a menopause clinic. Keep in mind some of the private ones promote their own stuff. I saw one that was promoting hormonal spray. They kind of made it up, I guess, and put it in a spray bottle and it's sprayed into your nares. But the most important thing about menopause it in a spray bottle and it's, you know, sprayed into your nares. But you know the most important thing about menopause, it's a normal part of the life cycle. It can affect your body in a variety of ways.
Speaker 1:
Important to speak to your doctor about menopause. Know that you two may be learning together on this journey, but doctors are brilliant. They're some of the most highly educated and intelligent people in society. They understand the lingo and they also understand they have critical thinking skills on steroids and so they can actually quickly be brought up to speed about this. And you know they are the best people to help you to stay healthy as you age and definitely let your doctor know if you develop changes in your menstrual cycles or if you're having any other symptoms of perimenopause or menopause. You're not too young for perimenopause at age 42. We have to get that out there. Menopause is not associated with older women. It's actually associated with midlife women, women in their 40s, women in their 50s, often at the peak of their careers and in the prime of their lives, but extremely busy as well. So important that you find a healthcare professional who's not only qualified to treat menopause related issues but also very easy to talk to and you know what. They should listen to your concerns and encourage you to ask questions. And you know what.
Speaker 1:
I have patients who have said they've gone, spoken to their doctor. They've been speaking to their doctor about perimenopause for eight, 10 years. You know and you know sometimes their, you know their journeys change and so that's why it's so important to have that conversation and get the evidence-based information. You know it's so dangerous today on social media. There's so much information out there. People are claiming that they can online virtually treat your rectocele, they can treat your neurogenic bladder, they can treat your prolapses, they can reverse your prolapses during the midlife years as well, women lose elasticity because of the decreased estrogen receptors in the urogenital tract, and so their bladder may fall down or they may get erectocele from increased. You know strain on the pelvic floor and constipation is a contributing factor. Genetics are a contributing factor.
Speaker 1:
You know you really need to see a doctor about these significant healthcare conditions and so you know I'm always skeptical when I see somebody who can, can always treat your condition. If you just pay and join up for their membership, they can treat it Well. You know we, we really have to be, you have to be very careful. And you know I speak to patients in my office about this all the time and you know what. Women are so smart they're not falling for it. Even you know, though I'm worried about it, they're not falling for it. You know they've seen the conflict of interest of doctors who are pushing and advertising and marketing and prescribing what they are pushing, and you know it's. But women are like, no, I've got the evidence base, I am skeptical. You know about that and I don't think that's right. And you know that particular doctor they might say is, you know, feels everybody should be on hormone therapy. It's important that you assess your risk.
Speaker 1:
There's a number of treatments for perimenopausal symptoms and menopausal symptoms, and you know, and we're coming up with more, and there's some new non-hormonal treatments coming down the pike. I saw recently one being approved soon by the FDA in the US, and so those are some of the things. So many women are afraid to take hormones. I have a patient who said I got hormone therapy in my fifties and I'm now dealing with a recurrence of breast cancer and I would never recommend hormone therapy, combined hormone therapy, to any woman. You know it's. People have their own personal experiences and yet other people never want to come off hormone therapy for the rest of their lives. It has changed their lives, in fact, and so you know. But it's important because every woman's journey is different and every woman's treatment, therefore, will be different. We are not carbon copies of each other. We are not cookie cuttered out there. We are not the same. We are individual and that is what makes us beautiful.
Speaker 1:
I am Maureen McGrath and this is my health podcast. Thanks so much for tuning in. I'm Maureen McGrath and you have been listening to the Sunday Night Health Show podcast. If you want to hear this podcast or any other segment again, feel free to go to iTunes, spotify or Google Play or wherever you listen to your favorite podcasts. You can always email me. You can always email me nursetalk at hotmailcom or text the show 604-765-9287. That's 604-765-9287. Or head on over to my website for more information. Maureenmcgrathcom, it's been my pleasure to spend this time with you.
Speaker 1:
This podcast is brought to you by Life360 Innovations, creators of the Contino urethral insert, a non-surgical, health Canada licensed medical device for men with stress urinary incontinence. Contino is easy to use and blocks the flow of urine without the need for adult diapers or pads. More than just a medical device, the Contino care Program connects you with experienced medical professionals and creates a personalized treatment plan that provides ongoing support so you can get back to life. Go to MyContinocom to see if Contino is right for you and book your free continence assessment. Get bladder leakage control with Contino and get back to living. Remember, go to mycontinocom. That's M-Y-C-O-N-T-I-N-O dot com.
