Tiffany Jackson is a physician with Baylor Scott & White Gynecology Specialists. Don’t ask her to deliver your baby—her practice is exclusively in gynecology. As a woman in the throes of the “change of life,” I asked the expert to share her insights and survival tips.
I tell people that the day you think you’ve lost your mind is the day you know you’ve started menopause. Is there a way to actually test for it? With regard to losing your mind, you’re probably referring to some of the mood changes that might occur with the transition. As the ovaries are starting to slow down and produce less hormone, women can experience more mood irritability, being a little bit more on edge or being easily irritated, if you will. Or even being a little more emotional—crying at commercials, that type of thing. But having said that, that’s not every woman’s experience.
Menopause, clinically, is when you have gone one full year without your period. So, in women who have had a hysterectomy, that may be a little more difficult to discern because you don’t get your period anymore. But generally, the average age is 51. Some women are younger than that; some women are older than that. Genetics definitely play a role. So you’ll start roughly around the age that your mother started menopause.
In terms of having the symptoms of menopause, the average duration is about seven years. But certainly women can start to have symptoms in their early 40s.
One of the scarier symptoms I experienced was memory loss. I would find myself sitting across from my best friend and I wouldn’t be able to come up with her name. Many women describe a brain fog—not being as nimble, perhaps, in terms of remembering things or multitasking. It’s what we call menopause brain.
For the most part, I have been white-knuckling my way through the change, but I know women who swear by pellets and hormone treatments. Do you recommend them? We could talk about this for a long time. To be brief, there’s a lot of controversy regarding hormone therapy. Essentially that’s because of what we’ve learned about hormone therapies in more recent years. Previously, a generation or two ago, we pretty much always put women on hormones. A woman had a hysterectomy, we put her on hormones. We thought that they were good for her heart and protected her bones. So every woman got put on some estrogen and progesterone.
But the Women’s Health Initiative was a pivotal study that came out around 2005 in which we looked at women who were using hormones. We saw that there was an increased risk with prolonged hormone therapies of breast cancer, blood clots, and stroke. Subsequent to that, we changed the way we looked at hormone therapy. So, in terms of using hormones, we generally recommend them for people having significant vasomotor symptoms, like severe hot flashes, because hormone therapy can be most helpful for that.
You can get hormone therapies in different ways. You can get pellets; you can use patches. There are creams; there are pills. But, at the end of the day, the risks exist regardless of the manner in which you receive the hormones. Unfortunately, sometimes the marketing of pellet therapies has described them as being safer, which is not necessarily accurate, since you can still suffer the consequences of traditional hormone therapy.
Are there things women can do on their own to ameliorate symptoms? Hot flashes are particularly bothersome, but there are things we take in every day that people may not even recognize that will make you sweat more. Caffeine, chocolate, alcohol, spicy food—all of those will make you flash. If you get anxious or stressed, you’re going to potentially have a hot flash. So trying to avoid those triggers can be really helpful.
Any final words of advice? I would just say not to be afraid of menopause. Definitely there are body changes that are going to happen, but I think this is another great phase of life and a stage at which women tend to be a little bit more confident in themselves, and they have an opportunity to explore things that they haven’t had a chance to do otherwise. So embrace the transition and look forward to it.