Menopause Symptoms: What You Need to Know BEFORE Choosing Treatment
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[00:00:00] Hello, hello, and welcome to a live episode of the Menopause Made Simple show. Now, have you been spending months, maybe even years, trying to treat menopause symptoms without ever fully understand what's causing them in the first place? And look, could that lack of understanding be one of the reasons that you're still struggling to find relief?
Well, if that sounds like you, well, I want you to know something right now from the very start. First of all, it's not your fault, and secondly, there is a better way forward, and that's exactly what I wanna talk to you about today. Now, last week we talked about Governor Gavin Newsom's decision to veto Assembly Bill 1940, legislation intended to address menopause in the workplace.
And during that conversation, I talked about something that I believe is one of the biggest obstacles to meaningful progress when it comes to menopause, and that's a [00:01:00] lack of foundational menopause education. And I don't mean just for women either, but for healthcare professionals, employers, policymakers, partners, and the general public.
Because here's the thing, we can talk about menopause treatment all day long. We can talk about MHT or HRT, non-hormonal medications, supplements, nutrition, exercise, and every other option that's out there. And trust me, there are plenty of people who are more than happy to tell you what you should be taking, buying, or doing.
But here's my question: How can you make an informed decision about who to listen to or what to do if you don't fully understand what's happening in the first place, right? And that's what I'm talking about when I say education before intervention. Now, I wanna be very clear about something. That does not mean that you have to become an expert in menopause before seeking treatment, [00:02:00] and it certainly doesn't mean delaying medical care when you need it.
It simply means that education should be part of the process first, and not an afterthought. You deserve to understand what's happening, why you might be experiencing certain symptoms, what else could be contributing to those symptoms, and what your options actually are You deserve to feel heard. You deserve to feel like yourself again as well.
Because look, menopause is not just about hot flashes and night sweats. It's a whole life transition. So I'm talking about why understanding your symptoms matter, how different symptoms and health factors can overlap, why there's no single solution for everyone, and what education before intervention actually looks like.
And towards the end of today's show, I am also gonna be sharing something that I've been working on as part of my executive education program through Harvard Medical School, and, [00:03:00] you know, and, and how it's helping me to further develop the Menopause Made Simple education platform that I've created. So if you're over 40 and anywhere in your menopause journey, stick around because this is a conversation that you definitely need to hear.
I'm Tafiq Akhir, Mr. Menopause here, and welcome to another episode of the Menopause Made Simple show. Now, let's start with something that I think is really important, because there's a big difference between knowing that you're experiencing symptoms and then actually understanding those symptoms, right?
And I think that this is where a lot of confusion surrounding menopause actually begins. For example, let's say you're 47 years old. You've always been a pretty good sleeper, but lately you're waking up at 2:00 or 3:00 in the morning, and for the life of you, you cannot go back to sleep, right? And it's happening several nights a week.
Now, [00:04:00] you're exhausted during the day. You're actually having trouble concentrating as well. You're forgetting things. You're, you're irritable, uh, that, that's more unusual than normal, and your energy has plummeted. And you're thinking, "Well, what the hell is going on with me," right? And if you've ever felt that way, please hear me when I say this.
You're not losing your mind, and you're definitely not alone in this. And if you've been told that you're too young or that your labs came back normal, that does not mean that what you're feeling is not real. So You end up googling, and before you know it, you've got 15 browser tabs open, three different supplements in your shopping cart, and somebody on social media telling you that all you need to do is balance your hormones.
Sound familiar? Well, honestly, I couldn't blame you, right? But when you do-- wh- when you don't feel like yourself a- and you do wanna find the answers, but the problem is that you've [00:05:00] identified several symptoms, but you haven't necessarily identified what's contributing to them. And that's an important distinction because sleep disturbances, brain fog, fatigue, irritability, difficulty concentrating, all of those things can occur during menopause, but that doesn't automatically mean that every one of those symptoms is being caused by menopause.
And it certainly doesn't mean that they all require the same intervention. Let's take sleep, for example, right? Changes in estrogen and progesterone during menopause can affect sleep. Hot flashes and night sweats can interrupt sleep. Changes in mood, increased stress, and other health conditions can also play a role.
And when you're not getting enough quality sleep, what happens, right? Your ability to concentrate can suffer. Your memory can be affected. Your mood can change. Your energy levels can drop. So now you've got several different symptoms that could be [00:06:00] connected to one underlying issue. But if you're looking at each symptom individually, well, you could end up trying five different things to address five different complaints without ever understanding how they're actually connected.
And that's why I talk so much about connecting the dots because menopause, it doesn't happen in isolation. Your hormones don't operate independently of the rest of your health. And the symptoms that you're experiencing, well, they don't always fit neatly into separate little boxes either, right? So and let's look at another example.
So Uh, let's say that you're experiencing joint discomfort during perimenopause. Maybe your knees are bothering you. Maybe you're waking up feeling stiff. Maybe your shoulders or hands are aching, and you just can't figure out why. Well, now, changes in estrogen during menopause can be associated with joint pain and stiffness as well.
But joint discomfort can also be related to [00:07:00] arthritis, injuries, inflammation, physical activity, and other health conditions. So the question shouldn't just be, is this menopause? The question should also be, what else could be contributing to this, and how do I figure out what's exactly going on with my body?
Because those answers matter when it comes to deciding what to do next. And here's something else that I want you to understand because just because a symptom is common during menopause doesn't mean that you should automatically dismiss it as normal or something that you simply have to live with Common does not mean that you have to suffer through it.
There is a difference between recognizing that a symptom can occur during menopause and determining whether that symptom needs further evaluation. And this is especially important when symptoms are new, persistent, worsening, or significantly affecting your quality of life. [00:08:00] And that's where having a qualified healthcare professional or menopause specialist, uh, uh, get- get- getting involved is really important, right?
Now, I also wanna address something else that happens more and more often. There is a tremendous amount of menopause information available today. And look, that's a good thing because women are talking about menopause more openly, healthcare professionals are sharing information, researchers are expanding our understanding of menopause.
But there's also a tremendous amount of misinformation, oversimplification, and marketing mixed into those conversations. And sometimes the loudest person in the room isn't necessarily the person providing the most reliable information. Just because someone tells you that they experienced a particular symptom and found relief with a particular product or treatment, well, that doesn't mean that same approach is appropriate for you.
Their experience is their experience. [00:09:00] You have to think about your health history, symptoms, risk factors, preferences, and needs because yours will be completely different. And look, y- there is no one-size-fits-all answer, and if this is one of the reasons that... Look, I don't believe menopause education should begin and end with a list of symptoms and a list of products or treatments.
It's important to understand the connections. What's changing hormonally? How do those changes affect different systems throughout your body? What other health factors need to be considered, and what options are supported by evidence? And when it, look, when is it time to even have the conversation with your healthcare professional?
Uh, because it may not be right at the beginning, right? But when you understand those things, you're no longer just reaching for every symptom a- as it appears or thinking about it that way. There's a much better position when you have informed questions, right? When you're able to evaluate your [00:10:00] options, when you're able to participate and, and have informed discussions about your care.
And that is the difference between simply knowing that you have a symptom and understanding what those symptoms could be telling you. And that takes me back to what I always say Education before intervention. Now let's take that a little further because I wanna show you how some of those symptoms, hormones, and other health factors can actually connect.
Now, why understanding those connection is so important throughout your menopause journey is also important, right? Now, another distinction that is important to understand is that menopause is a whole body transition, and I don't just say that because it sounds good, right? I say it because the hormonal changes that are associated with menopause can affect multiple systems throughout your body, and those systems don't operate independently of one another.
Your brain [00:11:00] communicates with your endocrine system. Your endocrine system influences your metabolism. Your sleep affects your mood, your memory, your energy, and your overall health. Everything is connected. And this is why it's important to understand that menopause is so much more than just a reproductive health issue.
Now let's start with estrogen Most of us are familiar with estrogen because of its role in menstruation, fertility, and reproduction. But estrogen receptors are found throughout your entire body, including the bones, the brain, muscles, cardiovascular system, and the urinary and reproductive tissues. So when estrogen levels begin to fluctuate, as they do during perimenopause, and then eventually decline after menopause, well, those changes can have effects that extend well beyond the menstrual cycle.
And depending on the person, those effects can look very different. One woman might experience frequent hot flashes and night sweats. [00:12:00] Another might notice in her sleep or concentration or her moods that change unpredictably. Another might experience vaginal dryness, urinary symptoms, or difficulty with intimacy.
And another might not experience many noticeable symptoms at all. Same biological transition, very different experiences. So if your experience doesn't look like your sister's, your best friend's, or your coworker's, that's okay. Your experience is valid. And now I wanna talk about something that doesn't get nearly enough attention, and that is the relationship between sleep, brain health, and emotional wellbeing, because this is a perfect example of what I mean when I talk about connecting the dots.
So during perimenopause, fluctuations in reproductive hormones can contribute to changes in sleep. And for some women, hot flashes and night sweats make those disruptions [00:13:00] even worse. But here's where things get interesting. Sleep isn't just about whether you feel rested the next morning. Your brain depends on sleep for important functions, including memory, consolidation, learning, emotional regulation, and attention.
So when your sleep is consistently disrupted, you might begin experiencing problems with concentration, memory, and mood. And what do many of c- of, of us call that, right? That's just simply brain fog. But brain fog isn't a formal medical diagnosis. It's a term commonly used to describe difficulties with memory, concentration, mental clarity, and focus.
And research suggests that cognitive complaints like this during menopause can involve several factors, including hormonal changes, sleep disturbances, mood symptoms, and stress. So let's say that you're struggling with brain fog. You're forgetting why you walked into a room, you're having trouble remembering [00:14:00] names, you're even finding it harder to concentrate on tasks that you used to find very easy to, to, to complete, right?
And now you're worried. Maybe you're even wondering if you might be developing early dementia. And if that fear has crossed your mind, it's totally understandable. It's also scary, right? But before you assume the worst, let's look at what else could be going on, right? What if you've been sleeping only four or five hours a night?
What if you're experiencing frequent night sweats? Um, what if you're dealing with significant stress or symptoms of depression or even anxiety, right? Because all of those things deserve consideration during this time, and that's why it's important to look at the bigger picture rather than assuming one symptom automatically points to one cause.
Now let's look at another connection, menopause, metabolism, and body composition. And I know this is an area that gets a lot of attention, and unfortunately, [00:15:00] a lot of misinformation as well. But let me clarify, because during midlife, women can experience changes in body composition, and most do, including an increase in abdominal fat and a decline in muscle mass.
But aging plays a role in those changes already, right? But menopause can also influence how fat is distributed throughout the entire body. And this is important because muscle isn't just about your body and neither is fat. Muscle plays an important role in strength, mobility, glucose regulation, and metabolic health.
And when you're talking about healthy aging, maintaining your muscle, losing fat, all of that is important. But here's where I want you to take note. If you're experiencing changes in your weight or your body composition, the answer isn't necessarily to eat less and exercise more. And please be gentle with yourself here because your body is not failing you either.
It's simply changing, and [00:16:00] you deserve to be patient and, and care for that because your... it, it really does matter that... how you're thinking about this stage of life and these changes that are happening in your life, because it can affect your confidence, it can affect how you see yourself, how you feel about yourself.
Uh, it can affect you wanting to interact with other people or even how you want to interact with your spouse, right? Now, your sleep, your physical activity, um, nutrition, medical health conditions, stress levels, and hormonal changes can all be related to your weight gain. And understanding those factors help you to make more informed decisions about what strategies are appropriate for you.
Because weight is a result, not a goal. The goal throughout menopause should be centered around better health, and that includes metabolic health, cardiovascular health, muscle strength, bone health, sexual health, and your ability to remain active and [00:17:00] independent as you age. Now, speaking of bone health, let's connect another dot, because estrogen plays an important role in maintaining your bone, right?
After menopause, declining estrogen levels contribute to increased bone breakdown, which can accelerate bone loss and raise the risk of osteoporosis and fractures. And here's something that makes this especially important You can lose bone density without experiencing any symptoms. You don't necessarily feel your bones getting weaker, right?
So while hot flashes and night sweats might get your attention, changes that can affect your long-term health could be happening without any obvious warning signs. And I don't wanna share that to scare you. I share that because I want you to be strong and active and doing things that you wanna do for years to come.
And that's why menopause education needs to go beyond symptom management. It's also important to understand the health [00:18:00] considerations that are associated with this stage of life, including bone health, cardiovascular risks, and as well as your metabolic health. Now, I wanna connect one more area that I think is often overlooked, and that's pelvic health, vaginal health, and intimacy.
And I know this isn't always easy to talk about, but it does matter, and so does your comfort, right? Declining e-estrogen, uh, levels can affect tissues of the vagina, the vulva, and urinary tract. For some women, this contributes to vaginal dryness, discomfort during intimacy, urinary urgency, and reoccurring urinary tract infections.
And these changes can affect much more than physical comfort. They can infu- influence sexual wellbeing, relationships, confidence, and overall quality of life. But once again, not every woman will experience these changes, and not every symptom has the same cause, which brings me back to the point that I've been making throughout this conversation.
[00:19:00] Menopause is a whole body transition. But, you know, let's take it further. It's a whole life transition, right? And understanding the connections matter because when you understand how hormonal changes can interact with sleep, brain health, metabolism, bones, muscles, pelvic health, and other aspects of your wellbeing, that, that can actually spill over into home life, work life, social life, and the relationships with people that are in those areas of your life.
See, you're not only better informed when you get that information, you're better equipped to recognize concerns, ask the right questions, and explore appropriate options. And here's something that I really, really wanna emphasize. Understanding these connections does not mean you should try to diagnose yourself.
That's not what foundational menopause education is about. It means that you can become more informed as a participant in your care, your options, and your [00:20:00] outcomes. You can also recognize that something deserves attention sooner rather than later. You can ask whether a symptom might be connected to menopause or another health condition, and you can have more productive conversations with your healthcare providers about what to evaluate and what options to consider.
That's what connecting the dots is all about It's about seeing the bigger picture instead of treating menopause as a collection of unrelated symptoms. And once again, you, you have to begin with the bigger picture, right? And okay, now let me take a second here because I, I want you to really understand what's happening and, and w- and And, and what I really wanna share with this information, because, um, I know I've shared a lot in, in, in a short amount of time, but, um, let's say this.
What does education before intervention actually really look like in practice, right? Well, [00:21:00] let me walk you through five things. That's what I'll do. So five things that you should understand about when navigating menopause-related symptoms and health concerns. And, um, I think this is gonna, gonna help because, uh, I guess the simplest thing to do would be to start with hot flashes.
Let's start with hot flashes as an example, since it is a universally known symptom, right? So first, identify what you're experienced. So let's say you're 48 years old, and you're suddenly starting to experience these intense waves of heat. Your face gets hot, uh, your chest gets hot, you start sweating, sometimes for no apparent reason, and now it's happening several times a day.
Or maybe you're 58, and your period stopped years ago, and you're still having hot flashes, because that happens, too. For some women, hot flashes can last for years after menopause. Well, start by paying attention to what's happening. When did the symptoms begin? Was there something that triggers them the same each [00:22:00] time or similar?
How often do they happen? How long do they last? Are they disrupting your sleep, your workday, or your daily activities? Because understanding what you experience starts with be- being able to actually recognize and describe it. You know your body better than anyone, so trust what you're noticing. Second, understand what could be happening and why.
Hot flashes are associated with changes in estrogen that affect how the brain regulates body temperature. But not every episode of sweating or feeling overheated is necessarily caused by menopause. Certain medications, thyroid conditions, and other health issues can produce similar symptoms. So education helps you understand the possible connections without automatically assuming that menopause is responsible for everything.
In fact, when Maria came to me, she was having hot flashes every 30 minutes, right? That's right, every [00:23:00] 30 minutes, seriously. And her doctor wanted to put her on HRT simply because of those hot flashes and the fact that she had already gone a year without having her period. But she wasn't ready to go that route mentally yet, which is why she came to me.
Now, after looking over her health history and the combinations of other symptoms that she had, I encouraged her to ask her doctor about a thyroid panel to check her levels. And sure enough, her thyroid levels were off. Her provider adjusted her medications and her hot flashes went away. She went from having hot flashes every 30 minutes to no hot flashes at all.
Her fatigue also lifted, she started losing weight, and she finally started feeling like herself again. So her hot flashes and fatigue were thyroid related, not menopause related. And Maria found her answer because the whole picture was looked at, not just one symptom. And that's the power of understanding, right?
Now, the [00:24:00] third thing is to explore your available options, because now that you understand what this might be happening, well, what can you actually do about it, right? Well, for hot flashes, options include menopause hormone therapy, certain FDA-approved non-hormonal medications, and there are even evidence-based behavioral approaches that work as well.
But those options aren't always interchangeable, and not every product claiming to relieve hot flashes has reliable scientific evidence supporting it. And again, that's why understanding the benefits, the limitations, and potential risks of each approach matters. Because otherwise, you're gonna be doing a lot of trial and error, trying this and trying that, hoping that something will work.
And from my experience and from the experience of women that have come to me and shared their stories, a lot of those things cause more strife, more, more anger, more frustration than they actually do symptom relief [00:25:00] Fourth thing you wanna do is evaluate what's appropriate for you, right? Because two women can experience the same exact symptoms and have very different health histories, treatment preferences, and personal priorities.
So what works for one woman might not be appropriate for another. And as the saying goes, one woman's medicine could be another woman's poison. So that means considering your medical health history, other health conditions, potential contraindications, and what you're hoping to achieve, because those are imperative to you for your relief.
And the fifth and final is to make an informed decision about your next steps along with your healthcare provider. Because when you're informed, you're better prepared to have a meaningful con- conversation, and conversations about what options are available, uh, what is best for you, right? So when you go to your doctor, instead of just saying, um, "I'm having hot flashes, what can you give me?"
Right? [00:26:00] You can explain what you're experiencing, how it's affecting your life, what you've learned about your options, and what you'd like to explore. And remember, education before intervention doesn't mean delaying necessary medical care. It means having the information you need to participate in decisions about your care.
That's the difference between reacting to a symptom and understanding how to approach it. And although I've used hot flashes as an example here, this same process applies to many other menopause related symptoms and health concerns, which brings me to another important point. There is no one size fits all approach to menopause.
And look, honestly, there shouldn't be, because understanding your symptoms is only part of the equation. The next step is understanding which treatment and support options make sense for you, your health, and most importantly, your [00:27:00] life. Now, before I continue, I do wanna just take a quick moment To, uh, share, uh, something that I've been working on.
So, uh, last week I completed the, um, Harvard Medical School Women's Health Executive Education Program. And, um, uh, as part of my capstone project, um, which is kind of centered around my whole philosophy of education before intervention, uh, the work has become part of the continued development of my Menopause Made Simple Symptom Support Series, which is seven individual educational trainings designed to help you and the people who care about you to better understand the s- the specific menopause-related symptoms and health concerns, including HRT, non-hormonal options, sleep, brain health, metabolism, pelvic health, hot flashes, and bone, muscle, and joint health.
Each training focuses on helping you understand what's happening, what [00:28:00] other health factors should be considered, what evidence-informed options are available, and when to seek clinical care. And because they're individual trainings, you can focus on the subjects that matter most to you. And this updated series will be coming the first week of November, and I'm opening the wait list now, and you can find the link in the...
for the Menopause Made Simple Symptom Support Series wait list in the description of this episode once we're done with the Live. Because understanding your options shouldn't be more complicated than the symptoms that you're actually trying to manage, and that's exactly what these trainings will help you do.
Now, there's something that I want you to think about after you leave today's episode. The next time you experience a symptom, notice a change in your health, or even hear somebody recommending the latest menopause treatment, I want you to ask yourself one question Do I actually understand [00:29:00] what I'm trying to address?
Not just what somebody told you it might be, not just what you read online, but do you understand enough about what's happening to ask the right questions and to make an unbiased and informed decision about what's actually comes next and what you wanna do? Because that's where the power of being an informed, uh, uh, consumer or healthcare consumer, I wanna say, begins.
Because this is about elevating your health and improving your health and feeling better for long-term health. You know, I think a lot of people, uh, forget the fact that, you know, menopause happens in the 40s and 50s, and for many women, you have 30, 40, sometimes even 50 more years after this. So you wanna make sure that you are as healthy, fit, and vital as you can be.
And I wanna be clear about something else too, because you don't have to have all the answers before you walk into your doctor's office. That is not your job. [00:30:00] But you should feel comfortable asking questions, requesting explanations, discussing alternatives, and making sure that you understand the recommendations that are being made about your health.
And if something doesn't make sense, ask again. If you need more information, request it. And if you're not getting the answers or the support that you need, it's okay to seek out another qualified opinion. Because at the end of the day, you're the one who has to live with the decisions that are being made about your health, and you deserve to be an informed participant in those decisions.
Now, if you've spent so much of your life taking care of everyone else, you deserve that same care too, and that starts, again, with understanding. And please hear this, because feeling better is possible. This chapter of your life can still be full, strong, and vibrant. And that's what I want you to take away from today's conversation.
Okay. I'm [00:31:00] Tafiq Akhir, Mr. Menopause here. I wanna thank you so much for joining me live today, and I hope that you'll check out this next episode coming up next, and that you'll come back and see me live next Wednesday. Thank you so much for your time. Be safe and be well. Thank you so much
