More than half of the Canadian population is female, and more than 45 per cent of those women are aged 45 or older – with the rest, obviously, on their way. Menopause is not a niche medical issue. It affects every woman eventually, and the conversation surrounding it needs to grow, especially among younger women.
“It’s never too early to start thinking about menopause,” says Dr. Jennifer Blake, CEO of the Society of Obstetricians and Gynaecologists of Canada. “The health that we have later on in life is laid down by the decisions that we make throughout our life. And things that you want to do for your health are much more easily achieved in your twenties than they are in your fifties.”
It’s never too early, but it’s also never too late. It’s like the old adage that the best time to plant a tree is twenty years ago, but the second best time is now. “Women are living one third of their lives in menopause,” says Dr. Marla Shapiro C.M., President of the North American Menopause Society and Professor within the Department of Family and Community Medicine at the University of Toronto. “Menopause is not like a doorway you go through and then it’s over, it’s never too late to start exercising, eating right, and maintaining a healthy weight. These lifestyle changes are not just important for menopause, they’re important for general health.”
But beyond maintaining a good level of health that will prepare their bodies for the transitions to come, women can also benefit from seeking out good information to fill in and correct some of the gaps and myths that the public understanding of menopause suffers from. “It’s important for women to do their research because the science and evidence surrounding menopause treatment have progressed a lot since 2001,” says Dr. Blake. “Women need to approach menopause with a very open mind and treat it as an opportunity to learn.”
The basic facts are easy enough to understand. Menopause is defined as starting one year after a woman gets her final menstrual period, which happens on average around the age of 51 or 52 for North American women (though about 5 per cent of women will experience menopause at age 45 or earlier). The time preceding that final period, when symptoms usually begin to manifest, is known as perimenopause and usually lasts about six years.
The nitty-gritty of the symptoms, however, is more complex, more individualized, and subject to more myths, misconceptions, and knowledge gaps. “Every woman will experience her perimenopause and menopause in a way unique to her, which is why having a conversation with her health care provider is so important,” says Dr. Shapiro. “When women think about menopause, they think mostly of hot flashes and night sweats, but there are a whole variety of other symptoms that women are not as aware of. Fluctuating estrogen levels can affect the body in so many ways, including things like mood changes, joint pain or discomfort, vaginal dryness or a change in personal lubrication, and changes in sexual intimacy.”
The genitourinary symptoms like vaginal dryness can be the most difficult to talk about, due to continued stigmatization and the insidious belief that there is nothing to be done, but good solutions do exist. “It’s important to normalize for women that genitourinary symptoms are not only something that we expect, but that they also, unlike hot flashes and night sweats, don’t get better over time, but instead are progressive,” says Dr. Shapiro. “We really need to end the conspiracy of silence and encourage women to understand that this is something important to talk about, and that there are safe and effective treatments available through their health care provider.”
That’s why education and outreach are so critical. Initiatives like World Menopause Day, observed on October 18, are working to inform and empower women to take a proactive approach to managing their own menopause and continuing a healthy lifestyle, built on a foundation of good diet and exercise, into later life.