Menopause

Although widely known as “the change,” here at Black Maple we believe in calling things what they really are (unless of course there’s a valid reason not to). Therefore, we do hereby declare that menopause should henceforth be known as M-E-N-O-P-A-U-S-E. The emphasis is warranted given that, for generations, women have been forced to speak of this natural transition in hushed tones as if discussing a dirty little secret instead of a fact of life for half the plant! (The male-dominated biases of the medical industrial complex have more than a little to do with this, no?) Well, we’re here to declare that menopause is neither dirty, nor a secret. Indeed, this absolutely normal transition of healthy aging is experienced by all biological females if they are blessed enough to have experienced a normal menstrual cycle, to have their uterus and ovaries intact, and to live into their 50s. Whereas a healthy menstrual cycle frequently becomes a fact of life for young girls by the age of 12, a person is considered to have reached menopause (which actually means the end of monthly cycles) if they have gone one year without a period or two years, if under the age of 40.

In the USA, the average age of menopause is 52, in the UK 51, and in Canada also 51, according to the Menopause Foundation of Canada. But recent studies also show that black women in the USA begin menopause about 8.5 months before their white female peers. After the period stops, you enter the post-menopause stage. But it is important to understand that menopause is preceded by perimenopause which can start years before, ushering in menopausal symptoms while women are still having their periods. (Shout out to the pioneering Madame Oprah Winfrey who first brought this stage and its symptoms to our attention years ago!) This means caution must be taken with heterosexual sex since pregnancy is still possible if menopause has yet to be reached. Sound fun? Well, it’s not all bad, and in fact, menopause can be downright liberating. So, what do you need to know?

While a small percentage of women, estimated at 12%, wake up one day and never have a period again, this is not typical. That said, what is “normal” varies widely with fluctuations between shorter and longer cycles and heavier and lighter flow. It all comes down to our hormones. Remember, the point of the period is the shedding of the uterine lining that has built up with the expectation that sperm might meet an ovulated egg, causing fertilization and a blastocyst to implant and be nourished across the 40 weeks of pregnancy. When that does not happen that lining flushes out, resulting in the bleeding that is the period. But as the ovaries run out of eggs, the level of hormones required to make this monthly miracle reduces dramatically, resulting in a host of possible symptoms. Those hormones are estrogen, progesterone, testosterone, and DHEA. Once the “normal” balance is altered, women can experience a host of unpleasant symptoms. For instance, the dip in progesterone (during perimenopause and menopause) that is naturally produced by the ovaries after ovulation leads to a hormonal imbalance that can cause mood swings, irregular periods, hot flashes, and changes in libido and blood sugar. Meanwhile, the dip in testosterone, often erroneously only thought of as a male hormone, can have devastating consequences. Since about 50% of a woman’s testosterone is produced by the ovaries, the high levels of our 20s get halved in our 40s. Whether caused by “surgical menopause”’ (when the ovaries are removed, often as part of a hysterectomy) or as a natural decline linked to ovarian function, dwindling testosterone can result in reduced energy and motivation, depression, and low libido. To counteract this dip, add testosterone-boosting foods like tuna, garlic, eggs, oysters, almonds, bananas, oats, and spinach to your diet. Meanwhile, lowered estrogen can result in the weakening of the pelvic floor which can lead to – well – peeing on yourself when you least expect it (think laughing and sneezing). However, the good news is that excellent prescriptions and natural treatments are at hand which can reduce or eliminate discomfort, annoyances, or unhappy new developments.

Typical symptoms include hot flashes and night sweats (due to fluctuations in hormones impacting the area of your brain that controls body temperature), insomnia (which effects about 53% of women), mood swings (linked to dips in estrogen), fatigue, aches and pains (due to associated impacts on your adrenal glands), heart palpitations, and osteoporosis. But sorry, we’ve saved the worst for last. Some final, delightful symptoms include brain fog (think, where did I put my car keys again x 100), weight gain, hair loss (good-bye lustrous locks?), and vaginal dryness (yes, estrogen is a natural lubricant), painful sex, urinary incontinence, and increased urinary tract infections (UTIs) known together as genitourinary syndrome, and heavier periods (yes, heavier). Did we mention tired-looking, lined skin from collagen loss to the tune of 30% within the first five years of menopause?

But before you panic, biohacking is real and there’s much you can do to combat, reduce or even reverse these symptoms. It all comes down to keeping our hormones in balance. This includes the aforementioned quartet, but also cortisol and insulin. As you might have gathered, hormones work together in your body like an orchestra. And just like an orchestra, when one instrument is out of tune or played out of time, the composition is no longer harmonious.

So, where to begin? Well, at Black Maple Magazine thanks to Dr. Mark Hyman, we know that food (the right kind, that is) is medicine. That means that for menopausal women, nutrition is everything! Poor nutrition (think processed and ultra-processed foods) and fad diets often lead to hormonal imbalances which make symptoms worse. Instead, nutritional therapist Alison Cullen recommends loading up on healthy veg (at least five portions a day), healthy fats and cholesterol from foods like wild mackerel, salmon, sardines, olive oil, egg yolks, and walnuts (the cholesterol is necessary for hormone production), and protein (lentils, chickpeas, lean organic meats, and wild caught fish). While you’re at it, choose smaller portions (which are easier to digest), healthy snacks (like dried fruits and nuts), drink up (water and coconut water, that is) since hydration reduces aches and improves energy, and just say no to that sugary coffee since the combination of caffeine and sugar spikes your insulin, releasing cortisol and depleting your already dwindling progesterone, making you feel even more fatigued. As for the weakened pelvic floor, commit to doing your Kegels (pelvic floor exercises) routinely.

But what about supplements you ask? Yes, supplements like vitamins A, D, E, K, and the B family as well as calcium, magnesium, zinc, and omega 3 fatty acids can positively impact hormone function. Vitamin D is crucial for black folks who already create less of it through sun exposure due to the greater quantity of melanin in our beautiful brown skins. Since vitamin D aids in the absorption of calcium, the combination of the two can help reduce the risk of osteoporosis which rises dramatically after menopause. Want more good news? Hormone Replacement Therapy (HRT) also known as Menopausal Hormone Therapy (MHT) in the form of tablets, gels, or patches can have transformational results for women. But the first step is getting a hormone panel run. Don’t forget to include testosterone. It’s best to work with your medical professionals to determine which type of HRT/MHT might be best for you. The good news is that the controversial studies of the early 2000s linking HRT/MHT to increased rates of cancer, stroke, and heart disease, have now largely been debunked. According to Dr. Rebecca Lewis of Newson Health Menopause and Wellbeing Centre, the increased risk of developing breast cancer after five years of HRT (5 extra cases per 1000) is less than that of overweight patients (24 extra cases per 1000). Explaining the benefits of HRT further, Dr. Lewis advises that since we have estrogen receptors in our brain, muscles, joints, ligaments, heart, bladder, and vagina, dropping levels provoke systems in various areas of our bodies. This means that HRT can alleviate annoying or debilitating symptoms and potentially boost overall health. Progesterone therapy is often combined with HRT/MHT to balance the impact of estrogen. While HRT/MHT can be combined with testosterone supplementation, more is not necessarily better. Too much testosterone in women can lead to aggression, acne, and excessive body hair.

If the prescription route is not for you, natural remedies might be your best bet. Evidence suggests that herbs like black cohosh, Devil’s Claw, melatonin, buckhorn oil, sage leaf, and St. John’s Wort might be useful for alleviating different symptoms. Another option is cannabidiol (CBD) the non-psychoactive element of cannabis which can help with sleep, stress, depression, pain, and other menopausal symptoms. All of these remedies have properties that may interact, for better or worse, with each other and prescriptions medications, so professional health care guidance and monitoring are necessary.

Many things that assist in alleviating the symptoms are obvious, but bear repeating. Choose a bedtime and stick with it, practice good sleep hygiene by keeping your bedroom cool and dark, avoid caffeine after 2pm, skip the alcohol (booze dehydrates and only exacerbates brain fog), stay in shape with moderate exercise (both cardio and resistance training), practice stress relief (like meditation), relax and wind down before bedtime with soothing music, try calming essential oils (like lavender, frankincense, ylang-ylang, and chamomile), or a cup of herbal (non-stimulating) tea.

Now it must be said that people experience health issues and health transitions differently due to distinctions in genetics, culture, and health equity all of which are related to our racial identities and socio-economic statuses. For instance, research indicates that African American women experience hot flashes more frequently and for longer – 10 years compared to 6.5 for white women – and are less likely to receive HRT/MHT treatment. Therefore, all women do not experience menopause in the same way. Given the commonality of institutional racism that permeates the health care systems in Canada, the USA, the UK, and other regions, it is essential that black women prioritize finding well-trained, compassionate, and culturally sensitive health care providers who can help them navigate this transition.

That said, let’s not forget the benefits of menopause. Yes, benefits, like saying goodbye to your hormonal contraceptives and PMS, fewer migraines (often linked to menstrual cycles) and – drum roll please – no more periods! The last point is huge for black women who frequently suffer from fibroids, sick cell disease, and thalassemia, all of which wreak havoc on the body often resulting in devastating anemia. No more monthly bleeding means an end to the cyclical loss of iron. This also means considerable savings at the pharmacy since there’s no longer a need to stock up on those pads and tampons. We’d also like to point out the fabulous fact that liberation from periods means sex can become more spontaneous, playful, and yes frequent, once you jump start your libido by getting your testosterone level back in order. As a bonus, research now suggests that menopausal women who have sex every week have estrogen levels twice as high as those who don’t. Sex also releases endorphins which can alleviate joint pain and migraines. We’d call that a definite upside!