Embodied Wisdom:

EMBODY.

Tidbits & Takeaways

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Before we know we are experiencing the menopausal transition, we feel something is happening in our bodies. An unexplained ache. A change to the rhythm and volume of our cycle. A sudden rush of heat. Our most comfy pants feeling a bit tight. What is actually happening? And WHY?

As estrogen levels fluctuate, ovulation occurs at unexpected times, followed by menstruation occurring in response. Due to the unpredicatability of our cycles, hormone testing does not accurately represent what is happening. It is like taking a snapshot of a movie: a hormone test does not tell the whole story.

❋ Menstrual Mayhem

  • Early symptoms indicating perimenopause:

    • Sleep issues, mood changes

    • Joint pain, itchiness (inflammation)

    • Increased UTIs

    • Migraines & headaches

    • Changes to body weight, shape, and metabolism

    • Changes to skin, hair & nails (thinning, thickening, loss)

    Later perimenopausal symptoms:

    • Vasomotor symptoms: hot flashes & night sweats. Usually occurs in later stages of perimenopause.

    Later transition risks:

    • Increased risk of cardiovascular disease

    • Decreased bone density leading to osteoporosis

❋ Physiological Symptoms

MHT (Menopause Hormone Therapy: estrogen taken orally or via a transdermal patch, progesterone taken orally; progesterone recommended to oppose estrogen) can help to alleviate or improve:

  • vasomotor symptoms (hot flashes, night sweats)

  • sleep quality/fatigue

  • mood swings

  • ability to concentrate

  • bone desnity

  • overall quality of life

Vaginal estrogen (applied topically) can help with vaginal dryness and pain during sex. Is not to be used as contraception, and is not enough to replace oral or transdermal estrogen.

❋ Hormone Therapy

Non-Hormonal Therapies for vasomotor symptoms:

  • Antidepressants (Venlafaxine, paroxetine, fluoxetine)

  • Gabapentin

  • Clonidine

Complementary and Alternative Therapies

  • Accupuncture – modest evidence

  • Natural supplements – minimal evidence

❋ Non-hormonal treatments

Regular intake is the best way to support consistent metabolism, to promote energy, support cognitive function, regulate mood and optimize body function. Increase fibre, change to complex carbohydrates, increase protein.

❋ Reinforcing nutrition

  • regulate metabolism

  • diet & nutrition (review Session 2)

  • exercise (coming in Session 6)

  • sleep habits (review Session 1)

  • stress management (review Session 1 and more coming in Session 5)

  • reduce exposures that make symptoms worse (i.e. alcohol, marijuana, stress, screens, etc.)

❋ Conservative Management

  • The menopausal transition brings big physiological changes to the body that contribute to a wide variety of symptoms and experiences.

  • Know that this is normal.

  • Regulating your metabolism can help (a lot!).

  • Sometimes medications can help too.

  • Every person’s experience is different.

  • Duration difficult to predict.

  • If you’re struggling – ask for help!

❋ In summary…

ESSENTIAL RESOURCES

Journal Prompts

  • Dr. Lorelei’s Presentation Slides (PDF)

  • If the doctor you are seeing seems unaware of the most current menopause research, you can ask them to consult with RACE Line to access expert advice from their peers and colleagues

Shared Resources

Menopause and U

The Menopause Society

The Menopause Society certifies health care practitioners who specialize in women’s health in the US and Canada, including those in Victoria. You can search for a MSCP accredited health care provider here.

More Resources

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Featured Facilitator:

Lorelei Johnson, MD

Dr. Lorelei Johnson is a Family Physician with special interests in women’s health, obstetrics and maternity care, mental health and eating disorders. She holds a Bachelor of Science as well as a Medical Doctor degree. Dr. Johnson currently practices in a multidisciplinary team at the women’s health-centred Full Circle Gynecology Clinic, in Victoria BC. In addition to managing a full-scope family practice with maternity and obstetrics services, she shares the role of Division Head of the Family Physician – Obstetrics team at the Victoria General Hospital.

Dr. Johnson also provides regular medical-monitoring consultant services to the Victoria regional Eating Disorders Program with the BC Ministry of Child and Family Development, and she feels privileged to be part of this innovative and dynamic service. She has a passion for advocacy and leadership, and is drawn to teams that provide multi-disciplinary, collaborative and patient-focused care. 

She has worked in the field of eating disorders for 8 years, providing clinical care to patients and participating in both regional and provincial working groups advocating to improve health care services for patients with eating disorders. She has worked in the field of women’s health, maternity, obstetrics and newborn care for 13 years, and sincerely enjoys helping patients and families navigate the various life transitions therein. Outside of work you’ll find her curling, cycling, practicing yoga, paddling, traveling, enjoying movies, and spending time with her family.

Sources

Vincent, C., Bodnaruc, A. M., Prud’homme, D., Olson, V., & Giroux, I. (2023). Associations between menopause and body image: A systematic review. Women’s Health, 19(1), 1–20. https://doi.org/10.1177/17455057231209536