Introduction

We wrote this book to give women of all ages a clear view of the physical, mental, and emotional changes related to menopause. For generations, women of all ages have approached menopause without knowing specifically what it would mean for them. Oh, you probably knew that menopause and hot flashes go hand in hand, but even that information isn’t always true. The truth is that you may never have a hot flash, and if you do, it will probably be years before you’re menopausal. Common knowledge about menopause is still too often dominated by myth and misinformation. (The medical community didn’t even officially recognize the link between estrogen and hot flashes until 1974!)

If menopause only concerned a small group of people on a desert island, this lack of information might be understandable. But over half of the world’s population will become menopausal one day. Menopause has been the misfit family member of the research community for years: a collection of symptoms and a very real phenomenon, but not a disease. Even medical textbooks pay scant attention to the topic. Today, one group is paying attention to menopause. The pharmaceutical industry sees great opportunity in the field of menopause, and more research is underway. If you’re looking for books to help reasonably intelligent women navigate the journey of menopause, your options are still somewhat limited to a choice between pretty, glossy pamphlets published by drug companies who may just be a tiny bit biased in their recommendations, or books that promote the natural aspects of menopause with such ferocity that you may feel guilty wishing for relief from troublesome symptoms. If you’re really persistent, you will find some academic articles in medical journals, but your eyes could glaze over as you try to pick out straightforward answers to your practical questions. We hope this book can fill that void. Our goal is to help you digest the research so you can make objective and informed health decisions based on your own experience with menopause.

Menopause is not a disease — that’s true. No one is going to die from menopause or its symptoms, but every day, women die from the medical effects of low estrogen levels. Your risks of certain diseases and cancers rise after menopause. Some folks may respond to that statement with one of their own, “Well, that’s because women are older when they go through menopause.” True again, but it’s also true that estrogen plays a role in an amazing number of functions in your body, some of which protect your organs, increase your immunity, and slow degeneration. This transformation we call menopause impacts our health in very significant ways. This book helps you understand the story behind the symptoms and the diseases.

Some women choose to use hormone therapy to relieve symptoms associated with menopause and protect their body from disease. The choice of whether to take hormones or not is quite controversial because hormone therapy has its own significant set of risks. The debate goes on in the medical community and media concerning the risks of hormone therapy. If you’re like many women, your confusion only grows as you read more on the subject. Each new study seems to contradict the findings of the last one. You’re an intelligent person. But how can you know which study you should believe? In this book, we try to provide enough information to enable you to make informed decisions about your health.

About This Book

We have no agenda in writing this book. We’re not trying to sell you medications, alternative health strategies, or remedies. This book presents accurate and up-to-date information from the most credible sources. It contains straightforward information based on reliable medical studies without the academic lingo common to medical journals. When no clear-cut answers exist and when quality research shows mixed conclusions, we let you know.

Everyone’s time is limited, so we cut to the chase. We cover the questions that are important to you during this phase of your life. If you want more detail, we provide an appendix full of resources to help with your personal research. We also try not to stray too far from the topic at hand. For example, during the years leading up to menopause, women may have difficulty getting pregnant. The same hormonal changes that cause those annoying symptoms prior to menopause also stifle fertility. Many women in their late 30s who are trying to get pregnant rely on hormone supplements. Despite the overlap in hormonal terms, fertility is not a concern for many women going through the change, so our discussion is limited.

Whether you’re going through the change, have already been there, or are about to start off down that road, you’ll find the information you need between these snazzy yellow and black covers. We cover all the health issues and therapy choices that confront women during the menopausal years.

Foolish Assumptions

Every author has to make a few assumptions about her audience, and we’ve made a few assumptions about you:

You’re a woman. (But, believe it or not, your treatment choices can have implications for the guy in your life, so we’ll talk just a tiny bit about his health, too.)

You want to understand what’s going on with your body.

You’re looking for straight talk for real people as opposed to scientific jargon and Medicalese (though we have a Medicalese icon to invite you into short — optional — forays into this territory).

You want to evaluate your risks of disease as you pass through midlife and move into your menopausal years.

You don’t want a book that claims to let you diagnose yourself or figure out what medications you need. You have a medical advisor to discuss these things with.

You want to be able to ask intelligent questions and discuss treatment alternatives with your healthcare providers.

You want to feel more confident about the quality of your healthcare.

You buy every book that has a black and yellow cover.

If any of these statements apply to you, you’re in the right place.

How This Book Is Organized

We’ve organized this book into five parts so you can go directly to the topic that interests you the most. Here’s a brief overview of each part:

Part I: The Main Facts about Menopause

The journey to menopause often catches women by surprise. You may not have been expecting to take the journey, or you may have been wondering when you would begin. In this part, we give you a quick overview of what your hormones are doing before, during, and after menopause. If you haven’t thought about things such as hormones and follicles for a while, don’t worry; we refresh your memory. Your sixth-grade health-and-hygiene course probably never finished the story. In this part, you get the whole story from how the egg makes its journey from the ovary to the uterus to what happens when the ovary goes into retirement. We’ve also added a chapter to answer the special questions you may have if you’re among the small group of women who (through illness, medical treatment, or some other factor) face menopause more suddenly or much earlier than most women will.

Part II: The Effects of Menopause on Your Body and Mind

Want to know how hormones affect the health of your body and mind? You can find the answers in Part II. We devote each chapter in this part to a specific body part or health issue. In each chapter, you get an overview of how hormones function in relation to this part of your body and the types of conditions that can develop, how to recognize them, and what you can do about them.

Part III: Treating the Effects

You may want to evaluate the pros and cons of hormone therapy (HT) from time to time during your journey through menopause. This part of the book brings you up to date on what the medical community knows about HT. We discuss the effects of HT so that you can make informed decisions. Reading these chapters provides added benefits as well: You’ll probably find it easier to evaluate the news about hormone research that comes out in future years.

We also include information about non-HT drugs and alternative treatments. This will help you make informed decisions on treating menopause symptoms and helping to protect your health during the menopausal years without hormones. You may be one of many women for whom hormone therapy isn’t medically appropriate, or you may just prefer not to take hormones, or to take them for as short a period as possible.

Part IV: Lifestyle Issues for Menopause and Beyond

Part IV is chock full of great ways to stay healthy and enjoy a long and active life during and after menopause. Staying healthy and active is simpler than you think. We discuss healthy eating habits and simple ways to stay fit. Whether you’re looking for natural ways to lower your risk of specific diseases or for ways to slow the aging process, you can find the information you need right here. We even get into the ways in which this new stage of your life can be richer and more exciting than any you’ve experienced yet.

Part V: The Part of Tens

If you’re a fan of For Dummies books, you probably recognize this part. These are short chapters with quick tips and fast facts. In Part V, we debunk ten menopause myths, review ten common medical tests you may encounter, suggest ten terrific exercise programs for menopausal women, and give you tips about ten powerhouse foods that will help keep you feeling your best — now and in the years to come.

Part VI: The Appendixes

A glossary of menopause-related terms and a list of menopause-related resources cap the book.

Conventions Used in This Book

We use our own brand of shorthand for some frequently used terms and icons to highlight specific information.

As you read this book, you’ll discover that menopause is a process, with different stages characterized by similar symptoms. These stages are referred to as perimenopause, the three to ten years prior to menopause when you may experience symptoms; menopause itself, which you know you’ve reached only after you’ve reached it because the definition of menopause is the absence of periods for a year; and postmenopause, which is your life after you’ve stopped having periods. In this book, we use perimenopause to describe the premenopause condition, and we use menopause to refer to everything after that just because the term postmenopause isn’t commonly used.

A major part of this book — the whole of Part III as well as sections in other chapters — talks about hormone therapy (HT), which is used to alleviate symptoms and address health concerns prompted by menopause. In literature and on Web sites, you can see hormone therapies referred to and abbreviated any number of ways, including hormone replacement therapy (HRT) and estrogen replacement therapy (ERT). But we stick pretty closely to using HT because we feel that it’s the most inclusive and accurate term. Just be aware that HT means essentially the same thing as HRT.

And, speaking of hormones, a couple of the more important ones for menopausal women have several subcategories:

Types of estrogen include estriol, estradiol, and estrone.

Progesterone is the class of hormone; the form used in hormone therapy is often referred to as progestin.

We sometimes use these terms interchangeably and only refer to the specific hormone as necessary for clarity.

Icons Used in This Book

In this book, we use icons as a quick way to go directly to the information you need. Look for the icons in the margin that point out specific types of information. Here’s what the icons we use in this book mean.

The Tip icon points out practical, concise information that can help you take better care of yourself.

This icon points you to medical terms and jargon that can help you understand what you read or hear from professionals and enable you to ask your healthcare provider intelligent questions.

This fine piece of art flags information that’s worth noting.

When you see this icon, do what it tells you to do. It accompanies info that should be discussed with an expert in the field.

The Technical Stuff icon points out material that generally can be classified as dry as a bone. Although we think that the information is interesting, it’s not vital to your understanding of the issue. Skip it if you so desire.

This icon cautions you about potential problems or threats to your health.

Where to Go from Here

For Dummies books are designed so that you can dip in anywhere that looks interesting and get the information you need. This is a reference book, so don’t feel as though you have to read an entire chapter (or even an entire section for that matter). You won’t miss anything by skipping around. So, find what interests you and jump on in!