How does a rock star enter menopause? Get Goop-famous expert advice
Esther Blum is an integrative dietician, bestselling author, and menopause expert — famed for coaching Ms. Goop herself, Gwyneth Paltrow, through menopause. (She’s also a MidstHer and you can read more about her here.) In her book, See ya later, Ovulator!: Mastering Menopause with Nutrition, Hormones, and Self-Advocacy, Blum “helps women make menopause their b*tch” with advice about nutrition, hormones, and self-advocacy.
Get ready to have your mind blown with all of Esther’s spot-on insight — here’s an excerpt from Chapter 11:
“The big pause: How to go into menopause like a rock star”
One of the main reasons I was inspired to write this book was because of the thousands of women I’ve had conversations with and treated in practice. I’ve heard more horror stories than I can count about interactions with their doctors that made me palm smack my head. I’ve excerpted pieces from conversations I’ve had with women just like you to share examples of the rampant negligence we’ve all been subjected to over the years. I’m sure you have plenty of your own stories to share. And believe me, I see you, because like you, I’ve had quite a few of my own experiences over the years!
Here are a few examples of what you’ve shared with me:
“I went to my gynecologist because I was having hot flashes and trouble sleeping. She told me that she took Benadryl shots every night to help her sleep and that I should put in an IUD to get me through.”
“I went to my doctor having hot flashes and could not sleep past 3:30 a.m. I was exhausted and had terrible brain fog. My doctor told me this was normal for menopause and refused to give me hormones.”
“I told my doctor I thought my hormones were off and my sleep was worsening, and she told me she’d be happy to put me on a low dose contraceptive. When I went home and Googled the medication, it said one of the side effects was insomnia and many women who took it never got their sleep back.”
One of the main reasons I was inspired to write this book was because of the thousands of women I’ve had conversations with and treated in practice. I’ve heard more horror stories than I can count about interactions with their doctors that made me palm smack my head. I’ve excerpted pieces from conversations I’ve had with women just like you to share examples of the rampant negligence we’ve all been subjected to over the years. I’m sure you have plenty of your own stories to share. And believe me, I see you, because like you, I’ve had quite a few of my own experiences over the years!
“I knew my hormones were out of whack, but my doctor told me my labs were all normal and I was perfectly healthy.”
“I asked my doctor to check my hormones and she told me there was no point while I was still having a period.”
“I was told I should just stay on birth control until menopause was complete, even though I didn’t feel like I wanted to stay on it anymore.”
“When I told my doctor I was feeling depressed and anxious and was going through menopause, she told me I should try antidepressants. Even if that helped my depression, it still wouldn’t get rid of all my other symptoms that came on since starting menopause like vaginal dryness, brain fog, and low libido!”
“I had terrible endometriosis and was told I needed a hysterectomy. Against my better judgment, I had my uterus removed and it was the worst decision I ever made!”
“My hormones are all over the place and it’s very hard to lose weight. No one will even test my hormones.”
Here’s what women are sick and tired of hearing from their doctors:
- Your labs are normal and you look fine (despite your symptoms).
- You’re just getting older.
- Birth control is the only option for your symptoms.
- This is common for your age.
To which I say:
- Your labs can be completely normal and you can still feel like dog poop.
- You’re 50, you’re not dead!
- Birth control suppresses hormones and if yours are already in the toilet, why add fuel to the fire?
- Just because these menopausal symptoms may be common in women our age, that doesn’t mean they are normal, and they still warrant medical treatment regardless!
Listen up, doctors—menopause is not a birth control deficiency. Nothing is worse than knowing your body inside and out, knowing when things are not right, and still not being heard. To second guess yourself and your body when you are the number one expert of what goes on down there (and hopefully who goes down there), erodes confidence and will only delay finding answers and getting solid treatment.
Let’s crack open what you can expect during menopause, educate and empower you, and put you in the captain’s chair to steer the ship throughout your journey. Let the Menolution begin!
Hot flashes
Just about every woman approaching menopause knows a hot flash when she feels one: the sudden overwhelming blast of heat that extends from your forehead to your toes, soaking you with sweat. Your hormones have minds of their own and are fluctuating and mixing up your body’s temperature regulation (the hypothalamus). You can experience hot flashes all over your body, or in just one area. But the extreme temperature change is uncomfortable no matter where you feel it.
Your face may also flush and turn red, or become blotchy. And the severity of your hot flashes can range from mild to severe. Many women wake up in the middle of the night sweating and sometimes soaking their sheets. This only adds to brain fog and fatigue from sleep deprivation. While there are some treatments available for hot flashes, many of them come with side effects. Knowing your options is important, so make sure your doctor is aware of your symptoms. And be proactive because hot flashes can last for a couple of years after menopause.
How to go into menopause like a rock star
Most women who come and see me experience many symptoms at once like hot flashes, low libido, night sweats, insomnia, vaginal dryness, sudden weight gain, and brain fog. They ask their doctors to run blood tests and when the results come back they’re told, “Everything looks fine and your labs are normal for your age.”
But normal does not mean optimal. Normal in this country means you’re struggling with weight, are either on a blood pressure medicine or statin drug (or both) and Prilosec, an acid blocker, because you’re having reflux. At night you use a CPAP machine, and maybe you’re also taking a sleep medication or antidepressant.
Historically, you’ve also been on 5 to 10 diets, and recently you’ve tried keto and Whole 30 and still the needle won’t budge. You notice that what worked in your 20s doesn’t work in your 40s and 50s, and it seems like overnight you’ve put on 10 to 20 pounds. What gives?
Welcome to the hormonal roller coaster ride that starts in perimenopause and takes you through menopause.
Perimenopause
Perimenopause begins before a woman officially reaches menopause. This stage can last nearly a decade, and most of us have zero idea of what lies in store. Our mothers never told us, and our doctors don’t have much to offer in terms of relief, aside from prescribing birth control. Truth is, we all have suffered in silence without a clue about how to get some blessed relief.
I like to think of menopause like this: You are backing out of your period and your body’s as confused about what to do as when you went into menstruation in the first place.
Your periods weren’t always regular then. You had mood swings like no one’s business, and you never knew exactly what to expect … Except now, your body is telling you, “Time’s up! The baby-making shop is closing (even if you’ve never had children), so last call everyone!”
You are now on a roller coaster ride of fluctuating estrogen and progesterone. Your period doesn’t show up on time anymore, you skip it altogether for a month or two, and it can either get shorter and lighter. Or, wait for it, you start to clot heavily with no apparent warning (“Perfect for those times at the beach or wearing white pants to a summer party!” said no one, ever).
Hold tight, because your ovaries are in flux with quick drops and steep rises in hormone levels that cause your symptoms. And because women have estrogen receptors all over our bodies, every organ system can be affected by the changes occurring in our ovaries. No wonder we experience so many frustrating symptoms!
Read more of this excerpt — about gut health and how it affects your hormones — on The Midst Substack.
This is an excerpt from See ya later, Ovulator!: Mastering Menopause with Nutrition, Hormones, and Self-Advocacy by Esther Blum. Copyright © 2022 by Esther Blum. Published by Hybrid Global Publishing. All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
