Medicine, too, has its own culture and way of defining things. According to the North American Menopause Society, menopause is ​defined as a normal, natural event, not a disease or dysfunction. [3] However, the reduction in ovarian hormones, specifically ​estrogen, can significantly impact women’s health, particularly in the United States.

For instance, post-menopausal women face a notable increase in cardiovascular disease compared to pre-menopausal women. [4] ​Additionally, bone density decreases, with a threefold increase in the rate of bone loss during menopause. [5] Osteoporosis, a ​condition characterized by reduced bone density, predisposes individuals to fragility fractures, which are difficult to recover from. ​There’s also an increase in sexual dysfunction, mood disorders like anxiety and depression, increase in metabolic disease, and a ​decrease in sleep quality. [5,6,7,8] Again, not all women experience these issues, and the severity and frequency vary across different ​cultures.

You may wonder why your healthcare providers seem to disregard your menstrual health or the changes you're experiencing during ​perimenopause or post-menopause. Unfortunately, this often stems from the misogynistic history of medicine. The American ​Medical Association has been responsible for systemic sexism and racism, which has historically limited women's roles in medical ​research and practice. [9] It wasn’t until 1993 that women had to be included in clinical trials, so we could understand how different ​treatments affect women compared to men. [10]

Aside from patriarchal perspectives, there's also a lack of training for healthcare specialists in managing menopause. A 2023 survey ​by the North American Menopause Society found that only 30.1% of OB/GYN residency programs provided formal training on ​managing menopause symptoms and complications. [11]

Given the limitations of modern Western medicine in supporting women through menopause, it’s crucial to focus on what you can ​do to take control of your health. I recommend focusing on what I call the "Five Pillars of Health":

1. Strength Training and Exercise

Many people, both men and women, often underestimate the intensity needed for effective strength training. The biggest mistake I ​see is using weights that aren’t challenging enough to trigger the desired response in your muscles, bones, and metabolism. The key ​is to aim for "hard but doable" in every working set.

General Guidelines:

• 
  
• Engage in 9 to 12 multi-joint movements each week.
  
• Perform 3 to 4 working sets of 8 to 10 repetitions per exercise.
  
• Take about a minute and a half of rest between sets.
  

Strength training differs from cardiovascular training in its goals, modalities, and benefits. Both are important, but they serve ​different purposes. It’s also essential to get at least 150 minutes of moderate-intensity cardiovascular exercise weekly. This doesn’t ​mean a casual walk; your heart rate should be up, making conversation challenging but not impossible.

A common misconception is focusing too much on physique rather than strength. Unless your livelihood depends on your ​appearance, prioritize building strength over achieving a certain look. This approach will serve you better in the long run, especially ​as you navigate through menopause.

2. Diet

When it comes to diet, I encourage an agnostic approach. Avoid extreme views and diets. You often hear about "superfoods" that ​claim to cure or cause diseases, but for every study that says one thing, there’s another study that says the opposite. Moderation is ​key.

Dietary Recommendations:

• Prioritize whole foods over processed foods.
  
• Practice mindful eating to understand your relationship with food.
  
• Avoid labeling foods as "good" or "bad." Instead, think about foods in terms of how they align with your health goals.
  
• Aim for 1 gram of protein per kilogram of body weight daily.
  
• Try to consume around 25 grams of fiber per day.
  
• Food logging can be a powerful tool for understanding your eating habits. It helps you become more mindful, intentional, and ​aware of your behaviors, providing you with clear data on how you’re actually eating, not just how you think you’re eating.
  

3. Sleep

Sleep is often the first thing people sacrifice when life gets busy, but it's one of the most critical components of health. If I could ​convince all my patients to treat sleep as holy, many health conditions could be minimized.

Sleep Essentials:

• Sleep is vital for recovery and allows your body to restore itself from the stresses of the day.
  
• Poor sleep is associated with an increased risk of cardiovascular disease, weight gain, and psychiatric disorders.
  
• Good sleep hygiene includes treating your bed as a place for sleep or sex only, minimizing screen time before bed, and allowing ​yourself 7 to 8 hours of sleep each night.
  

Sleep is not just a luxury; it’s a necessity for your overall well-being.

4. Relationships

No one is an island. Human connection is essential for well-being. A critical part of maintaining your health is having healthy ​relationships with people you care about.

Relationship Recommendations:

• Aim to have at least three individuals you can have honest, uncomfortable conversations with about the different stages of life.
  
• Invest in these relationships, and work on establishing healthy boundaries and clear communication.
  
• This will also translate into better communication and understanding in your relationships with healthcare providers.
  
• Healthy relationships are a cornerstone of emotional and mental health, particularly as you navigate the transitions that come ​with menopause.
  

5. Spirituality

This isn’t about religion but about your sense of self, your view of the universe, and your relationship with it. Spirituality is about ​identity and purpose, and it plays a significant role in how you experience life’s transitions, including menopause.

Spirituality Considerations:

Reflect on three key questions: Who are you? What does that imply for your life? How does the way you live reflect your perception ​of yourself?

Having clear answers to these questions can help establish a strong sense of identity and self.

This clarity can be particularly grounding as your body changes and society’s views on your role may shift.

Being rooted in a true sense of identity and spirituality can greatly influence how you experience and navigate through menopause, ​providing stability and confidence as you move through this natural phase of life.

In conclusion, my recent talk at Blissful Alchemist provided an opportunity to explore the critical role of the menstrual cycle in ​women's health and the profound impact of menopause. Understanding these changes is vital, not just for managing reproductive ​health, but for appreciating how hormonal shifts influence the entire body.

We also examined how cultural perspectives shape women's experiences of menopause and highlighted the shortcomings in Western ​medicine's approach to this natural life transition. Despite these challenges, women can take proactive steps to support their health ​through what I call the "Five Pillars of Health": Strength Training and Exercise, Diet, Sleep, Relationships, and Spirituality.

By focusing on these foundational aspects of well-being, women can build resilience, navigate the changes of menopause with ​confidence, and ultimately lead healthier, more empowered lives.

If you’re in the Fayetteville area and are looking for a medical practitioner who will take the time to understand you personally and ​will consider these different complex topics in your care, feel free to contact me! You can reach me at golfran@truecaredpc.com