1. Chapter 20 – Perimenopause & Menopause
Chapter 21- Our Later Years
Post Reproductive Years
Meghan Brown
2. Perimenopause as well as Menopause is a transition from our reproductive years, both resulting
at the end of monthly menstrual cycles. This transition usually begins in a woman’s forties and ends in
early fifties, but everyone is different there is no set time.
This chapter focuses on the reproductive health during Perimenopause and also attends to the
social and cultural context of the midlife transition. ( Chapter 20, Pg. 505)
What exactly is Perimenopause and Menopause?
• The book (pg. 506) states: “Perimenopause is the one-to-ten-year stretch during which the ovaries
function erratically and hormonal fluctuations may bring a range of changes, like hot flashes,
night sweats, sleep disturbances, and heavy menstrual bleeding” while Menopause is the final
menstrual period (usually final after a year with no signs of a period)
Just to mention..
• Some women reach the end of their menstrual cycle sooner than others due to chemotherapy or
radiation therapy, surgical removal of ovaries (hysterectomy), or other particular health
conditions.
• Early or Premature Menopause can come as a devastating shock to women, it is important to
realize the emotional effects this can have on a women in her mid life.
3. MIDLIFE CRISIS
• At this point in a woman‟s life she may begin to feel emotional, social, and physical changes – not just
perimenopause.
• Many point out the negatives of the transition like the end of childbearing years, sadness as far as things
they haven‟t done in their lives or children that have grown. It is important to point the focus towards
positive factors like not having children to worry about or the opportunities to change the things and
relationships that never were attended to before.
STEREOTYPES
• Stereotypes and discrimination concerning women and their physical/emotional changes during
this time in their lives causes great concern, especially in our society. Comedians, younger family
members, and males can be extremely judgmental in this time that women need the most
support. In a society based so much on superficial looks it is hard for an aging women to accept
and love herself even when others don‟t. Changes such as wrinkles, vision loss (needing glasses),
or hair texture thinning can all be ammo for the outside world. Others may want to poke fun at
these processes of the natural aging of women but getting older is inevitable and hopefully the
society changes so not every generation of our elders has to go through the scrutiny of the
„beautiful people‟ that are so synthetic with their looks. Aging is beautiful, it‟s a sign that a person
has lived their lives and wonderful experiences/ memories that are personal and mean so much to
them.
4. • Not only is Perimenopause emotional turmoil but the discomfort that plagues
some, if not most women due to the unpredictable fluctuations of hormones
include a variety of “ovarian chaos”: hot flashes, night sweats, nausea, migraines,
weight gain, sore breasts, and sleep trouble
Alleviating Discomforts
• When it comes to menopause symptoms like mentioned above there are natural and medical
remedies, each women is different along with her preferences and then she can find an approach
specific to her needs and wants.
• Non-medical Management includes meditation, yoga, relaxation, regular exercise, healthful food,
enough sleep, and support from family and friends
• Medical Management can be used in addition to non-medical management, this combination is usually
used for those who are suffering from intense or a variety of symptoms. “Estrogenic” effects are fibroid
growth, heavy menstrual bleeding, breast tenderness, and increased response to psychological
stressors. Hormone management involving estrogen and progesterone along with others that play a
role in this transition may need to be added or subtracted using hormone balancing medications.
5. PMS, if any term, is most known to the male population and the butt of most of societies „women‟ related
jokes. The understanding of it from a male perspective is that it just means that they can‟t have sex and
we‟re extremely moody. In reality though, our uterus lining is essentially being torn off the walls of that
organ and coming out of us, I would like to see a man be able to handle that without being on the couch for
a week crying in pain. In reality, women experience all sorts of discomforts during PMS that become even
more severe during early perimenopause and can sometimes carry throughout the end. There is light at the
end of the tunnel! After years upon years of this when perimenopause comes to an end and periods
become irregular and hormones eventually level out.
Normal Cycle includes: Swollen or tender breasts, water retention (bloating), anxiety, sleep disruption, or
irritation.
HORMONES FACTS
• Usually estrogen and progestin can help a menopausal women get through but there are also
nonhormonal methods. These methods include:
Antidepressants: Studies have shown that low doses of some antidepressants can be more effective at
preventing hot flashes than a placebo.
Gabapentin: A seizure medication used for pain control but it has been shown to be successful in treating
hot flashes as well as nausea and fatigue
Clonidine: Used to treat hot flashes, these are anti-hypertensives used best in combination with high blood
pressure.
Non-hormonal: Cutting out caffeinated beverages, avoid smoking, limit alcohol consumption, good sleep,
exercise regularly, relaxing, and filtering out frustrating noises and lights.
6. It seems the more women age the more taboo it becomes to talk about
personal body changes but they are important to know about in Our Later
Years so we can know how to solve them when the problem may arise.
Vaginal Changes usually revolve around the issue with dryness. This could be related to
the hormone changes within a women’s body at that time. This is because as the body
goes through this transition estrogen and progesterone levels decline in late
perimenopause and postmenopause, vaginal walls can become thinner, drier, and less
flexible and more prone to tears and cracks. Less lubrication is produced so it can take
longer to become naturally lubricated during sexual activity. Penetration may be
uncomfortable or even painful and can lead to irritation. Though, lubrications are easy
to get a hold of and as much as society wants us to believe that there is a expiration
date on sexual need is caught under what society thinks is socially acceptable.
Thoughts – It is extremely frustrating that society has built into the minds of younger
generations that older adults or even 90 year olds are not sexual active or do not want
to be. Although physically things may not work as mechanically as younger years this
does not put them out of commission. In my opinion, they should have more shows and
reality tv that is geared towards the older ages being regular individuals not just
grandmas and grandpas
7. In conclusion, Perimenopause is what begins the
whole transition into postmenopause. Once the
madness of hormonal changing and pain ends a
women must find her path for the last third of her
life.
One quote I really like from this chapter is, “There’s
a lot of mutual help; people really listen to each
other and laugh a lot. Now I don’t worry about
menopause or growing older the way I used to”
This is because supportive relationships provided
by friends and family can be the most important
factor in any situation- you can get by with a little
help from your friends
8. Aging and Health - Some women age better than others, just like some women
experience a more symptomatic menopause than others. A healthy life before reaching
menopause is healthiest because after it is harder to keep off the weight. These preventative
measures can ensure a healthier life in the older years, even if not sometimes it can be
reversible.
ITS IMPORTANT TO …
• Engage your mind Activities that stimulate brain activity like crossword puzzles, reading,
and playing trivia games may offer some protection against cognitive decline that comes
with aging
• Go to bed Older adults require the same amount of sleep as younger adults
• Schedule a checkup Pap tests, mammograms, bone density, blood pressure, and
cholesterol tests are important for older women to have annually
It is also important to plan ahead and create a schedule that supports a healthy ,
spontaneous, and ever stimulating lifestyle to keep the brain and body supported and sharp
9. Security means ways to create and support programs
that meet older women’s needs, including:
• Long term care: A continuous care system in which everyone receives care
appropriate to her condition, provided promptly and efficiently in a setting of
her choice and adjusted as needs change.
• Health Care: Protecting and Maintaining Medicare, as well as expanding
access to medical care not covered under Medicare.
• Work-Family Balance: The U.S. lacks policies that adequately support a
reasonable balance. It is important to spend time with family and loved ones
• Retirement security: Laws and cultural
10. Tell one fear of yours towards
aging as a women, as well as a
way to make that fear not a
fear through knowledge from
this chapter.
