Not Going Down Without A Fight — How To Conquer Menopause

Letting the hands of time march forward without the (self-inflicted) drama and self criticism is VERY mature. Although I’d like to be one of those women who embrace the wrinkled skin, go gray naturally, and rejoice in the sagging southwardly breasts that can be tucked into your pants, I’ve not completely given up all hope…yet.

Aging gracefully is a very admirable concept.

Though I’m happy to say I don’t define myself by my physical appearance, I recognize that my age IS “only a number” (no matter how staggeringly high…). That said, I do NOT plan to go down without a fight!!!

So for those of you in your late 40’s to late 50’s out there who are in the throes of…or well past the menopause, this tip is for you, my dears.

As a gynecologist, I’d say that the five biggest menopause related concerns are the following:

1. Why has my skin aged overnight?
2. Why can’t I lose a pound no matter what I do?
3. Why is my vagina like the Sahara desert (not dessert)?
4. Why do I pee 100 times a day and occasionally all over myself, if I laugh, cough, sneeze, or god forbid attempt to RUN anywhere?
5. How can I stop the sweating and flashing all night long so I can actually get some sleep?

Here are a few tips and tricks to conquering these menopausal annoyances.

Why has my skin aged overnight?

Reason: Good-bye period means good-bye estrogen, the hormone that makes your skin soft, smooth and full. It’s your natural filler and prevents wrinkling and thinning of the skin.

Answer:

• Hormone replacement: you can try to replace estrogen by using hormone therapy, but the minute you stop using it you will be back to square one. So if that doesn’t appeal to you, then the next best thing to do is to take your skincare up a notch.
• Retin A derivatives (stronger prescription strength) or retinols (weaker and less irritating) are highly recommended to reduce fine lines and wrinkles at the most superficial skin layer and can prevent age spots and signs of aging.
• Vitamin C is a key antioxidant to protect you from sun damage and is needed to make collagen and elastin — Two components that give your skin a soft, smooth appearance.
• Be liberal with the sunscreen!! Try to avoid sunscreens containing any of these Six TOXIC ingredients: avobenzone, oxybenzone, octocrylene, homosalate, octisalate, and octinoxate. Stick to those with zinc oxide.
• Build your collagen with non-invasive, minimal downtime microneedling radiofrequency treatments. Morpheus 8 is the new kid on the block and is one of the leading devices used to target the deeper layer of your skin (the dermis) for reducing wrinkles and thinning skin.
• Eat tons of vegetables and healthy fats with omega 3’s.

Why can’t I lose a pound no matter what I do?

Reason: There isn’t typically one answer here so this may take a bit of a deeper dive with your healthcare practitioner. You have to face a few hard facts. What worked in the past, is just not going to cut it now. Why?

• Your metabolism slows down with every decade of life. The loss of female hormones adds to this metabolic slow down. I have found that most of the time women are not eating correctly for their metabolism.
• There is a lot of sugar insulin imbalance going on. This requires a very detailed look at what and when you are eating. Intermittent fasting and sticking to two or three meals a day max is a big help.
• Muscle mass goes down with age — strength training is more important than cardio. I repeat MORE IMPORTANT.
• You are at an age where your liver needs help to filter out toxins. Toxic build up is a leading cause of weight gain. Figuring out how to improve your toxin offloading is key to weight loss.
• Are your other hormones in trouble? Are your stress hormones like cortisol and adrenaline out of whack? Is your insulin too high? Is your thyroid under active?
• Is your gut working properly? This helps to exit toxins from your body.

Answer: This of course depends on what factor or factors are at play. Consider getting a thorough assessment to uncover your underlying reasons for weight gain.

Why is my vagina the Sahara desert?

Reason: Once again, the lack of estrogen reduces collagen and elastin vaginally. This leads to less blood flow, less lubrication and moisture, and less elasticity. AKA: the Sahara.

Answer: Replacing estrogen or at least reproducing the effect of estrogen works wonders here.

• Non-hormonal options: look for topical vaginal treatments with moisture enhancing ingredients like hyaluronic acid, vitamin E and aloe.
• Use lubricants during sex — why cause more friction? (See what I did there? I even amuse myself sometimes…well, a lot, since Covid, but I digress.)
• Hormonal treatments: topical estrogen is transformative and works well. You must use this 2 to 3 times a week to maintain the benefit. Avoid applying it prior to sex, unless, of course, you want your husband to get more in touch with his feminine side.
• Downsides are that you have to keep using this until you want your dry vagina back and there is some amount of estrogen absorbed into your blood. If you don’t want or should not have this exposure then keep reading.
• Vaginal laser – Femilift or radio frequency – Forma V — these devices require three treatments up front to stimulate collagen and elastin and then one treatment a year to maintain the benefit. Great for those of you who don’t want estrogen, or don’t want to keep putting creams in vaginally at night. Downside is that it’s a bit pricier up front, but probably over time about the same as using prescription estrogen.

Why do I pee 100 times a day and occasionally all over myself if I laugh, cough, sneeze, or god forbid attempt to RUN anywhere?

Reason: Also related to the lack of estrogen and thinning tissue supporting the bladder structures. Also, muscle weakness can increase with age leading to weaker bladder and sphincter muscles.

Answer:

• Hormonal treatments: topical estrogen is also helpful here. See above for further information.
• Vaginal laser (femilift) or radiofrequency (Forma V) — these devices require four treatments up front to treat urinary stress incontinence. I usually recommend a combination of both ablative laser and deeper radio frequency to tackle bladder weakness.
• Vaginal testosterone weekly paired with pelvic floor exercises like Kegel’s are helpful.
• Surgery for severe incontinence or patients with prolapsed genital organs. Meaning, they are hanging low.

75-80% of the time we can get reasonable control over night sweats by fixing your diet and stabilizing blood sugar, reducing stress hormone levels and normalizing them and reducing body inflammation with non-hormonal supplements

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For more information about my wellness programs and my practice, check out my website drsadaty.com. Hey Look! You are already here…

Ready for the legal disclaimer? Information offered here is for educational purposes only and does not constitute medical advice. As with any health recommendations, please contact your doctor to be sure any changes you wish to consider are safe for you!