Interview with Claire Gill, founder National Menopause Foundation, by Robin Gorman Newman, founder, MotherhoodLater.com
Can you clarify the distinction between perimenopause, menopause and post menopause? Natural menopause occurs gradually over several years and has three phases:
Perimenopause. Perimenopause usually begins several years before menopause as the ovaries start to produce less estrogen. This phase lasts up until menopause when the ovaries stop releasing eggs. A woman may have menopausal symptoms during this phase as estrogen levels drop. The reduction of estrogen levels speeds up during the last one to two years of perimenopause and menopausal symptoms may be more pronounced during this time.
Menopause. When a woman has not had a period for one full year, she is in menopause. The ovaries have stopped releasing eggs and producing estrogen.
Post menopause. After experiencing menopause, a woman enters the post menopause phase. Hot flashes and other menopausal symptoms stop or lessen, and she can no longer become pregnant. Her risk for other health conditions increase due to increasing age.
Some women experience menopause at younger ages. When this occurs before age 40, it is considered premature menopause. Surgical causes include removal of the ovaries as may happen during hysterectomy. Other causes may include exposure to toxins such as chemotherapy which damages the ovaries or certain medical conditions such as premature ovarian failure.
When do women generally begin menopause? The average age for women to enter menopause is 51. But like so much in our physical lives, it can be different for many reasons. It’s important to pay attention to your physical symptoms and track your menstrual cycle, even as it lessens. If you have no period for 6 months and then start to bleed again one month, you have to start the count to 12 months of no period all over again. Menopause doesn’t officially happen until you’ve had 12 full months of no menstrual cycle.
How long does perimenopause typically last? Perimenopause usually starts several years before menopause, but for some women it’s even longer. We’ve found that many women don’t know this, and it can be confusing when you’re in your early 40s and start to experience symptoms of menopause. How women experience menopause is very different too. Some women have said they barely noticed they were heading into menopause, while others say it was incredibly difficult. Every woman is unique and her experience entering menopause may be different than what is the “average.” This is why I felt it was so important for there to be an organization like the National Menopause Foundation for women to learn about menopause and share their experiences with one another. We need to be informed and support one another as we enter this new phase in life.
Some women are more symptomatic than others. Any reason for that? What symptoms women experience during the menopausal transition varies greatly and can depend on both controllable (smoking, obesity) and uncontrollable (ethnicity, hereditary) factors. There are many ways to manage menopausal symptoms naturally and through hormone replacement therapy. The severity of the symptoms and a woman’s preference will determine how she goes about managing these symptoms. For more information about the most common symptoms of menopause and how to manage them, please visit www.nationalmenopausefoundation.org.
Does having children later in life impact when/how a woman experiences menopause? Pregnancy, or the age when you get pregnant, has not been shown to have any impact on when you enter menopause. One factor that does impact when you enter menopause is when your mother entered menopause, as there is a strong genetic link. This isn’t true for all women, of course. There are other factors that can impact when you reach menopause, including smoking, chemotherapy and ovarian surgeries. The good news is studies show that women who have children later in life tend to live longer.
What should women ask their doctor/healthcare provider about menopause? It’s important to keep up with regular visits with your doctor for preventive health care and any medical concerns during and after menopause. Preventive health care as you age may include recommended health screening tests, such as colonoscopy, mammography and triglyceride screening. Your healthcare provider might recommend other tests and exams, too, including thyroid testing if suggested by your history, and breast and pelvic exams.
If you’ve been experiencing menopausal symptoms, you should discuss them with your healthcare provider. Your doctor may order a blood test to check your levels of follicle-stimulating hormone (FSH) and estrogen. During menopause, your FSH levels increase and your estrogen levels decrease.
What is the National Menopause Foundation doing to support women at midlife? We have several resources to help women learn about menopause and connect with other woman for peer-to-peer support. Our free, anonymous online community, the Menopause Metamorphosis – https://www.inspire.com/groups/national-menopause-foundation/ offers an opportunity to connect with other women and discuss a variety of topics. Our quarterly electronic newsletter, The Hot Flash, provides information and inspiration for women. And our podcast – The Positive Pause – covers topics of interest and importance to women at midlife. We are also working on advocacy programs that will raise awareness about the needs in women’s health on America’s health policy agenda.
Any tips for women to practice good self-care as they experience hormonal changes? First, remember to be kind to yourself. If you can recall how confusing and frustrating it was to go through puberty, it should give us some inclination of what we might have in store as we transition to menopause. There’s a lot going on with us physically, emotionally and psychologically. And we’re also busy with adult responsibilities, whether professional, parenting, and/or caregiving and sometimes all three at once!
Meditation and mindfulness are often recommended for managing menopausal symptoms. It doesn’t have to be complicated. Even a few minutes of meditation a day have been shown to be beneficial. All the things that keep us healthy also help us transition through menopause. For example, eating a healthy and well-balanced diet (including increased consumption of calcium and vitamin D to adjust to our bone health needs as we age) is an important part of self-care. Regular exercise – even just 30 minutes a day – can help provide increased energy, brain power and sleep. We offer other tips for self-care and managing specific menopausal symptoms on our website as well.
What are the biggest physiological changes at this stage of life, and can any be reversed/improved upon? Some of the most common physiological changes that occur at menopause include weight gain (and shift in body fat from our hips to our belly); loss of muscle mass/strength (combat that with the exercise mentioned previously); and loss of bone density (women can lose up to 30% of their bone mass in the first 5-7 years post-menopause). Menopause is a great time to take stock of your overall health and put a plan in place to stay healthy and strong as you age! It’s never too late to start. You can take small steps every day to ensure that you remain active, healthy and empowered throughout your postmenopausal years.
The good news is weight, muscle mass and bone strength are all things that can be improved during and post-menopause.
Can hormonal changes be an emotional and physical experience? Hormonal changes impact us both physically and emotionally. If fact, mood swings, depression and anxiety are included among the list of possible symptoms of menopause because they are a common occurrence for women at midlife. Experts report that women who had severe PMS in their younger years may have more severe mood swings during perimenopause. Women with a history of clinical depression seem to be vulnerable to recurrent clinical depression during menopause. No one needs to suffer in silence. There are a lot of resources available to help lessen the impact of mood swings during menopause, including herbal remedies like St. John’s wort, lifestyle changes such as exercise, and even low-dose oral contraceptives can help stabilize hormone levels and provide some relief.
How can we go about changing people’s perception of menopause and women at menopause? The mission of the National Menopause Foundation is to help bring about a positive shift in how people perceive, understand and experience menopause. American culture doesn’t “prize” aging the way many other cultures do. Women of a certain age are not considered sexy or productive anymore. We’re calling BS on that! Midlife should be and can be the most dynamic, empowering and enjoyable time in women’s lives. We’re committed to sharing how to make that true for all women.
Claire Gill
After working for many years in senior leadership positions at a nonprofit in women’s health, Ms. Gill was surprised to realize there wasn’t a national nonprofit organization devoted to women at menopause, so she decided to create it. With support from a small group of experts in nonprofit management, business and healthcare as founding board members, she launched the National Menopause Foundation in September 2019, to create a positive change in how people perceive, understand and experience menopause through education, peer-to-peer support, activism and research.
Previously, Ms. Gill had a 20+ year career in Public Relations and Marketing for national nonprofit organizations and public relations firms with Fortune 500 clients. She joined the National Osteoporosis Foundation (NOF) in 2013 and served in various roles, including Chief Marketing Officer, Chief Mission Officer and Interim CEO, prior to assuming the full-time CEO role in May 2020.
Ms. Gill is a graduate of Syracuse University’s S.I. Newhouse School of Public Communications. She is a member of the Public Relations Society of America (PRSA) and Les Dames d’Escoffier International (LDEI), a philanthropic organization supporting women in the food, beverage and hospitality industries.
Tags: anxiety, changing hormones, depression, HRT, later in life moms, later in life mothers, menopause, midlife women, mood swings, national menopasue foundation, perimenopause
