The prevailing attitude of the medical profession toward menopause is that it is an illness. Hot flashes, depression, insomnia, fatigue or a dry vagina are thought to be due to a slowing down of the ovaries and, therefore, are treated with hormone-like drugs.

When women seek information about menopause, they often encounter a number of common myths:  

• that the ovaries stop functioning and a woman is infertile;
• that a woman has an estrogen deficiency and, hence, a hormone imbalance;
• that a woman gains weight and her bones become brittle;
• that estrogen replacement therapy (ERT) will correct problems associated with menopause.  

There is no scientific proof for any of the above suppositions! In fact, 

• a healthy woman's ovaries function throughout her life and continue to produce hormones and, less often after menopause, eggs;
• a woman frequently has higher estrogen levels after her periods cease, and there is no ideal balance to be disturbed;
• androgens, which influence the libido or interest in sex, continue to be produced and, in many women, tend to be higher after menopause;
• estrogen replacement therapy can, at best, temporarily mask the symptoms blamed on menopause. At worst, by suppressing ovarian activity, it can cause the ovary to atrophy and also increase a woman's risk of cancer.  

With regard to menopause, doctors never talk about the aging process. Highly regarded hormonal specialists, however, know that the severe symptoms blamed on menopause are due to the aging process or, even more likely, to lack of exercise, an inactive sex life, constant stress, ill health or vitamin deficiencies. We are made to think that it is beyond our power to correct these problems without medication. In truth, efforts made to change diet and to increase exercise are richly rewarded with improved health, more energy, a toned body and elimination of so- called menopausal symptoms.

Women do ovulate after menopause, but much less frequently than before. Fertility is, after all, dependent upon other factors besides ovulation: particularly the availability of a healthy, fertile partner and an active sex life. In addition, there are hosts of identifiable outside influences, such as cigarettes and alcohol, the Pill, tranquilizers, poor nutrition, poor circulation, a poorly functioning thyroid or liver damage, which can affect the ovaries and hormones adversely.

The symptom most often associated with menopause is the hot flash, which is also symptomatic of hypoglycemia (low blood sugar), a condition that affects a significant percentage of the population. A dry vagina, another frequent symptom, is also very common among women who do not have frequent sex. And the loss of a sense of well being or depression is a widespread phenomenon among people in their middle years.

Hot flashes, or hot flushes, are uncomfortable, inconvenient and sometimes frightening to many women. A feeling of warmth all over, disorientation, tingling in the hands and feet, insomnia, nervousness and headaches are sensations that many women experience. Many say that they tend to sweat profusely during and after a hot flash. (Sweating is the body's attempt to cool itself and is a natural reaction to heat.)

While hot flashes are disconcerting, they are not dangerous. Some women choose to live with them until they go away, instead of taking hormone-like drugs, and try instead to do strenuous exercises and to improve their nutrition. Women who have infrequent opportunities for sex have found that masturbating often increases vaginal lubrication. If you have a tendency to have a tender or dry vagina, some home remedies can be soothing and can help make sexual intercourse more comfortable. Aloe vera gel, yogurt or the kinds of ointments used for diaper rash applied to the skin are often helpful. Unless you have an infection, douching is one of the worst things to do; it robs the mucous membranes of any natural lubrication they have. Likewise, using so-called "feminine deodorants", which contain harsh chemicals and alcohols, can intensify a tendency toward dryness. Tight-fitting pants can also make matters worse and encourage infection by preventing air from circulating and adding stress to tender tissues.

Replacement Therapy
If menopausal symptoms are not caused by a lack of estrogen, then why do physicians prescribe estrogen replacement therapy?

Women do notice dramatic changes when they take hormone-like drugs. The drugs "pump up" cells, causing them to retain water. This can make wrinkles less apparent, the mucous membranes of the vagina more supple, and increased cellular activity can create a sense of well being and more energy. These "benefits," however, disappear when you stop taking the drugs.

*Material is adapted from A New View of A Women's Body, Federation of Feminist Women's Health Centers, Feminist Health Press, Los Angeles, CA, pages 76-77.