This Is Not Your Mother's Menopause

[Guest guest]

> This Is Not Your Mother's Menopause

> Mind & Body

> Wednesday, July 12, 2000 9:00 PM EDT

>

> By Trisha Posner

 

> The opinions expressed herein are those of the guest's alone. If

you have questions about your health, you should consult your

personal physician. This event is meant for informational purposes

only.

>

> Moderator: Welcome to WebMD Live's Mind and Body Auditorium.

Today we are discussing-

 

This Is Not Your Mother's Menopause by Trisha Posner.

>

> A few years ago, at forty-six, Trisha Posner left her annual

physical feeling wonderful -- until her doctor called to report

surprising news: Although Posner had not recognized her own

symptoms,

her blood tests indicated she was in full-blown menopause.

 

When her gynecologist urged hormone replacement therapy, Posner

balked, fearing it might increase her risk of developing breast

cancer, which had already struck her mother and two aunts. Posner

will discuss her quest for an alternative to a woman's usual

choices: take hormones (as most doctors advise), or do nothing and

risk the deterioration of her heart, bones, and mind.

 

She will reveal how she developed a personal program to counter

naturally the annoying symptoms of

menopause, like hot flashes and headaches, as well as the more

serious problems, like depression and loss of sexual desire.

 

> Trisha, welcome to WebMD Live. What made you write this book?

> Posner: I was thrown into finding out that I was in menopause by

my doctor, and was dumbfounded because I was young and was still

getting my period. I was perplexed and started to do research on

where I was going and what I was going to do. My gynecologist was

insistent at that time with hormone replacement.

 

I was leery since there was breast cancer in the family. So, I

decided to do the research and

found there was little for me when I watched all the programs other

than the hormone replacement. So, therefore, I went on this thing on

my own to find out why I was so frightened of hormone replacement.

 

Once I found everything out I needed to know, I felt it was

necessary to put it down for other people because there didn't seem

to be other choices around for people.

 

How could I take everything that hormone replacement said it could

do and duplicate that into a program for my heart, bones, desire,

dreadful weight gain, dry skin and thinning

hair? That's how it came about.

>

> Moderator: Why another book about menopause and why is this one

different?

>

> Posner: I think it's very different because it's written as a

personal journal. It's my journal and it takes you through my

finding out about menopause and through the history of my family. I

think many women can relate to the honesty in it, like the lack of

sexual desire and depression. What I'm telling you in my book is

that it's an empowering experience and a new beginning.

 

It's a natural process and nothing that's abnormal. And it gives you

an uplifting approach and I think a lot of women can say, " Yes,

that's what I was feeling. "

 

I also think there's parts in the book that are excellent for women

who are perimenopause, menopausal, postmenopausal. It's just a

different approach. I think it's also an excellent book for male

members of the family to read, for the husband, brother or boyfriend

to see what we actually go through.

 

My menopause was relatively not too bad at all compared with other

women. There are a lot of women

who've gone through this and their period just stopped with no

symptoms and there are others with horrendous symptoms.

>

> Moderator: Where you ready for menopause when your doctor told you

that you were in it? Was there any denial involved of possible

symptoms?

>

> Posner: I think there was an unconscious denial, not because of

the age thing, because I've never really been concerned about the

age, but I think it was more, " Me? I couldn't possibly be in

menopause.

 

I don't have any symptoms. " It was like a jigsaw puzzle and it was

pointed out to me the slight mood swings, the bloating and the one

big zinger, the hot flashes. And that was a hard one to deny. Every

time I would ask Gerald if it was hot in the room I'd pray he'd

say, " Yes, it is. " But the time I stuck my head in the fridge was

when you have to really look at it. It's like a relief you can't

explain when your head's in the fridge. Once I knew this was going

on, I had an interesting approach. Because I had done so much

research I decided it was time to go to war and let's see what we

could do.

>

> lmae47_lycos: Are you talking about natural hormone replacement

therapy? What about hysterectomy? How would you approach that?

>

> Posner: That's different because that's someone who's put into

straight menopause, which is not what happened to me, fortunately.

But I do think that someone that has that can still approach it in

the respect of taking all the right vitamins and herbs and

exercising to keep the bones strong and doing good things for the

mind and body.

 

It depends also if the woman is of child bearing age or not. I think

it's a much bigger shock to the body, particularly if the person is

young.

It's all of a sudden, you know, " My body has gone into

menopause. " I think it's far more scary, too, than just going into

the natural menopause.

>

> Moderator: Why and how did you decide that HRT (hormone

replacement therapy) was not for you?

>

> Posner: Because being that my mom had breast cancer and the sister

had breast cancer and my other aunt had breast cancer, I didn't

dismiss it completely and felt I had to give it the benefit of the

doubt and through my research to find out why I had the fears. I

found that the risk, as small as it was, was not the route I wanted

to go.

 

I just couldn't afford to take that risk. If I could

duplicate everything that HRT had for my mind and body then that's

what I wanted to do and that's what I was able to do.

 

That's what I managed to do and it worked very well for me.

>

> Moderator: How did you develop your own program?

>

> Posner: I first decided that I had to go and do as much research

as I could, so I went straight to the Internet, of course, which is

a fabulous tool. And, I used myself as a human guinea pig.

 

The one thing I started with first, because 90% of women have hot

flashes, I decided I would take the hot flashes as my number one

guinea pig thing.

 

I considered acupuncture and different homeopathic

approaches, but in the end what worked for me, I found, was black

cohosh and vitamin E.

 

I was very careful because I had read a study in Germany where they

tested the black cohosh. That study appealed to me. I

must say this is very important here - I used very small doses here.

I believe a little less is better. That was how that all came about.

 

 

I'm very careful also which vitamins I use. I use a very high

quality vitamin. But I think you have to be

very careful with quality. In the end, it's really a matter of trial

and error for each person with this whole process as well.

>

> lmae47_lycos: Being your mother and sister have had breast cancer,

doesn't that still put you at great risk with or without HRT?

>

> Posner: Yes, I think it does. But, you know, I think that I'm a

very, very positive person. And I have to say that I gave up smoking

15 years ago. I drink very little alcohol. I do enjoy my wine. I'm

extremely careful with my diet and I exercise.

 

So, my lifestyle is very different from my mother, her sister and

my aunt. I have a

father who had colon cancer and died from it. I don't have the fear

because I believe I take care of myself and minimize my risk, and on

top of that not taking my HRT

>

> Moderator: What did your doctor say about your own clinical trials?

>

> Posner: This was in the beginning a difficult one because I adore

my gynecologist, but he's always been estrogen gung-ho. So, I sat

across the desk from him and my head was spinning as he was spurting

out all this stuff for me: " Your skin will dry up, you'll get

wrinkled, your hair will fall out, your bones will deteriorate, your

mind will suffer.

 

If anything, " he said, " you're probably in failure

right now. " I was like, uh huh. But, in the end, once I finished my

program and went for my second test, his words to me, which were

like a dream come true, were, " Whatever you're doing, just keep it

up. It's fine with me. "

 

I had all the baseline tests, too. Once I decided I would do this on

my own, I took all the baseline tests, like blood

pressure, cholesterol, bone density. When I redid the tests again,

all my numbers were better than before.

>

> Moderator: How should a woman prevent osteoporosis if she is not

taking HRT?

>

> Posner: The thing that a lot of people don't realize is that HRT

will leave your bones at the level they are. So, your bones won't

get any better or worse, they'll stay where they are.

 

The only thing that can actually build bone is with weight bearing

and resistance exercise. Either with using free weights or weight

machines. It doesn't really matter if you use a two-pound weight or

a 15-pound weight, but you need some form of resistance.

That is the only natural thing to actually build bones. On top of

that you'd have to incorporate calcium supplements and vitamin D,

magnesium, some vitamin K, elements of boron.

 

But you basically find out this is really an ongoing situation. In

the news, one minute you're doing the right thing and the next

you're doing the wrong. Enough to put you in the nuthouse.

So, your calcium, and of course, not smoking. If you

smoke, all the good you're doing is just erased. And, trying to

be aware and constantly keep up with what's going on. And, if you

can go online and chat with other women, it helps. I'm learning

every day something new, and incorporating something into my program

and taking something out and it's an ongoing situation for all of us.

>

> Moderator: Did you ever think about phytoestrogens (plant

estrogen)?

>

> Posner: Yes, I did think about that. But, the thing is that the

naturals, with the research I did, the amounts of estrogen and

progesterone in the yam creams was a bit difficult to measure.

 

From what I could read, the studies haven't

come in as of yet where these creams end up. They probably only end

up concentrated in your saliva and not your uterus. So, that's why I

decided it wasn't quite right for me. And the symptoms that the

progesterone sometimes experienced were menopausal as well. But I

know some women who use them are happy.

We're all individuals and we

have to inform ourselves and be aware which is right for you and

which is right for someone else. I think it's important to make

individual choices.

>

> Moderator: How did you deal with thinning hair and dry skin?

>

> Posner: I've always had very good skin, so this was a real shock

for me. I started taking evening primrose oil, which I think is

absolutely fabulous.

 

Or, for women who have PMS (premenstrual syndrome), it's good to

take evening primrose and vitamin C because

it promotes collagen.

Burdock, red root clover, echinacea, selenium.

A whole bunch of things to see if they appealed to me and my body. I

used richer creams, too.

>

> Moderator: How did you take evening primrose - capsule or oil?

>

> Posner: I take it in capsule and sometimes it will say take two to

three a day. But, because I'm taking so many other oils, I only took

one a day. And, also for the hair, the evening primrose oil is

excellent as well.

>

> Moderator: What does the royal jelly do?

>

> Posner: Royal jelly is also very good for the skin and hair

because it's an oil base as well. I'm very careful and decide how

many of these things I need to take.

>

> lmae47_lycos: Did you do any research on compounded HRT and, if

so, how does it compare with over-the-counter products?

>

> Posner: I did a little bit, but not a tremendous amount, I must be

honest. I didn't do a lot of research into that. I thought it looked

more effective than over the counter, but I didn't do enough

research to really say to you this or that about it.

>

> Moderator: How could you be sure your results would be good?

>

> Posner: I don't think one really knows. It's like anything, you

approach it and hope you're positive. It was about a year experiment

and I didn't know, but I knew as I was doing it, things were

definitely feeling different and I was feeling better so things had

to be working. The exercise, for instance, I was just astounded.

>

> Moderator: Let's talk about diet and exercise.

>

> Posner: If this had not worked for me, then I might have had to

reconsider HRT. I gave myself the benefit of the doubt and gave

myself a good year. First of all, I was someone many years ago who

used to do yoga and pilates, which I love. They're really good for

the mind and body. And I had done the typical classes you have at

any

gym. And a little bit of weight training and stretching. But I found

by using my dear husband as my trainer to give me this weight-

training program, I started with tiny five-pound weights. I was just

astounded, at my age, how my body changed. I couldn't believe it .

 

It was so subtle. But bear in mind, I'm a very patient person and

don't need instant gratification. If you said to me it would take

six months to a year to see changes in your body, I'd say, okay,

fine. I would look at my arms and say, are these really my arms? I

wanted definition in my arms my whole life.

 

Diet also. I'd take one bagel,

which I found from research was a whole day's carbohydrates. I was

astounded. I turned all the white products to brown products. White

rice to brown rice, White bread to whole wheat. I'm not on any fad

diet, I just call it an eating plan.

 

I keep fats very low. I've never been a red meat eater, so chicken

and fish was the main thing,

vegetables and grains. I lost a considerable amount of weight and my

body fat went from 34% to 17% It probably took about a good year,

but

I was in shock. People would come up to me and say, " Oh, you've lost

so much weight. " And I'd say, " Have I? " I'd go to a shop and try on

a normal size that I usually tried, about a six or eight, and then I

would just go to the next smaller size and said to the

salesgirl, " Are these clothes cut larger? " I was amazed that I could

do this at my age. I was always programmed to believe that after 20

and 30, forget about it. You won't get yourself in shape. But, with

that weight loss and with that, my bone density test was even

better.

 

My heart was better. I was this person who hated gym exercise. Then,

I started to get into it because it was so gratifying and I started

to get like a high from it. And, I say to myself, if I can do it,

anyone who puts their mind and a little bit of discipline, and if

you

want it badly, I don't think it's hard for anyone to attain this.

>

> marionb1_webmd: Isn't her program a lot of work?? Seems so much

more difficult than going on HRT, no?

>

> Posner: No, I really don't think it is a lot of work because it

just becomes like a way of life, like getting up and cleaning your

teeth. Let's say you're scared of hormones and so you take one HRT

pill and worry for the rest of your life what's going to happen to

you. Everyone wants the one pill to just take care of everything.

It's really not such a lot of work. We're willing to work hard at

other things, but when it comes to our mind and body, we don't want

to do it. I know more women who spend more time researching a hair

dresser than they would research menopause. But, no, I say to you

it's such an easy thing for me to do now. It's no work whatsoever.

It's a little discipline, maybe that's the word to use.

>

> Moderator: Do you think that the women of the Baby Boom generation

are going to change the face of menopause over the next 15 years?

>

> Posner: I hope so. I pray so. I mean, it's just, we need to pull

down the walls and say, hey, I'm in menopause and it's just great.

 

We've got to get rid of the shame The most important thing is that

we must get rid of the shame because it's no shame. It's a fabulous

time.

 

We've got to tell people we're great, I feel great, I'm in a

new stage of my life. For me, it was like a rebirth, like

saying, " Okay, I'm going to reinvent my self all over again. "

>

> Moderator: Why do you think there is so much shame associated with

it?

>

> Posner: I think here, my cousin in London just got the book from

the library out there. She's about 54 and we were having this

discussion, and we believe there is such an age-obsessed country

here

in the U.S. And, the sexuality thing. Women are scared that men are

going to think that now that she's not menstruating then she's not

sexy.

 

Just read that book, Feminine Forever written in 1966 by a New

York gynecologist, Robert Wilson and you'll see. It was a best

selling book and it was financially backed by medical labs that

produced the most widely prescribed estrogen replacement.

 

He talks about his mother as being like the most dreaded thing for

him that ever happened and that women, once we stop menstruating,

are like castrated.

 

He was classifying it as an estrogen deficiency disease,

and it's just a natural thing. I think that the women of our

generation have the power to say, that is it, there's nothing wrong

with this, this is a great time of life and we are menopause babes

and we're out there and we're coming out. We have choices. That's

why

 

I call it, This is Not My Mother's Menopause, because my mother

who's 87 went to the doctor one day and he said, " You have to take

this pill, " and she went home and took the pill and that was the end

of it.

 

But we have so many choices and have so much power in our hands

and we just don't realize it. I have an extraordinary relationship.

But, I always say I paid my dues in finding the man of my dreams and

we've been together 20 years and we're partners and we work

together.

 

I must say this to you that, believe it or not, a lot of guys send

me letters thanking me for this book. I've had guys saying, " This

book has really helped me understand my sister, my mother, my wife.

I've read it twice and the things you talk about in there relate to

me as a man in my fifties. " I think a third of the reviews are from

men and I'm very proud of that.

>

> lmae47_lycos: Now that I don't understand. Why shame? Every woman

will go through this, it is not a disease. I have heard it referred

to as that too

>

> Posner: No, it's not a disease. It's just a natural thing. It's

like getting our periods was a natural thing. It's just another

passage that we go through. Quite frankly, for me, it was so

liberating for me to burn those tampons!

>

> Moderator: You actually burned your tampons?

>

> Posner: You know, it's very funny, I am a little bit of a whacko

when it comes to shopping. Being British, I love all these big

places

like Costco and all that. And Gerald always says I'm stocking up for

World War III and I bought so much of them. And I used to say to him

as soon as menopause hit I'm going to burn those things. And he took

me quite literally and we had a nice little bonfire. That's why I

say the book does have that side of humor to it, which you can

really appreciate.

>

> sammy49_webmd: May I ask the title of the book?

>

> Posner: My book is called, This is not Your Mother's Menopause:

One

Woman's Natural Journey Through Change and it's available at

www.barnesandnoble.com. The web site is www.posner.com where you can

also find out more and get the book. You can also find my husband's

work there, too. He also has a show on the History Channel every

Sunday morning at 10:30. It's a wonderful little show. He's one of a

panel of four men on this show

>

> lmae47_lycos: Off the subject a little: You say your father had

and

died from colon cancer. Have you had the screening for this?

>

> Posner: I'm going in November. I think actually a great person who

has done wonders for that is Katie Couric. I think it's a test that

all us ladies when we're at least 50 because it's one of those tests

that if they find everything early you're just A-OK. My uncle had

that done and he lost it for 20 years afterwards. I'm pretty good. I

go for my mammograms. In fact, I'm going next week for that. I do

all my tests each year, like my eye exams.

>

> Moderator: Did you have to rethink your relationship with tofu and

soy during menopause?

>

> Posner: I did think about it, absolutely. I'm very open-minded and

to be very honest with you, I cut down on it a little. It did bother

me a little. I cut down a little on the soy supplements I was

taking.

The more I looked into it, it made a lot of sense on that. All that

about Asian women are brought up on soy and in America we just

incorporate it into our diets now and it made sense. I'm open minded

that way and always willing to learn.

>

> lmae47_lycos: Just a side note: I have had the colonoscopy. It is

not the monster I thought it would be. It was quite easy, no pain,

and my only complaint was that I was hungry, so I urge all to get

this done. No one should have to die from colon cancer.

>

> Posner: Fantastic! Thank you! I appreciate that. It makes me feel

better. For November I'll make my husband take me out for a fabulous

dinner after!

>

> Moderator: Let's talk about the depression and the mental aspect

of menopause.

>

> Posner: That was a very interesting one. I am, by nature, a very

up

person. In the morning, as soon as I get out of the bed, I'm very

happy and it was very confusing and scary. I would look at Gerald

sometimes and I'd say I'm so blue I'm going to cry. He'd say why?

 

And I'd have no idea. That was prior to my doing research into this.

I'm not an expert because I'm not a doctor, but I think that the

combination of all these hormone changes going on in your body and

then all the information you're getting in itself can be quite

downing.

I have to really say this, that anyone who suffers from

clinical depression I have such sympathy for them because mine was

so

mild. It's impossible to describe, but nothing can make you feel

better. You feel like your soul has been robbed from you.

 

But once I started to get control of my menopause, I think my

mental attitude changed. I'm such a control freak that I think it

gave me that little

zest for it to come back. I don't really know which pill or which

herb, but it could have been the gingko, or a

combination of many things, or the exercise, or a bunch of things,

but I did not try antidepressants because it wasn't consistent

enough.

 

I would have it and then it would disappear for days. The

only thing I did consider was St. John's wort, but by the time I

thought about it, I was luckily over that period. You feel like

you're going mad, actually, and I really have a lot of sympathy for

anyone who's going through it.

>

> Moderator: You mention in the book that are other societies where

women of this age are revered. Why are Americans so afraid of it?

>

> Posner: I think, unfortunately, it goes back to we're obsessed

with youth. I'll bring it into movie careers, like once a woman goes

into her forties they're done, finished.

 

It's not like that in England. I have a girlfriend where she's tried

so many times in soap operas to

introduce a healthy, vibrant woman going through menopause. They'll

do gay issues, AIDS issues, incest, abortion, inter-racial

relationships, single motherhood, but they will not put menopause

in.

In fact, she wanted to use me as this healthy vibrant woman going

through this and they wouldn't have her put it in. They think it

takes the sexiness away. I mean, why can't we be sexy?

>

> marionb1_webmd: I've heard about essential fatty acids (EFA) being

good for you. Do you use this and do you think it's worth adding?

>

> Posner: Oh, yes, definitely. Being that I'm on a low-fat diet, I

think essential fatty acids scare a lot of women. They're not fat.

They're very good for the heart. And, it's just good for an overall

thing, like high blood pressure, especially if you have a

deficiency.

It's especially good for cancer, allergies, arthritis, Your immune

related diseases. But I recommend keeping them in the fridge during

the summer. We can't manufacture them and that's why we need to put

them in. That's why I eat a lot of fish, by the way, which contain

the omega-3 fatty acids.

>

> sammy49_webmd: Luckily I have a great little eight-year-old to

keep

me busy and feeling young, but what symptoms should I look for? I

feel so young and cheery at age 49 that I wouldn't know what to

expect! I will read your book!!!!

>

> Posner: Well, I think it's very hard because I never would known,

as we've just discussed, but I went for this test called FSH

(follicle-stimulating hormone) which a lot of doctors give, a

follicle stimulating hormone test.

 

Normal ratio is between 2 and 10. Mine was 150! One hundred and

fifty is you're out of here. You're a menopause baby ! You're gone!

This is exactly what we're learning. I never knew this. My first

thing is that I got my period and spotting

is not a real period. So, I didn't believe him and went for another

blood test. Menopause is technically one year after your last

period.

 

That's something we don't normally know. What we think of as

menopause is really perimenopause. You could be in perimenopause and

not be aware of it because eggs stop dropping at 40 anyway. Some

periods will get shorter and some will get heavy clotty when you're

in perimenopause as well. Some symptoms are so mild you're not even

aware of them, like my migraines and tender breasts. Bloating. I've

always had those. Things that look normal are so subtle that you

keep making excuses.

 

Well, I've gained weight around my waist because I'm

49. And you can always go and have that FSH test. A lot of things in

the book are wonderful for any woman at any age. There's a little

bit

for everybody in there. I've had women on HRT that tell me they've

picked up things from my book that have been helpful. I had a friend

who had to go on HRT.

 

She had that condition where her skin starts crawling and she was

sweating through three uniforms. She still took

parts of my book to help her as well. So, you can incorporate both.

>

> Moderator: Has your doctor changed how he prescribes HRT since

you've written this book?

>

> Posner: I don't think so. I gave him the book and I wrote in the

inscription, " I know we don't always agree but I'll still love you

to the end. " I showed it to his wife as well who's an allergist. I

don't think my gynecologist will ever change. I think he's a hormone

junkie. He believes in it and that's his thing. He's a great

gynecologist and I wouldn't continue to go to him if I didn't think

he was. It's just we have a difference of opinion.

>

> Moderator: How long will you stay on this course of treatment? For

the rest of your life?

>

> Posner: Certain things, yes. But I've already started to eliminate

the double estrogen. I've eliminated the black cohosh. It's always

in motion. You're always changing.

 

I had mentioned before about my eyes. I just added to my program

bilberry and lutein, which I took because my mom has a macular

degeneration. With my program, it's very

different from HRT because with HRT if you stop taking it you

actually lose the benefits. But, with me, I'm eliminating things. I

no longer have the hot flashes so I'm eliminating those things. But,

I won't eliminate the calcium or the 400 IU vitamin E, or the

evening primrose oil. But, there are things I know my body doesn't

need if I've been treating it for certain symptoms. There's always

adding and taking things out. It's constantly changing.

>

> Moderator: How long did your hot flashes last and how do you know

that they've stopped if what you took covered up the symptoms?

>

> Posner: First of all, I did the experiment with it. By eliminating

the estrogen and ended up with my head in the freezer, because it

boosted right up again. But I started to cut back and see what would

happen. I would do every other day and then every three days. So

far, since I've cut back and I'm back on my low dosage, nothing,

thank God, is happening as of yet. I now take a low dosage of

vitamin E and maybe occasionally I'll take the black cohosh every

three or four days. So far it's been okay, but it's trial and error.

>

> Moderator: What is your view of menopause now that you've passed

through it? What can other women learn from your experience?

>

> Posner: I think menopause for me was an empowering experience. I

don't know why it gave me a zest and confidence I didn't think was

possible.

 

I think something women should listen to that comes from

Margaret Mead, the post-menopausal zest, it's real and it's been the

most fantastic experience of my life and I wish I could get like

fairy dust and sprinkle it all over women out there and say it's

going to be a brilliant time and not to worry. It's like a new stage

and new life and everything new is coming up for me. I feel so free

from it.

 

I feel fantastic. I really wish I could share this with so

many people, I wish I could take what I'm feeling in my body and put

it in a bottle and give it out freely to everyone. It's just a

wonderful time. Just get rid of the shame.

>

> Moderator: Do you have another topic for your next book?

>

> Posner: I'm toying with a few things. I might do something with

nutrition with women and health. I think I like this whole thing

with women and health. As I'm learning about my mind and body, it's

a great thing to share with other women. I think I'll make it more

on a thing about choices and being informed and independent and

confident.

 

Really out there for the consumer. I enjoyed sharing it. If I only

hit one woman out there, then that's great.

>

> Moderator: Trisha, thank you for joining us. WebMD members, please

check the Live Events Calendar for the next live event.

>

> The opinions expressed herein are those of the guest's alone. If

you have questions about your health, you should consult your

personal physician. This event is meant for informational purposes

only.

>

> Copyright 2000 WebMD Corporation. All rights reserved.

>

> webmd.com/content/article/1700.50868