Menopause. While it’s a normal part of a woman’s life, it isn’t something that has been well studied or something doctors discuss much with patients.

Meg Jewell, an ob/gyn with Barton Health in South Lake Tahoe, is doing her part to change the narrative. She recently gave a talk called Insights into Midlife Hormonal Health for Women.

She is the only doctor within Barton’s system who has specialized training in menopausal medicine.

            “Women’s health research is historically underfunded, receiving only about 1 percent of health care research and development for female specific conditions beyond oncology,” Jewell said. “Keep this in mind when you are voting.”

She pointed out it’s common for doctors to receive zero training in menopausal health. Considering it’s possible for a woman to spend 40 percent of her life in this phase, there is a huge void in expert knowledge.

            Jewell said the medical system in the U.S. is not designed to evaluate the whole person because people are referred to specialist after specialist. She said it’s not uncommon for a primary doctor to prescribe anti-anxiety medication when in fact “often hormones are the cause of underlying symptoms.”

(Graphic: Barton Health)

Mood changes are the norm, with 58 percent of perimenopausal women ages 45-55 reporting anxiety and 62 percent showing signs of depression. The cause is often fluctuating hormones and sleep disturbance.

Perimenopause is the transition from reproductive years to menopause. On average the transition takes four to 10 years. Post-menopause is defined as one year after the final menstrual period. This occurs because of the reduced function of the ovaries.

“It is a time of rapid hormone change,” Jewell said.

While menopause is making headlines of late and is a common topic on social media, Jewell warns people to be careful where they get their information and medicine from.

What most people associate with the transition is hot flashes and night sweats, with four out of five women experiencing these—often starting in perimenopause. Only 20 to 30 percent of women seek medical advice even though these symptoms can last seven or eight years and into menopause.

More than half of women say menopause affects their sex life—and not in a good way other than no longer having to worry about getting pregnant. Jewell hopes more research will go into why women have a low libido.

She said exercise is the most important thing a woman can do because it improves mood, sleep, stress level, cognitive abilities, and metabolic health. She advocates for 150 minutes of moderate or 75 minutes of vigorous intensity every week, along with two days of resistance training.

Movement is also necessary because weight gain is common. Eating “real” food and getting enough fiber and protein are key. Calcium and vitamin D need to be monitored as well to ensure women are getting enough; this can be achieved through nutrition.

Other negatives associated with menopause include increased risk of cardiovascular disease, which is the leading cause of death for women. This includes heart attack, stroke, high blood pressure and heart failure. Osteoporosis is another threat. In fact, there is a high mortality rate for those who sustain a hip fracture after the age of 65.

Muscle mass decreases, cholesterol increases and increased insulin resistance are normal.

Drugs can help with some issues. Hormone replacement therapy (HRT) is another option to counteract the depletion of estrogen and progesterone. HRT got a bad rap for years, but more recent studies are proving its effectiveness.

Alternative therapies showing promise include cognitive behavioral therapy, hypnosis and mind body therapies like yoga, deep breathing and meditation.

Jewell first likes to start with working on sleep, nutrition, exercise and stress management.

Notes: A version of this story first appeared in the Tahoe Mountain News.