Menopause: pause and take control with real solutions

By Vicki Cheeseman, Associate Editor

The word menopause gives most people pause. It happens, but no one wants to talk about it ... until two doctors, David C. Miller and Lovera Wolf Miller, came on the scene and wrote Womenopause: Stop Pausing and Start Living, a book that acts as an informative yet compassionate guide through menopause.

More than 6,000 women reach menopause in the United States every day, and these women can glean much from Womenopause to help them live through the half of their lifetime between perimenopause and postmenopause. The book offers real solutions on everything from hormones and hot flashes to brain and bone preservation, breast health, skin, fitness, food, sleep, and intimacy.

Dental Assisting Digest^™ recently had the opportunity to interview the authors. Lovera Wolf Miller, MD, FACOG, NCMP, is a board-certified obstetrician and gynecologist, a fellow of the American College of Obstetrics & Gynecology, and a certified menopause practitioner. David C. Miller, MD, MA, DABPM, FIPP, ABIPP, NCMP, is board-certified in pain and anesthesiology, has taught neuroanatomy at UCLA, was an instructor in physiology and neurophysiology, and is also a certified menopause practitioner.

DAD: Your new book, Womenopause, promotes what you call a “Menopause Makeover.” What exactly is that?

Drs. David and Lovera Miller: There are two main points to the Menopause Makeover. The first is a more complete understanding of the definition of “menopause” (the pausing of menstruation), including an appreciation of how hormone changes during the transition can affect a woman’s physical, emotional, and spiritual life. The second point to the Menopause Makeover is a clear, fresh look at all legitimate ways a woman can consider to optimize her health at midlife, including nutrition, exercise, relaxation, supplements, and medications.

DAD: You offer a plan for women to feel fit, feminine, and fabulous in just four weeks. How can one make such a transformation so quickly?

Drs. David and Lovera Miller: We have a great deal of experience treating menopausal women and have published data (North American Menopause Society Annual Meeting, September 2008) that demonstrates most women can reduce or even eliminate menopausal symptoms in only four weeks through a combination of lifestyle changes and medical management. Womenopause includes 32 “real-life” vignettes taken from Lovera’s menopause practice attesting to how the Womenopause Challenge results in significant, measurable improvements in four weeks.

DAD: What do most women not understand about perimenopause?

Drs. David and Lovera Miller: Perimenopause is characterized by irregular menstrual periods as a result of declining ovarian function that occurs naturally with aging. The symptoms of perimenopause (hot flashes, night sweats, memory malfunction, mood irregularities, and changes in feelings of well-being) may be quite difficult and occur not because of a gradual loss of estrogen but because of wildly fluctuating estrogen levels in the bloodstream. Some women experience symptoms of perimenopause for a decade before menstrual periods finally stop.

DAD: Do a lot of women fear menopause?

Drs. David and Lovera Miller: Ironically, women appear to “fear” the treatments for menopause and the actual experience of menopause gets dragged into that fear. Womenopause has its sights aimed squarely at dispelling the misconceptions about what menopause means to a woman and how safe and effective menopause treatments are for the majority of women.

DAD: What are some solutions for women who suffer from hot flashes?

Drs. David and Lovera Miller: Women have successfully self-treated hot flashes since the beginning of time. After menopause, the permanent cessation of menstrual periods, hormone levels stabilize (at low levels), and hot flashes generally subside all on their own ... or they may not; 30% of women are still bothered by hot flashes 10 years after menopause; up to 20% continue to be bothered 15 years after menopause. For some women, hot flashes become a permanent part of their life. The biggest no-brainers for taming Hot Flash Fever include strategies that have minimal risk and expense. It is useful to separate the no-brainer choices into two groups. Group #1 includes the bail-out options: dress in layers, use a fan, take a cold drink, dunk your hands in cold water, go outside, and try to think about something pleasant. Group #2 includes the plan-ahead options: stop smoking, exercise regularly, shape your waist (BMI less than 27). Practice a relaxation strategy you can use effectively even when the heat is on, such as yoga. Stay away from known triggers and avoid spicy foods. For the next tier of hot flash control options, many people would list the nutritional herbs and supplements. It is felt they are low risk and not terribly expensive. Some women report improvement in hot flashes with the use of evening primrose oil, soy pills, and the herbal supplement, black cohosh. Scientific data is lacking concerning the effectiveness and safety of these supplements compared to placebo. A more expansive treatment of this subject is covered in Chapter 17. Vitamin E (200-400 IU per day) probably has some benefit in preventing Hot Flash Fever, but do not exceed doses greater than 800 IU per day. Prescription antidepressants are effective in relieving hot flashes independent of their effect on mood for up to 60% of women. Some antiseizure medications may be effective. There is only one medication approved as safe and effective for sever hot flashes by the FDA: estrogen.

DAD: Thank you both for your time.

For more information about Womenopause and the authors, please visit www.womenopausebook.com.