Back in our teens, most of us had an adult in our lives who gave us “the talk”— advice on what to expect as puberty changed our bodies, and how to navigate the experience of our hormones going haywire. Often, those trusted adults would tell us about their own experiences in puberty, too, including what they worried about at the time, and all the things they wish they’d known back then — which made the coming changes in our own lives feel way less scary and more manageable.
However, most of us haven’t had a similar experience when it comes to menopause. In fact, a recent study showed that only 9% of women talk to their mothers about their menopause experiences — despite the fact that we can often glean knowledge, insights, and crucial health information about our own menopausal transitions from these conversations.
It’s definitely time for a change. That’s why Stripes hosted the live event, Hi Mom! How Was Your Meno?, in which board certified OB-GYN and creator of The Galveston Diet, Dr. Mary Claire Haver and her daughter, Katherine Haver, a senior Nutritional Health student at Louisiana State University, discussed inter-generational communication about menopause. In their conversation below, they have the menopause “talk” we’d all like to have, touching on everything from practical information about symptoms, to hopes for future generations. Read on, and steal these questions for your own menopause talks.
Check out Dr. Mary Claire Haver’s favorite products here.
What were your symptoms? What symptoms do we have in our family?
Dr. Mary Claire Haver: I don't know if I ever told you this story about my mother. She had had a hysterectomy shortly after her last baby at 43, and she suffered terribly from menopause. I remember going into this dark room, and she was under the covers, just absolutely miserable.
She was prescribed this “miracle medicine,” which ended up being estrogen — I think it was called Premarin back in the day. Then her doctor took it away from her right about the time that I got my medical license. My dad called me very upset, out of concern for my mom, and literally begged me to write her the prescription to put her back on her hormone therapy.
And I did, even though I was fearful because of the Women's Health Initiative study and all the information that had come out [at that time about HRT]. But he said, “She's not able to function without it and I'm worried.” I kept that at the back of my mind when I started my own menopause journey and decided to go on hormone therapy myself.
Katherine Haver: I remember her talking about hot flashes when I was younger. I didn't really understand what it meant at the time, but I do remember her being like, ‘Oh, I'm having a hot flash’. So it's definitely been in the background for a long time.
Dr. Mary Claire Haver: The first physical menopause symptoms that I noticed in my own life were hot flashes and disrupted sleep, and it was awful. If you're not getting the recommended amounts of sleep and you're not getting restful sleep, nothing in your life goes well. At the time, I was also working crazy 24-hour shifts at the hospital, so there were at least two nights a week where I was going without sleep due to my job, and then I was coming home and having massively disrupted sleep due to menopause. That was pretty terrible. The hot flashes were awful. I also lost a ton of hair and that was distressing.
Katherine Haver: I remember you talking about weight gain and hair loss. There were also other symptoms, like burning tongue and frozen shoulder, that sounded really scary.
Dr. Mary Claire Haver: I created the Galveston Diet — an anti-inflammatory nutrition program and community designed for those in perimenopause, menopause, and beyond — because of the weight gain in my midsection.
There are things that you'll do to maintain your homeostasis that work amazingly well in your twenties and thirties — and then all of a sudden, they stop working. I don't want you to get hit by a brick wall and feel like you're helpless and hopeless. I want you to walk into this prepared and understand that these things could happen and that you have some clear strategies on how to move forward.
Katherine Haver: I think conversations like this, asking your mother-figure, “how old were you when you started experiencing symptoms? And does that mean I could also experience them?” are so important.
How do you know if you’re going through menopause? And can some of the symptoms be mistaken for other conditions?
Katherine Haver: What do you think is the first thing that people should look for to know if they’re in menopause?
Dr. Mary Claire Haver: Most people understand that your periods become erratic and then stop. Most people understand that hot flashes can be a part of this, as well as night sweats, and mood changes.
But there are over 40 symptoms that can be associated with declining estrogen levels. There is not one organ that is not affected from the decline in estrogen. Your skin, your bones, your teeth, your hair, your kidneys, your heart, your lungs, your brain — especially your brain. The decrease in cognitive function is huge, so most women in perimenopause will know that something has changed. But because we are so biodiverse and individual, our symptomatic profiles are never going to match. Just because my hot flashes were severe and your grandmothers were, too, does not mean that yours are going to be.
Also, doctors aren't great at recognizing perimenopause because we don't have a checklist. Out of all the possible symptoms, you might have two, you might have all 40, you might have none. It really takes someone who knows what they're doing and who can rule out other conditions. Hypothyroidism looks a lot like perimenopause, PCOS looks a lot like perimenopause, autoimmune diseases can look a lot like perimenopause, osteoarthritis can look like perimenopause. You have to rule those out, then you can start talking about perimenopause treatment.
How do you keep your body healthy throughout your life?
Dr. Mary Claire Haver: Since you have a nutrition degree, what advice would you give people your age right now about staying healthy long-term?
Katherine Haver: I would say: go to the gym. Muscle building is important and I think a lot of us, due to diet culture, are very scared of getting bulky. We’re scared of eating too much and gaining weight. However, there’s importance in growing muscle and maintaining muscle throughout your twenties, thirties and forties. Muscle is the organ of longevity and it's what's going to keep you getting off the toilet with ease at 80. It helps with insulin resistance and many other metabolic things.
I recently started lifting weights and it's partly because of everything that I've learned about the importance of building muscle and prioritizing protein. Don't worry about getting bulky — worry about your bone health and keeping up movement.
Dr. Mary Claire Haver: I think the societal pressures of having a smaller body have really wreaked havoc on our overall health and made us equate the number on the scale with health. When is that number really an accurate way to measure health, Katherine?
Katherine Haver: The scale only tells a part of the story. Undereating and chronic dieting make people lose muscle mass, and women who are hitting menopause are impacted by that. I'm so glad that little girls growing up now will have this body positive influence and hopefully we'll all live longer and break fewer hips in the future.
How should the next generation address menopause?
Katherine Haver: What do you think is the future of menopause care? What do you think is something that my generation can look forward to? What is the upside of this?
Dr. Mary Claire Haver: The U.K. is currently the leader in menopause care. When a woman has a menopause visit, before she even comes in, her doctors go through her history, her symptoms, and they start making a plan for her treatment and care. It’s a premenopause visit — like a pre-pregnancy visit — where they talk about what the treatment options are. Are you going to be a good candidate for hormones? If you can't take those, what else can we do? What are some lifestyle changes you can do that will ease you through this process as well?
Katherine Haver: One thing that I've noticed from following you is that a lot of people are frustrated with their physicians having to catch up to their symptoms. Information is power and making sure that everybody has information, is informed and understands what's happening to their body is really important.
Dr. Mary Claire Haver:: Absolutely. On our website, galvestondiet.com, we have some tools on ways to discuss hormone therapy with your healthcare provider as well as peer-reviewed studies you can print out and hand to your doctor in support of your own care. Many women have educated their own healthcare providers and were able to change their minds about allowing them to begin hormone therapy.
Katherine Haver: I think that's the most important part of this conversation, maintaining an open dialogue and keeping it open for the next generation of women who will be embarking on this new chapter of life.
This conversation has been lightly condensed and edited.
Photo by Danik Prihodko