Better Living, During and After Menopause

A truly personalized and multi-faceted approach helps women to pass through this time of radical transformation without worrying about unpleasant symptoms, both physical and emotional.

A delicate time of life

Women approaching their fiftieth birthday these days are fit, healthy and live in a culture where remaining young, beautiful and active are essential. They have new desires, their children have grown up so they’ve got time to spare and want to remain active for a long time to come. However, despite this can-do attitude, their bodies are starting to show signs of physiological change.

This is perimenopause, starting around age 47 and leading a woman to the end of her periods, normally four years later. Everyone knows that you can’t stop the biological clock, and you just need to get through this period and its unpleasant symptoms: insomnia, hot flushes, mood swings, dry skin, weight gain, loss of sex drive. And that doesn’t even begin to address the psychological acceptance of passing into the “senior” category of life…

It’s not easy to talk about with your friends and family, this divide between your own self-image and your new age-associated identity. It’s easy to laugh about it with your friends, but during those sleepless nights they don’t seem to help much. However, help is at hand: medicine has made many advances and produced a range of effective treatments. These won’t stop the clock, but they’ll help you get through this difficult time of your life.

Preventing the consequences

Of course, nothing can prevent the menopause, tied in as it is to the natural production of the last egg in your personal stock. The number of eggs you have is fixed and the end is genetically programmed no matter what your health or lifestyle is like. However, it is useful, when you are around forty years old, to prepare for the years to come. A slim non-smoker who exercises regularly will hit menopause in better shape than a woman with a poor lifestyle.

You need to exercise and eat less in order to reinforce your cardiovascular system, as this is worst affected during later years. If it is well balanced, your body will be less affected by the arrival of menopause. And during your mid-fifties, once the physiological stage is over, medicine can really help keep you in shape with the prescription of very small doses of hormones and dietary supplements. Just a little nudge to help you make the most out of the thirty years or more that everyone has left after the mid-point in your life.

Are hormonal treatments something to worry about?

In 2002, the first and only randomized, double-blind study – conducted over a large swathe of the USA and including 16,000 women – concerning hormone replacement treatment was alarming. It showed clear increases in the risks of breast cancer and vein thrombosis with women who took the treatments. The way the results were obtained however made Doctor Thierry Pache, the surgeon general at Clinique La Prairie Menopause Center, absolutely furious: “Only one product was tested, and on a population of women with an average age of 62 – ten years after the onset of menopause – a large proportion of whom were obese and ex-smokers.

These results reveal a widely used practice in the 1990’s where certain doctors flooded women with hormones at a raised standard dose without personalizing the prescriptions.” Also, nobody took into account a physiological fact when revealing the raised incidence of breast cancer: a vastly increased life expectancy, but with internal regulatory mechanisms in poorer shape. “Today, we know that one in eight women will develop a breast tumor, with or without hormone treatment”, states Doctor Pache.

Fifteen years have elapsed since the start of this study, the “Women Health Initiative (WHI)”, fifteen years which have seen more progress in the treatment of menopause than in the entire previous century. Doctor Pache is now seeing the medical community turn towards a practice which he has always used: medium or low doses, depending on the health, needs and medical history of the patient to be treated. “There has been an immense loss of trust, even today, among women who are now afraid to use substances that could change their lives from the onset of menopause, since all the incapacitating physical symptoms are either greatly reduced or eliminated.”

Also, Doctor Pache shatters a modern misconception: that if it is better not to smoke at all, women who can quit can receive hormone replacement treatment. “It’s true that young smokers should not take the contraceptive pill. Public opinion has expanded this incompatibility to cover hormones in general. However, it’s not a question of dosage- this is much lower when treating menopausal symptoms.”

A personal approach

The key to success in menopause treatment is personalizing the program for each woman to take. “Everything starts with a discussion, letting the doctor understand the physical and emotional needs of the patient and arranging all the necessary examinations.” Classic gynecological tests, ultrasound, mammography and bone density are the basic examinations, to which may be added a blood hormone report and sessions with a dietitian if the patient has gained too much weight.

One in two women accepts hormonal treatment. For the others, Doctor Pache resorts to herbal medicine, homeopathy or the skills of an acupuncturist who is a permanent member of the multi-disciplinary medical staff. “Creating a network of specialists around each patient is a key factor to achieve success. Using full dialog and clear explanations, it is our responsibility to help women accept this new phase of their lives. We can help ease a range of symptoms, but the patient ages and their body changes. These are the facts. The most important thing is to let them know that there are pleasant ways to overcome these changes, and feel good.”

The menopause center

Created in 1995 by Doctor Thierry Pache, an FMH gynecology and obstetrics specialist, the Menopause Center offers a multi-disciplinary approach to women at the onset of perimenopause, or during full menopause. The approach, as part of the “Better Aging” concept behind Clinique La Prairie, is personalized, based on physical and hormonal analysis, and respects the medical history and culture of the patient.

This article was first published in INSIDE The magazine of Clinique La Prairie, #2 Fall-Winter 2013/2014.