Managing menopause

Police officer Angela Epp is one of many women who are learning to deal with this change of life

COPD health-care professionals.
Angela Epp uses exercise to help manage menopause symptoms.
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The Mature Women's Centre

Menopause & you

Dealing with menopause

Winnipeg Health Region
Wave, March / April 2017

Like all middle-aged women, Angela Epp expected to experience some of the more common symptoms typically associated with menopause.

So the hot flashes, night sweats and insomnia didn’t come as much of a surprise.

But then Epp started to experience more severe symptoms. She found herself feeling unhappy, suffering from mood swings and, most distressingly, finding it hard to concentrate on her work and worried that she was forgetting important facts needed for her job as a police officer. Then it got worse.

“I was waking up in the night with heart palpitations that were so bad, I thought I was having a heart attack,” she says, recalling her first few months of being menopausal.

As it turns out, Epp’s experience with menopause, which started about three years ago when she was 50, is not all that unusual, according to Dr. Debra Evaniuk, an obstetrician-gynecologist at the Mature Women’s Centre at Victoria Hospital and one of the Winnipeg Regional Health Authority’s leading experts on the subject.

As Evaniuk explains, menopause is clinically defined as the absence of a woman’s period for 12 months. This dramatic change of life, characterized by a reduction in the production of estrogen and the end of fertility, is often accompanied by a number of common physical symptoms, such as those initially experienced by Epp.

Less well known, though, is the fact that as many as one out of 10 women going through this transition will experience more severe symptoms, including lack of energy, lack of interest in sex, and brain fog. In addition, many women may experience psychological effects, such as mood swings, anxiety and depression.

Evaniuk says many women are able to deal with the less-severe symptoms of menopause, which can last up to 15 years or more, without too much trouble or need of medication, such as hormone replacement therapy.

”But when the symptoms are having an impact on their lives, they should seek help from their family physician or another health-care professional.”

That is exactly what Epp did.

When she first sought treatment, she was given a prescription for hormone replacement medications and a low-dose antidepressant. The hormone replacement medication resolved her hot flashes, anxiety and insomnia almost right away. But it was about this time that Epp also started to gain some weight, something that can happen as women age. 

So, after talking to her doctor, Epp decided to drop the antidepressants and make some lifestyle changes. Now, in addition to taking hormone replacement medication, Epp is also eating healthier, swimming five days a week, and doing yoga to stay flexible.

“Right now, I’m re-tuning my happiness,” she says, adding that the changes have helped alleviate her menopause symptoms.

But it wasn’t just the seriousness of her symptoms that Epp felt compelled to take care of.
Along with making lifestyle changes to her diet and exercise routines, she took up the cause of being a menopause advocate at her workplace: the Winnipeg Police Service.

As a staff sergeant, Epp is one of an increasing number of senior female leaders in a largely male workforce. She was worried that menopause was having a negative effect on her performance as a 25-year member of the service.

“My mother didn’t talk to me about menopause, so I didn’t know what to expect,” says Epp. “I knew it was a natural part of aging, so I was surprised at how debilitating the symptoms were, especially the depression and memory problems. I wasn’t happy, I was hot all the time, and I work primarily with men. It’s hard to have a conversation about it.”

As part of her research into the issue, Epp discovered that many women going through menopause often felt like they were perceived as having lost their drive and focus, no matter what line of work they were in. Women also found it hard to speak to male superiors and managers about their symptoms, a situation that led to increased anxiety about their jobs, she says.

“There is a sentiment that menopause is a lifestyle choice,” she says. “But it is a biological certainty for all women and a natural part of life for women. Still, it was too often a taboo topic in the workplace.”

Among the 1,985 members employed by the Winnipeg Police Service, approximately 11 per cent are women, she says. Among the civilian work force, 68 per cent are female. And in both groups, about 35 per cent are of the age when they are experiencing menopause transition.

While attending an international conference for policewomen in Wales in 2015, Epp became intrigued by Kathryn Colas, a presenter who spoke about the effects menopause has on the body and the mind and tied it into police work.

“That was my ‘aha!’ moment,” says Epp. “I knew that when I got back, I wanted to do something. So I began by speaking to senior police officers in Winnipeg. I received permission to make presentations at professional development days and ‘lunch and learn’ sessions. And since I’m a police officer and we like this sort of thing, I gave it a name: Project M.”

The presentations, which are open to everyone, are designed to demystify menopause and help reduce the anxiety women feel in the workplace as they go through the change of life. 

“Women need support, from their peers and their managers and senior leadership,” she says.

In the case of the police service, support starts with recognizing some of the unique challenges women face as they go through menopause. For example, a police uniform, with its utility belt and body armor adding an extra 25 pounds, can exacerbate the effects of a hot flash, says Epp.

In addition, many women experience menopause-related insomnia, a condition compounded by the shift work that is an integral part of being a police officer.
Epp says the police service has demonstrated a willingness to discuss issues that women going through menopause face in the workplace.

“We’re talking about it, which makes a huge difference,” she says. “I talk to the supervisors about how to support women, on an individual basis. Given support, women can work through their symptoms and be a driving force again.”

Another woman who also had difficulty with menopause is Grazia Prochazka.

Grazia Prochazka.

Initially, Prochazka thought she had everything about menopause figured out, thanks to her work as a pharmacist. “I thought: how hard can it be? I know about the drugs, I’ve read about the symptoms,” she says. “And then, one August, it hit like a ton of bricks.”

She found herself irritable, with frequent hot flashes and night sweats. After consultation with her doctor, she was referred to the Mature Women’s Centre at Victoria Hospital.

“I’ve been coming here for three years now,” says Prochazka, who works as a clinical resource pharmacist in geriatrics and rehab at Deer Lodge Centre and Riverview Health Centre. “I initially went through all my symptoms with a nurse. And then I talked about my diet with a dietitian and my exercise and stress levels with a kinesiologist.”

She looked at hormone replacement therapy, but decided to try changing her lifestyle first. “I learned coping mechanisms, like carrying a fan and wearing layers I could take off,” she says.

She also learned that exercise guidelines for adults – which call for 150 minutes of moderate to vigorous exercise a week – weren’t enough for her goals of losing the weight she’d gained around her middle.

“Those are just maintenance minutes,” she says. “I had to take it up to 250 minutes, and add 5,000 steps to my week. I bought a fitness tracker, and now I walk everywhere, including 10 minutes at lunch and 10 before supper. I have walking DVDs that taught me to move around and get more exercise.”

Both Prochazka and Epp looked at using herbal supplements, like black cohosh, red clover or soy, but decided against them, and also some more questionable treatments, like laser therapy.

“I did my own research on supplements and also spoke (to another pharmacist), but I decided I would rather go the exercise and diet route,” says Prochazka.

“Working with the folks at the (Mature Women’s) Centre helped me work through the symptoms. They helped me deal with the symptoms and make them more manageable. Just because they’re natural doesn’t mean you have to suffer,” she says in reference to menopause symptoms.

Evaniuk says hormone replacement therapy is recommended for alleviating the bothersome symptoms of menopause. Lifestyle changes, such as eating a balanced diet and becoming more active, can also help someone going through menopause feel better. But she cautions against using herbal supplements without speaking to a doctor or pharmacist first.

Evaniuk’s final word on the subject? Women need to give themselves permission to seek
help. “This is an opportunity for women to focus on their health. There are many years ahead and menopause is the perfect time to refocus on health promotion and disease prevention. There is a lot of misunderstanding around menopause,” she says. “Women need to take time for themselves, and get the help or the medication they need if their symptoms are severe or bothersome.”

Susie Strachan is a communications specialist with the Winnipeg Regional Health Authority.

Wave: January / February, 2017

About Wave

Wave is published six times a year by the Winnipeg Health Region in cooperation with the Winnipeg Free Press. It is available at newsstands, hospitals and clinics throughout Winnipeg, as well as McNally Robinson Books.

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