Black women going through menopause could never imagine a festival-like experience complete with a DJ where they could come and get information from doctors and wellness professionals, talk about sex, ageism, and a host of other issues in a room full of like-minded women, primarily women of color a few years ago. But Monique Cupid and Dixie Lincoln-Nichols, two of Life in the Pause Festival’s founders, achieved that in their second year. The two will be launching Black in the Pause this January.
One of Life in the Pause’s highlights was an in-depth discussion moderated by Lincoln-NIcolns featuring two doctors: Dineasha Potter-McQuilkin, MD, a double board-certified Gynecologist and Lifestyle Medicine specialist, and Dr. Gabrielle Francis, a Naturopathic Doctor.
They began the discussion with an overview. We are born with all the eggs we will have. Dr. Potter-McQuikin notes that by the time we hit our 40s or get closer to menopause, we will have 1-3% of those eggs left and start to feel the effects of making less estrogen and progesterone because we have them all over the body.
“You can have vaginal dryness, itchy skin, heart palpitations, cholesterol changes, and be at increased risk for insulin resistance, Dr Potter-McQuilkin explains. “You could also have sexual dysfunction. It impacts your life significantly in many ways.”
Dr Francis adds, “In your 40s, the engine’s winding down, and many women have thyroid and adrenal depletion from being on the go and never recharging. “And so this period of perimenopause, which is the 10 years before menopause, can often feel like the rugs being pulled out from underneath you if those backup generators are not doing the work they need to do.”
“Start preparing for your menopause years in your late 30s by really getting your lifestyle intact, getting yourself checked, and making sure you’re in balance, not just your hormones, but [things like] your blood sugar and your lifestyle,” Dr Francis says.
“Can you share a little bit more about some of the not-so-common menopausal symptoms? Because last week, while driving, I felt an electric shock in my body. When I got home, I went on to threads. I just had an electric shock, and this is how it felt. Who’s ever felt it?” Lincoln-Nichols explained. “People started responding. So that’s an uncommon symptom. Tell us about some more unusual symptoms people might be experiencing.”
Dr. Potter-McQuikin said those symptoms can include vertigo, anxiety, mood shifts, depression, and the shocks she described. A lot of these symptoms are categorized under what is being called the “new menopause.”
A New Way to Treat Menopause Symptoms
Part of it is that we have reached a breaking point. “[Patients were coming to her saying] I grew up managing 16 different things. I was at work; I could manage my kids and my aging parents. I could do it all. But then, one day, it came to a stop. What do I do now?” Dr. Potter-McQuikin pointed out. “They thought they just had to deal with it. But now they’re finding that you don’t have to deal with it. There are so many things that you can do the way you show up during those transitions. So, in terms of lifestyle, diet, and stress management, there are things that we can do. Before, we thought we couldn’t take that one because it was going to cause breast cancer, breast cancer, strokes, and heart attacks.”
Synthetic hormone replacement therapy (HRT) is not the only option.
“When I can, I would like to start with bioidentical hormones. That means it’s the same hormone and chemical structure as you think. Because honestly, I’m just trying to give you back what you’re missing, which is why we’re having these symptoms. So [it would be] estrogen and progesterone. They have some testosterone as well,” Dr. Potter-McQuilkin said. “But not to say that these synthetic ones are bad. If you come to me saying that you’ve been on synthetic hormones, and if it’s working for you, we can talk about it. It’s about patient preference and individualizing care.”
Dr. Potter-McQuilkin also points out that she prefers to use FDA-approved bioidentical hormones because they are more likely to be approved by her patient’s insurance. Compounded formulas using estradiol may not be approved by insurance.
Dr. Francis recommends natural levels of HRT based on the results of her patient’s lab tests. “The least invasive is using the phytoestrogens and the phyto progesterones, which are herbs that bind their estrogen and progesterone receptors. But I still recommend those based on the lab testing,” she said. “Then the next tier up is bioidentical natural; those are the ones Dr Dineasha was talking about that are made of pharmacies. The estrogen comes from the soy-based, and the progesterone comes from Mexican wild yam base, but it is estrogen progesterone by the time it’s made.”
It’s worth exploring treatment options with your doctor sooner rather than later. And understand that menopause is more than hot flashes and night sweats.
