Menopause is the transitional time when a woman is in her late 40s and 50s marked by a decrease in estrogen production and symptoms that can include hot flashes, mood and sleep disturbance, and other physical and emotional changes. Every woman will eventually experience it, assuming she lives long enough, and yet, the topic has been and remains taboo.
A new documentary, “The (M) Factor: Shredding the Silence on Menopause” is looking to break what it calls the cycle of shame for women. Jewish Family Service will be screening the film, followed by a panel discussion with experts in the field, on February 9th. Pam Kelner, executive director of JFS, says this program is an important part of JFS mission to both educate and empower the community, “In addition to the screening of the film, we have put together a panel of experts who will shed light on a topic that is generally shrouded in mystery and stigma. Women who attend this event will be empowered to make more informed health decisions. I am personally looking forward to being in community with women and learning more.”
According to the film, 55 million women in the United States are currently experiencing menopause, but often even doctors are not interested or equipped to help their patients. “There’s a lack of interest among clinicians,” says Dr. Nancy Lipsitz MD, an OB/GYN and Menopause Society Certified Practitioner, “Some OB/GYNs really only want to focus on obstetrics and seeing younger people. And there’s not a lot of knowledge and training with perimenopause and menopause.”
Lipsitz says this lack of attention to women’s symptoms reflects societal bias around women’s aging. “Older women say they feel invisible. So, can [their symptoms] be attributed to normal aging versus true hormonal decline? I think there is a tendency for women not to be listened to.”
One of the key issues discussed in the film is the use of hormones to help alleviate symptoms. For the last two decades doctors have debated the safety and overall benefits of hormone therapy with the pendulum swinging back and forth which also adds to confusion for patients. “We have a good 20 years of people who went through their training starting any time after 2002 when the Women’s Health Initiative came out, that during their training there’s a fear of hormones amongst the clinicians to not prescribe.”
The Women’s Health Initiative (WHI) was a long-term national study of women’s health that focused on cardiovascular health, cancers and osteoporosis. The WHI investigated the use of estrogen hormone therapy to prevent chronic disease, but the results led doctors to stop prescribing them for menopausal symptoms. Now however, Lipsitz says the pendulum has begun to swing back. “Before the WHI study we treated everyone with hormones. Then the study came out and everyone stopped the hormones. And now we don’t want to go back to square one, but these things are nuanced. Hormones are not a panacea. There’s definitely a role for them.”
Lipsitz says this debate around hormone therapy is just one example of what women go through just to try and become informed. “There are not many areas of medicine where you’re going to have so much controversy or feelings about it. Where people come and say, ‘My doctor doesn’t believe in hormones, or won’t prescribe them.’”
In addition to addressing the most common symptoms, which typically begin around age 51, Lipsitz says today’s more effective genetic testing for ovarian cancer can lead to early menopause for younger women, something that Ashkenazi women are at higher risk for than the general population. “One out of 30 Askhenazi women carry the BRCA gene, versus one out of 300 or one out of 400 in the general population. So, we do have a higher number of women than average who may have their ovaries removed at a younger age.” She says that can increase the risk of menopausal symptoms and other medical problems.
In addition to the physical symptoms, menopause can affect a woman’s mental and emotional health. Lynn Barton, LCSW, is also one of the panelists for the event. She says although women do not usually contact her for health problems, often during therapy sessions, she uncovers how overall physical health, like menopause, is affecting their emotional health. “We start to look at how that might impact or exacerbate feelings of depression, feelings of anxiety, feelings of fatigue, or lost in a fog.”
These feelings also have an impact on a woman’s relationship with others. She says she thinks discussions like the JFS event are important to include men as well. “It would seem to me that any man who is in a relationship with a woman of this age, it would be good for them to know all of this too.”
Barton says conversations around women and aging highlight the disparity between the sexes. “It’s sort of, at times, a razor’s edge. Because we don’t want to say we are governed by hormones, which would lead men to say, ‘Well they’re not fit for certain jobs.’ But we want men to realize that they’re going to have issues to deal with their hormones and we are too.”
The Jewish Observer is published by The Jewish Federation of Greater Nashville and made possible by funds raised in the Jewish Federation Annual Campaign. Become a supporter today.
She also stresses women should not only focus on the negatives of aging and loss of fertility. “They don’t have to worry about getting pregnant. They don’t have to worry about some of the same things. It can be a time of more freedom as well as a time of loss.”
Barton also points to the film’s discussion around hormone therapy but says the first thing a woman should do is talk to her doctor about all her symptoms and feelings. “See if there’s anything that can be done medically, but in addition to talk with a mental health provider about what’s going on and the consequences.”
The panel’s moderator is retired educator and JFS board member, Lynn Heady. She agrees the film’s work to bring menopause out of the dark is long overdue. “Our medical issues are usually put on the back burner and men’s issues are a little more in the forefront,” she says. For example, the film’s trailer discusses the use of testosterone for women and the difficulties women have accessing it. “For men it’s so easy to get and there’s no charge. But it is not approved for women. And yet one of the doctor’s [in the film] says that is one of the things that has a high incidence of helping.”
Heady says she was happy to be asked to participate in the event and says JFS is the right organization to bring this to the community. “The breadth of what they do for the community is just so amazing. They don’t leave anybody out. If there is an issue, they’re willing to tackle it.”
Lipsitz says when it comes to finding reliable, accurate information, social media and the internet can be problematic since many so-called experts also have products and services they are selling. But she says the film does accomplish its goal of destigmatizing conversations around menopause and women’s aging. She also cites the Menopause Society as another valuable resource, with information and current guidelines and research. But at the end of the day, she says it is most important to find a doctor who is both interested and informed about the topic. “Many people understandably want to keep going to the doctor they’ve always gone to.” But she says women should feel empowered to ask questions and make sure they are getting answered, and if not, they should seek out a menopause certified practitioner.
The M Factor film and panel discussion is scheduled for February 9th at 10am at the Gordon Jewish Community Center. To learn more or to register, visit https://zurl.co/EqXHA
