Below is an excerpt of Dr. Booths interview about menapause that appeared in MPowered Women, a wonderful site with expert information, support and inspiration, giving women the resources and knowledge they need to power through menopause:
"Rebecca Booth MD is a US gynecologist and obstetrician, and the co-founder of VENeffect anti-ageing skincare. She has practiced medicine for over 30 years, and been featured in, amongst others, The Oprah Magazine and Good Housekeeping. She refers to menopause as her ovarian retirement plan, and says the key is for women to support each other through it."
What is your age and stage?
I celebrated my 60th birthday in April of this year and I stopped my periods when I was about 50. I am postmenopausal, but it can be a confusing term; as I share with my patients, it simply means I am beyond the one-year anniversary of my last period because of what I call my “ovarian retirement plan.” While my ovaries will not be coming back to work, the phenomenon we call “the menopause” is a process, not just a state. It is unique to women as we experience the final ticking of the biological clock.
When did your symptoms start and what were they?
As a gynaecologist I was very familiar with early symptoms of ovarian decline. Because of the extended time required to complete medical school training, I was always acutely aware of the risks of my biological clock.Ultimately, the biological clock is the reason for menopause. My mother had not experienced many menopausal symptoms, or if she did, she could not recall them. In my mid-40s I began to notice a change in my heat tolerance. Looking back, I now realize that over time I became intolerant of sheep’s wool, then cashmere, and finally the only knits I could wear were linen, cotton or silk.My periods had long been a problem, in fact I had a hysterectomy in my 40s due to history of intolerable menstrual cramps and a common condition known as adenomyosis (a cousin to endometriosis). My ovaries remained functioning after my hysterectomy, but as I moved into my late 40s, I began to notice vaginal dryness, pain with sex, and night sweats. My hair was becoming thin at my temples, and more wiry. I found it increasingly difficult to control my weight, especially around the middle.
What has been the most challenging thing to deal with?
I find the greatest challenges are gradual changes to my appearance that seemed to subtly influence my communication with others. For example, I find that my “resting face” appears less positive due to changes in elasticity of the skin around my cheeks, eyes, and the corners of my mouth. This sometimes gives others a feeling that I do not approve of them, or that I am not as happy or satisfied as I truly am.Also, with declining estrogen my cartilage and connective tissue attachments to my skeleton have experienced a more rapid decline and this has compromised my functionality. I have degenerative disc disease, a chronic pain syndrome involving my spine and causing a loss of height, resulting in even more collection of weight around the middle. This was accelerated with menopause and science has demonstrated that skin, joint and bone collagen declines more rapidly with the ticking of the biological clock.“For me, the key to vitality is the combination of movement, metabolism, inspired diet and self-care.
Have there been any positive symptoms?
No longer having to deal with the menstrual period is truly liberating for me and most of my patients. With regard to hormones, I no longer feel my aesthetic and my moods are manipulated by Mother Nature’s directive to demonstrate fertility. The “on duty, off-duty” nature of the hormonal cycle, while brilliant in its design, was a burden with regard to my personal goals. Menopause offers a consistency that I rarely experienced as a young woman after puberty.
What are the things that are getting you through?
I have chosen to take hormone therapy as a way to negotiate with my ovarian retirement plan. While the estrogen patch does not offer the levels of estrogen I experienced in my fertile years, the consistent dose helps offset changes in my bone health, negative metabolic effects, improves my heat intolerance, supports my vaginal elasticity. At this time I feel these benefits outweigh the risks of estrogen therapy for me.As for the most important strategy: lifestyle, I focus on the waist to hip ratio as an extremely reliable indicator of my metabolism. I strive to optimize this through a low carbohydrate and high plant protein dietary approach.Plant protein contains plant estrogen, “phytoestrogens” that help mimic the waist whittling properties of estrogen at peak fertility. I exercise every day and combine an aerobic practice with focus on height maintenance and core work in order to improve the waist hip ratio as well as stabilize my spine.I practice meditation to help with stress in order to improve my performance, my relationships, as well as to keep insulin surges down (and anti-stress approach).Finally, I have a strict skin care regimen and I was so determined to address the “biological clock of the skin” that with the help of my sister, I developed a line of skincare packed with phytoestrogens to support the elements of glowing skin (collagen, elastin and hyaluronic acid). Luckily for me I have a sister whose beauty industry experience helped us formulate products. We named our line VENeffect to capture the “Venus Effect” of skin at peak hormonal vitality.
What has made the biggest difference?
I believe, and I share with my patients, lifestyle to be the most influential of all approaches to negotiate with the ovarian retirement plan. Strategies that make us healthy also inspire our aesthetic, and our life satisfaction. For me, the key to vitality is the combination of movement, metabolism, inspired diet and self-care.“Sharing secret solutions to these challenges is something that women excel at, and absolutely must do for one another.
Did you seek any advice from experts, friends or family?
Throughout my gynaecologic career I have been keenly focused on learning everything I can about how to best to negotiate with, and to optimize our hormonal vitality as women. I am so fortunate to be in a practice of 11 female physicians and we share our challenges professionally and personally, helping hone our solutions.Equally enlightening have been my experiences with my patients, who have taught me a great deal about the future. Caring for women throughout their life spans for 30 years (and counting) is an amazing teacher.
What was the advice you received?
My patients have taught me many things through the years, but the greatest lesson I hear over and over is that life is a series of challenges that often seem insurmountable, but with time and support, most always resolutions are found.Sharing secret solutions to these challenges is something that women excel at, and absolutely must do for one another. Women who continue to nurture strong bonds with other women they admire seem to struggle less in times of transition.
Is there anything you wish you’d known?
I wish I had known more effective ways to communicate the science surrounding a woman’s unique physiology with my patients earlier in my career. Metaphors I have developed through the years with the help of my patients, my sisters, my female colleagues, and my own experiences have been extremely beneficial in the last few years.I wish that medical training provided more useful ways for all caregivers to communicate to women – and to men – what our unique physiology means to our health, our happiness, and most certainly are relationships.
What has been the impact on your daily life?
While any transition that affects every aspect of your health is a challenge, I do feel that the consistency of my postmenopausal physiology, optimised with my lifestyle changes and hormone therapy, has actually improved my coping mechanisms, sleep patterns, and moods compared to times in my life when cycling hormones manipulated all of the above.
Has there been an impact on your relationships?
My husband, also a physician, has always been a big fan of women, having grown up in a matriarchal family with four sisters. I often (probably annoyingly so) shared with him the process of changes I was experiencing in peri and menopause, and he claims he finds my research in the field very interesting.Because there is a natural, but more subtle decline in a man’s hormonal vitality over time (despite the absence of a “testosterone retirement plan”) he feels my experience is relevant to his in many ways. He has appreciated my openness to hormone therapy as it is an option for many men who experience low testosterone with age, and he would like to keep his options open.“I always gently remind women that it is not a disease, and that it can be a time of great liberation
Is there anything you’d do differently?
While I think it might have benefitted my metabolism and my scalp hair to start hormone therapy a little earlier, I wanted to experience some of the changes firsthand so that I could relate to them and understand them better clinically. There is no greater teacher than experience.
What do you say to other women about the menopause?
I always gently remind women that it is not a disease, and that it can be a time of great liberation, a time to take back priorities as one’s own as opposed to those influence so heavily by Mother Nature’s goals for us.With regard to hormone therapy I explain that it is not a “bipartisan issue,” in other words I support the decision for women who choose to benefit from hormone therapy, and I support women who choose not to take it. My goal is to help with strategies either way, and certainly to target strategies for a woman who does not have the option for hormone replacement.
What are your thoughts on this time of a woman’s life?
While a challenge, menopause is an opportunity. When understood and negotiated through healthy choices the transition from the fertile years can offer freedoms that are simply not afforded the younger woman.
Your menopause was…
An incredible learning experience.
You feel MPowered
when…I share the knowledge of our fascinating physiology that I have learned as a caregiver of women, and I can see that my patient, reader, friend or family member understands its secrets and the tools she has to optimise her vitality.I feel empowered when I empower others with knowledge – this is an enormous gift to me.
This interview with Dr. Booth appeared in MPowered Women