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The change of life
From humor to hormones, women find ways to cope with menopause as they enjoy their lives

By Peggy O'Farrell
Enquirer staff writer

Ice water is instrumental in helping Lisa Bouldin-Carter deal with night sweats associated with menopause. The North Avondale woman takes a glass to bed each evening. She uses a fan at the office during the day to handle hot flashes.

Lisa Bouldin-Carter relies on a fan and a big glass of ice water, along with the occasional nap, to manage her menopause symptoms.

Deb Drayton depends on her sense of humor and the cold stone floors in her house.

Jill Layne uses bioidentical hormones in an individualized prescription.

And Diane Jackson gets acupuncture, along with herbal supplements.

Until 2004, many women often relied on hormone replacement therapy (HRT) to treat menopause symptoms, especially debilitating hot flashes and night sweats. But when the Women's Health Initiative revealed that HRT didn't prevent some diseases it was thought to and slightly increased the risk of others, women started scrambling for other options.

Some, such as Bouldin-Carter and Drayton, are toughing it out without drugs or hormones.

Bouldin-Carter, 53, of North Avondale, takes a glass of ice water with her to bed every night to cool off when the night sweats strike. During the day, she has a fan in her office to help ease hot flashes.

"It would be wonderful to come into the office and not feel like I need to take off some article of clothing," she says.

But she has adjusted: If she can't sleep at night, she gets up and does something. If she's tired the next day, she finds time to take a nap.

Drayton, 54, of Burlington, didn't want to take hormones because of a family history of breast cancer.

"I've just toughed it out. It hasn't been as bad as I thought it was going to be," she says.

Ice water helps, Drayton says. When she has a hot flash, standing barefoot on the cold stone floors in her kitchen and foyer helps, too.

"When we were building the house and had to choose materials, I picked up this sample of the flooring and held it up to my cheek and said, 'Oooh, must have this.' "

She does have memory problems and makes a lot of lists. "Then I lose my list, so that doesn't help."

Tailored treatment

For some women, hormone replacement therapy is the only thing that eases symptoms. More women are turning to bioidentical hormones -

custom-compounded mixes of estrogens and progesterone that are identical to hormones produced by the body.

Jill Layne, 60, of Landen had a long list of symptoms when she had her hormone levels tested: Her hair was falling out. She was exhausted. She had hot flashes. Her muscles ached. And, in her own words, "I couldn't tell you what 2 and 2 was."

Her test results told the story: One form of estrogen was extremely low. And her testosterone level was extremely high, which explained the hair loss.

An individualized mix of two types of estrogen and progesterone restored the balance of her hormone levels. But she and her doctor had to keep tweaking the mix to get it right, Layne says.

"You have to play with it, but it's totally customizable," she says.

Bioidentical hormones are manufactured, but they are chemically identical to hormones produced by the body. They're available by prescription in standardized doses or in custom-compounded mixtures from specialty pharmacies.

Dr. Claudia Harsh, an obstetrician-gynecologist with the Alliance Institute for Integrative Medicine in Kenwood, says bioidentical hormones make sense for women who want HRT. But, she adds, there's little evidence that they're safer than synthetic hormones, such as Premarin, if used for long periods.

Harsh, like most doctors, recommends using the minimum level of HRT for as short a time as necessary to control symptoms.

A balancing act

Diane Jackson, 51, of Delhi Township uses a variety of remedies to address her hot flashes, mood swings, night sweats and insomnia. Her approach includes monthly acupuncture, a progesterone cream and a mix of herbal supplements.

It's worked, she says.

"The night sweats and hot flashes have subsided. It's just been amazing. I'm not grouchy anymore," she says.

Acupuncture eases hot flashes for some women. It also helps reduce stress, and that can go a long way toward making menopause symptoms more bearable, Harsh says.

"The biggest thing women have to understand is that there's a connection between stress and their cortisol levels and their hormone balance," she says.

Cortisol, the so-called "stress hormone" can further disrupt fluctuating levels of female hormones, Harsh says, and make menopause symptoms worse.