A CHANGE FOR THE BETTER
Helping Women Stay Healthy
in Life's Second Act
Every woman goes through it; yet, it is a unique individual experience. And although it's a natural part of life, it leaves many women feeling baffled and concerned. The "it," of course, is menopause. Technically, menopause is the time in a woman's life when she has her last menstrual period. In reality, it's a time marked by physical, mental and emotional changes that can span years as a woman makes the transition to midlife.
A host of books and websites discuss menopause, but many women find they need to talk through midlife changes with others. That was the case for Chris Badano. She turned to a logical source for advice — her mother. "My mom didn't remember," says Badano. "She said it was something that wasn't talked about back then. "Soon after, Badano learned of a new program through her workplace intranet. "It caught my eye because it mentioned midlife women," she explains.
The Froedtert & Medical College of Wisconsin Total Health for Midlife Women Program was designed for women between the ages of 40 and 60 to help them better understand the changes they are experiencing. It encourages them to take a proactive role in their health by focusing on prevention, wellness, health risks and education. A knowledgeable nurse specialist takes time to listen, obtains a full health history and conducts a series of assessments that address perimenopausal and menopausal symptoms, as well as serious disease and other health issues. "We want the program to be an enhancement to the care provided by a woman's own doctor," says Marlys Swanson, RN, BSN, nurse specialist for the program. "Women can sit in a quiet, private and unhurried setting to talk and ask questions."
The program was developed in 2003 by a team of Medical College of Wisconsin health care providers and administrators led by Vanessa Barnabei, MD, PhD, Medical College of Wisconsin obstetrician/gynecologist and the program's medical director. "In the first group of women to go through the program, we found their main concerns — along with changes they were experiencing — were weight and stress management," says Dr.Barnabei. "We address those issues, but also make women aware of risks for other health issues, such as osteoporosis and cardiovascular disease."
Badano admits she was unaware of a woman's risk for heart disease. "I went to Total Health because of problems with hot flashes and mood swings. But I learned something I didn't know — heart disease is the number one killer of women," says Badano. Swanson agrees there is a great need to educate women about heart disease. "Compared to men, women are at a greater risk for having a heart attack, are more likely to die from a first heart attack and are more likely to have a second heart attack within that first year. And a woman's risk increases when she goes into menopause."
The program's comprehensive assessment also addresses osteoporosis. "That's a big one, too," Swanson adds. "I've met many women who had no idea their calcium intake was too low to maintain bone health." According to Dr. Barnabei, osteoporosis can be life threatening. "Many women don't realize a hip fracture can significantly impact quantity and quality of life. The rate of death in the year following a hip fracture for an elderly woman is 50 percent. Up to one half of women will have a significant fracture in their lifetime, which can lead to a chronic disability."
Women should work with their doctors to screen for signs of early bone loss and pursue ways to prevent further bone loss. Lifestyle changes can help, and medications can slow down or even reverse bone loss. All women need an adequate calcium intake — about 1,200 to1,500 milligrams a day — and may need to take supplements, although it is ideal to get calcium in foods and beverages.
With the information and encouragement Swanson provided, Badano made lifestyle changes that addressed her physical and emotional symptoms, as well as her risk for heart and other diseases. She quit smoking, developed coping skills for dealing with everyday stress, improved her diet and exercises more. Additionally, she follows Swanson's advice to receive regular medical exams and screenings, such as mammograms and cholesterol tests.
Badano also found ways to deal with hot flashes. Approximately 80 percent of American women experience hot flashes as they approach menopause and in the years that follow. But the experience is different for each, Swanson notes, and she counsels them to try different approaches. "Dressing in layers and natural fibers like cotton, keeping the room cool, sipping cold water or doing deep abdominal breathing at the start of a hotflash helps some women," she says. There is also relief in over-the-counter remedies such as vitamin E, black cohosh and soy, or by avoiding known triggers, such as spicy foods. When hot flashes significantly affect quality of life, women need to discuss it with their doctors and may want to consider prescription medication.
In addition to the one-on-one advice she received, the Total Health Program introduced Badano to additional sources of information. She now regularly visits Small Stones, a health resource center of Froedtert & Medical College of Wisconsin. "The nurse educators at Small Stones helped me find books on diet, exercise and heart health, and introduced me to aromatherapy," she says. Total Health participants receive a free one-year membership to Small Stones. Badano also attends a menopause support group sponsored by Froedtert & Medical College of Wisconsin. Led by Swanson, the group meets once a month. "It's open to all interested women," Swanson explains. "Sometimes we invite a speaker to talk about a specific subject, such as osteoporosis."
An all-female advisory board comprised of nurses and physicians from a broad spectrum of medical specialties oversees the Total Health for Midlife Women Program. (The advisory board includes experts from primary care, gynecology, sports medicine, surgery, psychiatry, women's health research, pediatrics and patient education.) Julie Mitchell, MD, Medical College of Wisconsin internist, serves on the board and says its multidisciplinary team takes a comprehensive approach to women's health and wellness.
"Midlife is a classic example of the interaction of mind, body and spirit. Women look at their lives and reflect on what they've done and where they're going," notes Dr. Mitchell, "But it's also a time when heart, bone and other diseases can become apparent, so it's a good time for women to think about lifestyle, take stock in their health and find information on how to stay healthy."
Says Badano about her experience with the program, "It was wonderful to have everything explained to me and to be given options for dealing with it all. It felt so good to find out what I was feeling was perfectly normal."
For more information about the Total Health for Midlife Women Program, call 414-805-3666 or 800-272-3666.