ALSO BY CHRISTIANE NORTHRUP, M.D.
Women’s Bodies, Women’s Wisdom
Creating Physical and Emotional Health and Healing
Mother-Daughter Wisdom
Understanding the Crucial Link Between
Mothers, Daughters, and Health
The Secret Pleasures of Menopause
The Secret Pleasures of Menopause Playbook
A Guide to Creating Vibrant Health Through Pleasure
The Wisdom of Menopause Journal
Many of the stories that appear in this book are composites; individual names and identifying characteristics have been changed. Nevertheless, they reflect authentic situations in the lives of the thousands of perimenopausal women I’ve seen in my practice over the years. If you think you recognize yourself in these pages, the similarities are strictly coincidental unless I have received your specific written permission to use your story.
Copyright © 2012, 2006, and 2001 by Christiane Northrup, M.D.
Illustrations by Scott Leighton
Copyright © 2012 by Christiane Northrup, Inc.
All rights reserved.
EBook Edition published by Christiane Northrup, Inc. 2008
Fully revised EBook Edition published 2012
Print edition is available through Bantam Books
www.bantamdell.com
BANTAM BOOKS and colophon are registered trademarks of Random House, Inc.
Some of the material in The Wisdom of Menopause was originally published in
Health Wisdom for Women, Phillips Publishing International.
Library of Congress Cataloging-in-Publication Data
Northrup, Christiane
The wisdom of menopause: creating physical and emotional health during the
change/Christiane Northrup.—Rev. and updated.
p. cm.
Includes bibliographical references and index.
Tradepaper ISBN 978-0-553-38672-1
Digital ISBN 978-1-4019-3997-7
1. Menopause 2. Menopause—Psychological aspects.
3. Menopause—Religious aspects. I. Title
Printed in the United States of America.
2 4 6 8 9 7 5 3 1
EBook Published by Christiane Northrup, Inc.
is a registered trademark of Christiane Northrup, Inc
For more information about Dr. Northrup and her work,
please visit: www.DrNorthrup.com.
This book is dedicated to the pioneering spirit
embodied in the women of the baby boom generation
Contents
List of Figures
Acknowledgments
Introduction: The Journey Begins
Midlife: Redefining Creativity and Home
Blazing a New Trail
Chapter 1. Menopause Puts Your Life Under a Microscope
“Not Me, My Marriage Is Fine”
The Childbearing Years: Balancing Personal and Professional Lives
Why Marriages Must Change at Midlife
My Personal Fibroid Story: The Final Chapter
The Joy of Co-creative Partnership
The Forces That Change the Goose Also Change the Gander
Real Menopause Hits
My Marriage Goes Bankrupt
Armadillo Medicine: The Power of Vulnerability
Celebrating the Past While Creating a New Future
Chapter 2. The Brain Catches Fire at Menopause
Our Brains Catch Fire at Menopause
Learning to Recognize and Heed Our Wake-up Calls
Is It Me or Is It My Hormones? Debunking the Myth of Raging Hormones
The Multiple Roles of Your “Reproductive” Hormones
Embracing the Message Behind Our Menopausal Anger
Emotions, Hormones, and Your Health
How Our Midlife Brains and Bodies Are Set Up to Heal Our Past
Finding a Larger Meaning
Chapter 3. Coming Home to Yourself: From Dependence to Healthy Autonomy
The Empty-Nest Syndrome
Boomerang Babies
Powerful Feelings, Powerful Healing
Caring for Ourselves, Caring for Others: Finding the Balance
Hitting Pay Dirt: Getting Clear About Money at Midlife
Coming Home to Yourself
Vocational Awakening at Midlife
A Road Map for Navigating Unknown Territory
Chapter 4. This Can’t Be Menopause, Can It? The Physical Foundation of the Change
What Is Happening in Your Body: Hormonal Changes
Perimenopause Is a Normal Process, Not a Disease
The Three Types of Menopause
Perimenopause and Hormonal Levels
Is There a Test I Can Take?
Menopause and Thyroid Function
Menopause and Adrenal Function
What to Expect in Your Transition
Chapter 5. Hormone Therapy: An Individual Choice
A Brief History of Hormone Therapy
Bioidentical Hormones: Nature’s Ideal Design
A Hormone Primer: Essential Information Every Woman Should Know
How to Decide Whether or Not to Take Hormones
A Dusting of Hormones
How Long Should You Stay on Hormones?
Chapter 6. Foods and Supplements to Support the Change
Basic Principles of Herbal Therapy at Menopause
Menopausal Healing Foods
Traditional Chinese Medicine and Acupuncture for Menopause
Start Somewhere
Chapter 7. The Menopause Food Plan: A Program to Balance Your Hormones and Prevent Middle-Age Spread
Making Peace (Once Again) with My Weight
Six Steps to Midlife Weight Control
The Hormone-Balancing Food Plan
Optimizing Midlife Digestion
The Final Frontier: Accepting Our Bodies
Chapter 8. Creating Pelvic Health and Power
What Is Yours, What Is Mine, What Is Ours? Reclaiming Our Boundaries
Hormonal Imbalance: Fuel to the Fire
Menstrual Cramps and Pelvic Pain
Heavy Bleeding
Fibroids
An Empowered Approach to Surgery or Invasive Procedures
Master Program for Creating Pelvic Health
Urinary Health
Chapter 9. Sex and Menopause: Myths and Reality
The Anatomy of Desire
Sexuality at Menopause: Our Cultural Inheritance
Menopause Is a Time to Redefine and Update Our Relationships
Hormone Levels Are Only One Part of Libido
Secondary Libidinal Support: Estrogen and Progesterone
Testosterone: The Hormone of Desire?
Aids to Lubrication
Telling the Truth
Ten Steps to Rekindling Libido
Chapter 10. Nurturing Your Brain: Sleep, Mood, and Memory
Enhancing Midlife Sleep
Depression: An Opportunity for Growth
Memory Loss at Menopause: Is This Alzheimer’s?
Hormones and Alzheimer’s
Nonhormonal Ways to Protect Your Brain
Maximizing Midlife Wisdom
Chapter 11. From Rosebud to Rose Hip: Cultivating Midlife Beauty
Making Peace with Your Changing Skin
Preventing or Treating Wrinkles
Midlife Acne
Rosacea
Hair in the Wrong Places
When Good Skin Care Isn’t Enough: Deciding on Cosmetic Procedures
Varicose Veins
Chapter 12. Standing Tall for Life: Building Healthy Bones
Osteoporosis: The Scope of the Problem
We’re Designed for Lifetime Sturdiness
How
Healthy Bone Is Made
Are You at Risk for Osteoporosis?
Measuring Bone Density
What About Bone-Building Drugs?
Get Strong
Healing Your Fitness Past
The Sunlight–Bone Health Connection
Shore Up Your Earth Connection with Plant Medicine
Straight, Strong, and Flexible for Life: Master Program for Healthy Bones and Joints
Chapter 13. Creating Breast Health
Our Cultural Inheritance: Nurturing vs. Self-Sacrifice
The Emotional Anatomy of Breast Cancer
Program for Creating Breast Health
Breast Cancer Screening
The Promise of Thermography
Putting Breast Cancer Risk in Perspective
The Breast Cancer Gene: Should You Be Tested?
The Effect of HT on Breast Health
Bioidentical Hormones and Cancer Risk
The Tamoxifen Dilemma
Chapter 14. Living with Heart, Passion, and Joy: How to Listen to and Love Your Midlife Heart
The Heart Has Its Say at Menopause: My Personal Story
Cardiovascular Disease: When the Flow of Life Is Blocked
Palpitations: Your Heart’s Wake-up Call
Gender Bias and Heart Disease: Our Cultural Inheritance
Reducing Your Risk for Heart Disease
Carbohydrates, Sugar, and Heart Health: What Every Woman Should Know
Cardioprotective Supplements
Foods for Heart Health
What About Aspirin?
Get Moving!
The Heart-Estrogen Link: What’s Really Going On?
How to Love and Respect Your Midlife Heart
The Heart-Opening Effect of Pets
The Intellect Is Certain It Knows, but the Heart Always Wins
Epilogue: The Calm After the Storm
Resources
Notes
About the Author
List of Figures
Figure 1: The First Two Wake-Up Calls: PMS and SAD
Figure 2: Currents of Wisdom
Figure 3: The Hypothalamus-Pituitary-Ovary Connection
Figure 4: Reward Across the Life Cycle
Figure 5: Why Traumatic Memories May Be Relived at Midlife
Figure 6: Emotional Anatomy
Figure 7: Hormone-Producing Body Sites
Figure 8: Menopausal Symptoms Timeline
Figure 9: Kinds of Estrogen
Figure 10: Kinds of Progesterone
Figure 11: Body Mass Index Chart
Figure 12: Types of Fibroids
Figure 13: Pelvic Organs with Supporting Muscles
Figure 14: The Clitoral System
Figure 15: The Anatomy of the Skin
Figure 16: Female Vertebrae
Figure 17: Bone Remodeling
Figure 18: The Lymph System
Figure 19: The Heart-Emotion Connection
Acknowledgments
I would first like to acknowledge all those whose skills and insights helped me birth the first edition of this book during my own perimenopause back in the early 2000s, especially Mona Lisa Schulz, M.D., Ph.D., Joel Hargrove, M.D., and the masterly and legendary editor Toni Burbank.
For this updated version, I gratefully thank:
Marnie Cochran of Random House for her enthusiasm and editorial skill.
Theresa Zoro for her veteran publicity skills.
Ned Leavitt for being a soul-mate agent.
Scott Leighton for both his medical illustrations and his wonderful energy.
Hope Matthews, my Pilates teacher, for assisting me in keeping my body flexible and strong.
Julie Hofheimer, my massage therapist, who is a midwife of both body and soul.
Fern Tsao and her daughter Maureen Manetti for their skill with Traditional Chinese Medicine and for keeping my chi flowing freely.
My team at Hay House, Louise Hay, Reid Tracy, Margarete Nielsen, Dani Riehl, Donna Abate, and Nancy Levin, and the entire staff of both Hay House and Hay House Radio for helping me pleasurably produce my website, PBS shows, and radio show—and also orchestrating uplifting speaking engagements.
Judie Harvey for her Web and editing skills, and great sense of humor.
Doris Cohen, for her impeccable skill as a psychologist and friend who also has access to rock star angels and spirit guides.
Katy Koontz for living out her scribe archetype with such skill, speed, and panache. She has been a godsend during this and so many other writing projects.
Sue Abel for helping keep my home clean, restful, and beautiful and for taking such good care of my cats when I’m not here.
Mike Brewer for keeping my home and grounds maintained and lovely.
Abby Shattuck for her gardening skills and feeling for plants and the earth.
Chip Gray and the Gray family of the Harraseeket Inn in Freeport for providing delicious, gourmet, low-glycemic, organic food in a beautiful setting. They have created an invaluable oasis of comfort, warmth, and nourishment that I treasure.
Paulina Carr for her cheerful willingness to do whatever needs to be done. And also her ability to stick with it until she gets an answer.
Janet Lambert for her superior bookkeeping skills and general all-around great attitude.
Diane Grover for being the rock at the center of my whole life—keeping everything organized, clear, fun, meaningful, and on track. She is the woman behind the woman—and also the woman beside the woman. She is a first-chakra genius for whom I am enormously grateful every day.
Charlie Grover, Diane’s husband, whose good humor and willingness to provide backup and down-to-earth commentary are precious.
To my daughter Kate for being the perfect CEO (creative expansion optimist) for Team Northrup.
To my daughter Annie, who truly is the diva of the word and of my heart.
My mother, Edna, for continuing to be an inspiration about what’s possible in one’s eighties. To my late father, George Wilbur, whose work was the inspiration for my approach to women’s health. To my sister Penny Kirk and her husband, Phil, who have been such good friends and business co-creators. And to my brothers, John and Bill, and their wives, Annie and Lori. I cherish them all more than I can say.
Christiane Northrup, M.D.
INTRODUCTION
The Journey Begins
In the year or two before I actually started to skip periods, I began to experience an increasingly common feeling of irritability whenever my work was interrupted or I had to contend with a coworker or employee who was not as committed to accomplishing the job as I was. Looking back, I recall that when I was in my thirties and my children were younger, their interruptions when I was in the middle of writing an article or talking on the phone were only mildly irritating to me. My love and concern for their welfare usually overrode any anger or frustration I might have felt.
But as I approached menopause, I found myself unable to tolerate distractions such as my eighteen-year-old asking me, “When is dinner?” when she could clearly see I was busy. Why, I wondered, was it always my responsibility to turn on the stove and begin to think about my family’s food needs, even when I wasn’t hungry and was deeply engrossed in a project? Why couldn’t my husband get the dinner preparations started? Why did my family seem to be almost totally paralyzed when it came to preparing a meal? Why did they all wait in the kitchen, as though unable to set the table or pour a glass of water, until I came into the room and my mere presence announced, “Mom’s here. Now we get to eat”?
The same thing occurred when it was time to get into the car and take off on vacation. Only when I myself made a definitive move toward the door did my family mobilize. It felt as though my presence caused them to lose their own personal initiative to take charge of a situation, be it dinner or a family trip. Still, during my child-bearing years I accepted this, mostly good-naturedly, as part and parcel of my role as wife and mother. And in so doing, I unwittingly perpetuated it, partly because it felt s
o good to be indispensable.
During perimenopause, I lost patience with this behavior on all levels, whether at home or at work. I could feel a fiery volcano within me, ready to burst, and a voice within me roaring, “Enough! You’re all able-bodied, capable individuals. Everyone here knows how to drive a car and boil water. Why is my energy still the organizing principle around here?” My indignation grew as I mumbled to myself, “If I were a man in the prime of life and at the pinnacle of his career, I wouldn’t be interrupted like this. Everyone would be wondering how to help me, instead of the other way around!”
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