Singer and voice professor Michelle Latour shares her journey through menopause, including factors in how to manage symptoms and biological changes in ways that helped her continue to thrive in her work as well as manage other aspects of entering middle age.
I was not prepared. If you had told me 20 years ago, even 5 years ago, that this would be my life, I would not have believed you. I am incredibly fortunate to have a fulfilling life filled with love and success, but I do have a lot on my plate. In fact, it is overflowing with a stressful balance between contending with my middle-aged issues, serving my amazing voice students, and caring for my 84-year-old mother.
My health issues are not serious or life threatening, but as you age, things start to slowly deteriorate. Mine was a subtle, imperceptible process, but eventually I started noticing curious differences. Peering into the magnifying mirror and exclaiming, “What? Where did that wrinkle come from?” The shocking discovery upon trying to unsuccessfully yank on my trusted pair of jeans and observing, “Hey! Where did that bulge come from?” And my favorite, when demonstrating a concept during a Zoom lesson and thinking, “When did my arms starts to jiggle like Jell-O?”
Other signs weren’t so inconspicuous. I’ll never forget teaching an in-person lesson and experiencing my first hot flash. I remember wondering, “Why am I profusely sweating?” And then it hit me. Menopause! The results of a Follicle-Stimulating Hormone Levels (FSH) blood test a few days later confirmed my suspicions. I was, indeed, in menopause.
What does this mean and why don’t we talk about it more often? My primary care doctor, Dr. Rama Harouni, of Harouni Concierge Care in Las Vegas, admits, “Menopause affects each person differently, but one thing is for sure: menopause signifies the end of reproductive years for a woman and points out that we are aging. Given society’s obsession with youth, beauty, and sexuality, menopause does not find much of a spotlight.”
Dr. Harouni further reveals, “Menopause is difficult and tricky to manage. Most physicians avoid the conversation due to contradictory data about management of menopause as well as the emotional rollercoaster that comes with it. There is no one clear treatment available. It’s easier to talk about high blood pressure! Think about it this way…if you have strep throat, your doctor would know exactly what to do: Amoxicillin and done. However, finding the correct treatment for menopause can take months of discussions, trial and error, and weighing pros and cons of various treatments.”
After experiencing my first hot flash, I began researching options, one of which was starting Hormone Replacement Therapy (HRT). I consulted Dr. Harouni about the pros and cons. She informed me, “Positive outcomes from taking HRT include better sleep, fewer mood swings, improved bone and muscle strength, and improved sexual health. Negative side effects, particularly if used long term, include increased risk of breast and ovarian cancers, increased risk of heart and vascular diseases (strokes and heart attacks), as well as increased risk of blood clots.”
Since I did not have a history of cancer or heart-related issues, HRT seemed like a viable option. Ultimately it came down to sleep. As I have aged, getting a good night’s sleep has become increasingly difficult. It only took a few nights of being rudely awakened from night sweats to give me clarity. I could not fathom a future with little to no sleep, so it was a no-brainer to begin a low dosage of Prempro.
Rama Harouni, MD
There were additional changes. The biggest would have to be the constant fuzziness that had become my brain. I cannot tell you how many times I have walked into a room intent upon doing something, only to realize I had no idea why I had walked into said room. Or the propensity for forgetting words in the midst of a conversation. This is not helpful when trying to explain a pedagogical concept during a lesson.
The most recent development, and probably the most serious, was receiving DEXA test results, which measures bone density, and learning that I have osteopenia. According to clevelandclinic.org, “Osteopenia is a loss of bone mineral density (BMD) that weakens bones. It’s more common in people older than 50, especially women.”
Possible treatments for osteopenia include taking medication to protect bone mass, dietary changes, using supplements, and exercising. Except for the medication, I had already implemented those suggestions. Dr. Harouni recommended Actonel, but possible side effects include developing acid reflux and experiencing a weakening of the jaw bone. Since I had previously dealt with acid reflux and had major jaw surgery in 2013, the side effects were not a risk worth taking for me. For now, I wait and see what happens in the next few years. A glimmer of hope is that HRT does help with bone density.
Michelle Latour
Other menopausal changes include arthritis in my left hand, occasional moodiness, loss of muscle mass, and high cholesterol. The high cholesterol has been puzzling as my eating habits have remained unchanged and I eat fairly healthfully. When I started to gain weight in my early 50s, I begrudgingly swapped out my beloved breakfast of chocolate Pop-Tarts and heavily sugared coffee for whole wheat toast, fresh-pressed green juice, and matcha green tea. Lunches evolved from a chocolate chip cookie and a Starbucks Frappuccino to salads. Dinner changed from huge bowls of pasta to more healthful options. So why high cholesterol? Apparently, just another fallout from menopause. I am currently working with Dr. Harouni on tackling that issue.
I also went back to exercising. In my 30s and 40s, I had trained for marathons and practiced Bikram yoga. About four years ago, for a variety of reasons, I stopped being active altogether without changing my previous eating habits. Eventually I felt so miserable from living off of carbs, caffeine, and sugar, coupled with a sedentary lifestyle, that I knew I needed a change. I started walking. It was frustrating how difficult that was at first. How had I gone from running a marathon in under four hours to huffing and puffing from walking one measly little mile? Exercising slowly became easier, and I grew to love my morning walks. I lost weight but, more importantly, I felt good about myself.
Dr. Harouni validates my experience: “Women who use exercise as a tool to manage stress and anxiety are much better equipped to handle menopause. Metabolism and muscle mass can decline as you age. Most of us move less, drink more [alcohol], and eat out more often. It takes an effort to keep our metabolism high and muscle mass adequate. Our habits, diet, and exercise levels as a young individual will affect our aging process.”
I knew I had graduated to a different age bracket when I had to purchase my first pill organizer. I do not take a lot of medications, but between prescriptions, allergy pills, and a wealth of supplements, I take 17 pills a day. And let’s not talk about my penchant for going to bed well before 9:30 p.m. How did I ever stay out until 2:00 a.m. after a concert? Conversations with my friends now hover between sharing our most recent health scares, dealing with elderly parents, planning for retirement, and household projects.
And, finally, my eyesight eventually tanked. I have been wearing reading glasses for nearly a decade. At my most recent check-up, my ophthalmologist increased my prescription as well as suggested lubricating eye drops. As you age, your eyesight continues to worsen and tear production decreases. According to mayoclinic.org, “Dry eyes are more common in people over 50. A lack of tears is more common in women, especially if they experience hormonal changes due to pregnancy, using birth control pills, or menopause.” I now use Crocodile Tears for daily eye drops and Retaine for night-time eye ointment.
The comical side is that my husband and I constantly peer over our glasses at each other between reading and having a conversation. Same goes for teaching. My students are used to me looking at them with my glasses perched halfway down my nose.
Is menopause and being middle aged all that bad? Absolutely not. It has not impacted every facet of my life. I still have excellent hearing, I have gray hair sprouting up only in my eyebrows, and I have noticed only small changes with my voice. And I take great pride in having an incredibly successful voice studio.
Most importantly, I have gained confidence in that I do not feel the need to impress anyone or fear that people will not like me. I am utterly content with the person I have become, despite the eyeglasses, the sags, the wrinkles, and the lifestyle shifts.
