Thursday, February 4, 2010

New Moms and Menopause

Raging hormones are certainly an expected side effect of the expectant mom, but when the expectant mom is simultaneously approaching menopause, the term “raging hormones” doesn’t even begin to describe what she’s going through. Thanks to the miracle of modern medicine and fertility drugs, this scenario is not the oxymoron it used to be. Indeed, there are more than a few moms out there ‘enjoying’ morning sickness along with hot flashes. I should know. I’m one of them.
It’s no secret that women are having children later in life, hence the growing collision between ‘new momhood’ and menopause. The National Center for Heath Statistics in Washington, D.C. reports that births to women ages 45 to 49  the years when most women are approaching menopause  rose 15 percent from 1990 to 1999. Although more uncommon, births to women age 50 and older are also rising largely because of fertility treatments. According to Dr. David DiChiara, MD, of Beverly Hospital, “Two of my patients in their mid-forties had premature ovarian failure and premature menopause, and went the donor egg route. Several got pregnant by accident, if you will, and then two to three years later went into menopause.”
Having worked long and hard to get pregnant myself, I was ready for the morning sickness, the swollen ankles, even the gestational diabetes, of which I had all three. However, I was not prepared for the simultaneous upheaval of my confused 46-year-old uterus. To put it mildly, the old uterus didn’t know whether it was coming or going. On the one hand, it was, I suspect, delighted to be a ready receptacle for my blossoming embryo. On the other, it was only too happy to say so long to the monthly menstrual cycles that had wrecked havoc on it for more than 30 years.
Now, three-and-a-half years later, I’m proud to say I’ve weathered nine months of pregnancy, 14 months of breast feeding, and too many months of the terrible twos. However, it’s the last eight months that have been the toughest in terms of bodily changes. As my daughter rounded the three-year mark, my 49-year-old body was hell bent on embracing the menopausal journey. I fully expected to have fitful sleep patterns when I was pregnant. Ditto, when I was nursing. However, I was really looking forward to a more normal nocturnal schedule once my daughter began sleeping her 12-hour stints. Not so. It seems as you approach menopause, one of the side effects of changing hormonal levels can be insomnia. The doctors were quick to tell me that sleeplessness would most likely get worse before it got better. In fact, they said I might be one of those ‘lucky’ women who could look forward to another 10 years of insomnia.

Rhonda, a new older mom who had her son when she was 43 and went into menopause four years later, says, “Which came first? The exhaustion from lack of sleep from being a new mom, or the lack of sleep because of shifting hormones? Then, the mood swings because of lack of sleep? “She calls this the ‘older mom conundrum’.
Adds Rhonda, “I experienced hot flashes and mood swings, as well as fitful sleeping patterns. But because my nights were often interrupted by my son, I got used to functioning on less sleep and didn’t connect this rollercoaster ride to hormone shifts.”
For Rhonda, the experience of being a new mom and an older new mom often blended: “If you add the perimenopausal symptom into the mix of new mom experiences, it can wreck havoc with your mind, body, and soul. But, sometimes I wondered, is this the experience of being a new mom or an older new mom?”
What were the other challenges we menopausal moms could look forward to? How about the physical limits of the middle-aged body? I had no problem getting down on all fours to play “horsey” with my daughter. It was the getting back up that was a problem. I suspect you wouldn’t hear 20-something moms emit the grunts and groans I was unable to suppress as I went bi-level.

Linda, at age 53, agrees, and adds that life experiences and not having the career issues a 20-something mom might have, helps provide wisdom and patience at every turn.
“After 19 years of marriage, at 43 I had a surprise pregnancy, a very rough delivery, and a long healing process. So, I can truly say motherhood is the most exhausting, yet the most rewarding job I’ve ever had.”
Linda, who leads an Arlington-based, older first-time moms group that began in Arlington nine years ago, adds that menopause wasn’t an issue until she reached her 50s. “In fact, after the birth, for the first time in my life my periods were regular. Besides, who has time to think about menopause while taking care of a baby?” Having sailed through the menopause storm with hardly a symptom, Linda thinks her lack of hot flashes might be due to the diet of tofu and veggie soup she began consuming on a twice-weekly basis at age 51.
Rhonda adds, “Because I’m often around younger moms, I forget that I’m older and need to remind myself that it’s okay to go a little slower and take a break when necessary.”

As Hot Flashes, Warm Bottles: First Time Mothers Over Forty author Nancy London confirms: “While all mothers feel tired, the perimenopausal mother’s fatigue is compounded by her post-birth/premenopausal hormone cocktail. This potent mix creates a bone-deep fatigue that is poignantly juxtaposed against the high-energy needs of her young child.”
So much for energy levels. And what about weight gain? Thanks to a pregnancy diet to hold in check gestational diabetes, I only put on 16 pounds during my entire pregnancy. However, because I was deprived of certain goodies for nine months, I managed to make up the difference after the baby was delivered. In fact, I now weigh a solid 20 pounds more than when I was pregnant! At least when I was carrying my daughter, her growing needs helped to balance the calories. The experts say the weight gain is not helped by menopause and I can expect to put on an additional 10 pounds every year unless I make some minor dietary changes. Like starving myself, I wonder?

Another dilemma sometimes faced by the older new mom is whether she is the mother or grandmother of her child. I’ve certainly been on the receiving end of sidelong glances trying to ascertain which. In my husband’s case, since he’s already fifty-plus, more often then not, people assume he’s the granddad. But he’s no longer insulted. In fact, my husband now takes pride in the fact that he sired a daughter just two months shy of his 50 birthday. With me it’s a bit more sensitive. Afterall, I may be menopausal but I’m not yet 50. However, if you do the math, my daughter could just as easily be my granddaughter. And, if this were the old, pre-fertility drug days, she most likely would be.
On the brighter side, some of the research is more positive for us older moms. At the risk of offending young moms everywhere, I quote Dr. Sherman J. Silber, author of How to Get Pregnant With The New Technology. He says older moms not only tend to be more nurturing and better able to handle a child, “they actually have children that are more confident and brighter. By and large, the children are more intelligent," says Dr. Silber. He theorizes that these children are better cared for during the first 24 months of life, a fact that he believes can influence a child's personality and intellectual ability.
Says Rhonda, “I also believe that, being a little older, I might have a little more to give: I have more life experiences and so can focus this phase of my life on sharing those experiences with my child.”

Although there is no medical proof to date, according to the website Mothers Over Forty – The UK’s Premier Resource for Older Mothers and Fathers, editor Jan Andersen says: “There is evidence to suggest that women who become pregnant in there forties are less likely to suffer adverse symptoms during menopause. This is apparently due to the elevated levels of hormones that circulate in the body during pregnancy, which may give some protection against the less pleasant physical aspects of the approaching menopause.”
Suffice it to say that the experience of the menopausal mom is a mixed blessing. The two stages  motherhood and menopause  signal passages in a woman’s life. One tends to symbolize the opening of a door, while the other, the closing of one. However, having experienced some of each, I can honestly say the birth of my daughter makes the onslaught of menopause much more palatable. Because, while my physical body is rebelling in ways which signal the advance of the aging process, the experiences I’m sharing with my three-year-old make me feel just a little younger every day. Still, whenever I hear those 20-something new moms complaining about the perils of motherhood, I find myself thinking, “You should try this when your 50, sister”.

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