Dr. Rachel DiSanto, a board-certified family medicine physician and medical director at Iredell Physician Network, addressed questions about menopause in a statement released on Mar. 16. DiSanto discussed the biological and cultural aspects of menopause, its symptoms, and ways women can manage this phase of life.
Menopause is an important topic because it affects women during middle age and can have significant physical and psychological impacts. Understanding the process helps reduce stigma and encourages women to seek appropriate care.
DiSanto described menopause as a biological event that typically occurs in women in their 40s or early 50s but noted that timing varies based on individual genetics and conditions. “It’s not a hard and fast rule, but women will commonly follow their mother’s patterns in terms of timing,” she said. She emphasized that menopause is not a single event but rather a prolonged phase involving hormonal changes similar to puberty.
Discussing historical perspectives, DiSanto said, “In the Middle Ages, they called it the witching time because they would see women going through unexplained changes that made them think they were losing their minds.” She explained that only recently has society begun to view menopause more as a biological process rather than something associated with irrationality or hysteria.
Cultural differences also play a role in how menopause is experienced and perceived. “In the Far East, particularly in Japan, menopause is celebrated because of their veneration of age in traditional cultures,” DiSanto said. She noted that Japanese women often experience different symptoms compared to Western women.
Common symptoms include hot flashes, mood changes, fatigue, cognitive difficulties such as forgetfulness, weight gain, hair loss, and sleep problems. Describing hot flashes specifically, DiSanto explained they occur when the brain’s thermoregulatory center malfunctions: “This causes blood vessels…to dilate so heat can dissipate into the air.” She added humorously: “It’s a cruel joke of biology that women get hotter as they age and men get colder because their testosterone levels decrease.”
For managing symptoms and thriving during menopause, DiSanto recommended healthy lifestyle choices such as diet and exercise along with possible medications or hormone replacement therapies (HRT). She cautioned against for-profit online supplement companies: “I’m not saying they’re all dangerous…but my experience with patients…is that they’re not receiving any follow-up lab testing or safety monitoring for blood pressure.” She advised patients to consult with healthcare providers before starting new treatments.
Mental health support is also crucial during this transition. “Don’t just dismiss a woman’s feelings because she’s menopausal,” DiSanto said. “Help them get the help they need so they can return to their level of health that is productive and engaged.”
