by Carol Hoffman

Katherine is facilitating the committee meeting this morning. Usually she is very smooth and calm, but today she is flushed and sweating. She seems upset as she walks around the podium, removing her jacket and dabbing her face with a tissue.

Katherine, a 52-year-old healthy and productive worker, is experiencing one of the most common symptoms of menopause, the hot flash. Menopause is a natural, normal hormonal change which most women experience in their forties and fifties, and some in their thirties. For most women, it is a gradual process that can take many years.

Menopause is rapidly becoming a significant workplace issue. The large baby boomer generation is now reaching middle age, and there are an increasing number of women in the workplace. At Berkeley, 87 percent of female career staff are between 30 and 60 years old. Much like pregnancy, menopause is associated with symptoms that can affect the woman's work and personal life.

"The hormonal changes of menopause may affect eating, sleeping, body temperature, energy level and productivity, among other functions," says Mary Jo Knueven, a nurse practitioner at University Health Services and instructor of the menopause class for Health*Matters.

Some women can have no symptoms at all or only mild hot flashes for a short period of time, while others may experience severe symptoms of profuse sweating that may require them to change clothes and bedding nightly. Women may also experience forms of insomnia, including early awakening. Irritability, anger and feeling down also may be present, due either to inadequate sleep or changes in hormone levels.

According to Knueven, the challenge for women in managing these symptoms is exacerbated by the inability to clearly identify the causes. "Are my worries about deadlines the source of my insomnia or are hormones causing me to lose sleep? Is my increased workload affecting my relationship or are these emotional and desire changes based on hormonal shifts? Am I having trouble remembering words because of hormones or general overload? "

Unfortunately, just as it is impossible to always understand the causes of the symptoms, there is no clear prescription for symptom relief.

"Since menopause is normal and not an illness, many women have concerns about medical intervention for symptom relief," says Knueven.

Good health habits are helpful during this time. Knueven recommends that women make an increased effort to get regular aerobic exercise, do weight-bearing exercises and maintain a nutritious diet, including 1000-1500 mg calcium per day. Consume alcohol only in moderation, if at all, and stop smoking. Meditation, yoga, breathing and relaxation exercises are helpful techniques to reduce stress. Seeking support from friends, colleagues and family also is recommended.

For some women, moving toward a more healthy lifestyle is sufficient in managing symptoms, notes Knueven. "Other women may need to address the symptoms of hormonal imbalance with hormone replacement therapy, to help them live manageable and productive lives.

However, women need to consider that hormone replacement therapy may influence other conditions -- such as reducing the risk of heart disease and osteoporosis, while possibly increasing the risk of breast cancer with long-term use."

The benefits and disadvantages of replacement therapy and alternative treatments need to be evaluated on an individual basis by each woman, in consultation with her personal health care provider. Still, decisions can be difficult given insufficient and sometimes conflicting medical information.

Many women like Katherine may find that being active participants in their health care decision-making, following healthy self-care strategies, sharing coping strategies with other women and finding support can help them get through the disruption caused by menopausal symptoms.

For More Help...

Ä "Menopause," a three-session class on Tuesdays, April 8,15 and 22 from noon to 1 p.m. Call Health* Matters at 643-4646 to enroll. The third class provides opportunity for individual questions and discussion and is open to all interested women.

Ä "Self-Care for Menopause" and "Menopause: What Men Need to Know" are educational packets available from Health*Matters at 643-4646.

Ä UHS Self-Care Resource Center has books, videos and other resource materials for midlife women. It is located on the second floor of the Tang Center, 2222 Bancroft Way. Call 642-7202 for more information.

Ä CARE Services offers individual counseling, assessment, referral and groups for faculty and staff and their families. For information, call CARE Services at 643 7754.

Carol Hoffman,LCSW, is a manager with UHS-CARE Services.