I first heard Kerry Roberts on the She2.0 podcast where she was talking about sleep and menopause. Kerry and her colleague, Carolyn are pharmacists and certified menopause practitioners working at Brant Arts IDA in Burlington, Ontario.*
After listening to Kerry, I knew I had to get in touch and learn more about her field. When I was going through the, ahem, heat of menopause I really could have used someone with the expertise and training to help guide me through the migraines, food and alcohol intolerance (shoot me now), and, of course, the night sweats.
If you need to hear some great tips on sleep and menopause – including night sweats, insomnia, sleeping too little or not falling asleep right away, have a listen. Her suggestions helped me extend my too-short sleep.
Here are the highlights from my discussion with Kerry.
What is a menopause practitioner?
I had never heard of a menopause practitioner before so I asked Kerry to explain who they are and what they do. She sent me this explanation:
Menopause Practitioners are medical professionals that help women through their transitional years. They are dedicated to promoting the health and quality of life of women through their vast knowledge of menopause & peri-menopause. These experts aim to improve symptoms and alleviate a variety of women’s health concerns such as: sleep disturbances, night sweats, hot flashes, low libido, mood swings, anxiety, depression, vaginal dryness, irregular menstruation and more.
A Certified Menopause Practitioner must be a health care professional (usually a physician, pharmacist or nurse) who has passed a competency exam in menopause, administered by the North American Menopause Society (NAMS). These practitioners are required to complete ongoing continuing education and must demonstrate their expertise in the field to maintain this credential/title.
NAMS is “recognized as the preeminent resource on all aspects of menopause to both healthcare providers and the public. NAMS is a 501(c)(3) nonprofit organization.”
It draws from a variety of fields to help women better navigate the health and wellness of the menopause years and beyond. If you’re interested in finding out about the latest developments and practices in menopause symptom treatment, visit their website.
When Should I See a Menopause Practitioner?
If you are like me, you might be in denial about whether or not you are in perimenopause. I experienced irritability, mood swings and fatigue in my mid-forties but decided it was just a phase and I could suck it up. It never occurred to me that I could actually do anything about my symptoms.
If you are experiencing new, unexplained symptoms (the Brant Arts IDA questionnaire suggests at least 3 symptoms at a significant level) that fall under the umbrella of menopause, you might want to seek out some professional guidance.
Since many different types of healthcare practitioners can be certified, some are able to take blood samples to measure hormones while others, such as pharmacists, are not. The same goes for writing prescriptions.
But here was the interesting part – helping women through menopause rarely requires blood tests.
Because when you are in perimenopause, your estrogen level is usually fine, it’s your progesterone level that is changing.
Further, your hormone levels will vary greatly throughout the day and week, so whether you take blood samples now or in a few days, at night or in the morning, your hormone levels will be all over the map.
Kerry says that a menopause practitioner can tell clinically where you are in your stage of life just by the severity of your symptoms.
Their goal is to help you alleviate your symptoms and they aim to use the lowest possible doses of therapy to do that.
Because of this strategy, a menopause practitioner may differ in their approach to help you from your family doctor (if they are not a certified menopause practitioner). Family doctors will follow provincial/state guidelines for treatment of menopause related symptoms.
In theory, the provincial and state governing bodies are supposed to be referring to NAMS for the latest information on treating menopause symptoms.
However, they can be months, if not years, behind the times.
Need an example? Here in Quebec, the recommended practice for using estrogen (a form of hormone replacement therapy, HRT for short) post-menopause is 5-10 years and no more than 10 years.
However, when speaking to Kerry, she said that current recommendation, according to NAMS, is that you can continue to use HRT as long as your symptoms last and as long as you need it, no end date needed.
Do Menopause Practitioners only focus on HRT?
Many women either choose not to or are not a candidate for HRT and might wonder what other options exist to help alleviate symptoms.
Because each woman responds differently to treatment options and has different treatment preferences, menopause specialists work with you to create the best course of action.
Kerry and her colleague, Carolyn Wishkin, always start with a questionnaire to highlight what symptoms need the most attention.
The first line of action to help alleviate symptoms tends to focus on lifestyle alterations. Commonly, they will suggest ways to:
- Alter your diet,
- quit smoking if you are a smoker,
- create an exercise routine,
- improve your sleep habits, etc.
Many women will find a noticeable improvement after taking lifestyle steps (as hard as some of them may be).
If you opt to start HRT, practitioners will always start with a low dose. In fact, menopause practitioners often start with a lower dose than what doctors generally prescribe. Their aim is to have you on the lowest dose that improves or eliminates your symptoms.*
If you would rather opt for trying herbal supplements, Kerry notes that while they are not as potent as HRT, they can still help relieve symptoms. Something to keep in mind is that they must be taken consistently and it takes a few months for their full effects to kick in.
Keep in mind that, in some studies, herbal supplements did not perform as well as placebos. The thinking is that sometimes just the thought that you are taking a supplement is enough to calm down your adrenal gland and help the symptoms go away. Which leads us to the big elephant in the room – stress.
Stress is a big problem amongst midlife women for so many reasons. Stress will make any menopausal symptoms you have worse. It’s one of the big reasons so many professionals encourage women to focus on self-care first. We tend to feel guilty about it but in fact, if we feel better and less stressed, we can handle our other responsibilities better.
In addition to stress, some of the other symptoms that they can address are:
- Hot flashes
- Bone health
- Heart health
- Joint pain
- Foggy thinking
- Increased irritability
There are many more symptoms and you can evaluate your needs using the questionnaire.
Symptoms tend to be at their peak two years before and two years after menopause, although perimenopause symptoms can start as early as 10 years before menopause while post-menopausal symptoms can last 15 years or longer after menopause (night sweats, for instance).
How Can I Find A Menopause Practitioner Near Me?
Kerry and Carolyn both work at Brant Arts IDA in Burlington, ON as pharmacists and certified menopause practitioners.
With Zoom calls now being common, it’s possible for you to have a consult with either one of them (see this page for fees). You may prefer to seek out someone closer to home, in which case you can find the list of menopause practitioners on the NAMS site.
Kerry and Carolyn have hosted workshops in the past to help women navigate perimenopause. With CoVid, they brought the workshops online. What they found was that of their attendees, 73% of women suffering from symptoms do not treat them due to not knowing about the treatment options available to them. The workshops have helped women have more control over how to manage menopause.
You can contact Kerry or Carolyn for more information or sign up to receive their newsletter.
*This information is brought to you for education purposes. There is no affiliate or sponsorship involved. However, in full transparency, Brant Arts is one of our "brick and mortar" partners.