Women’s Wellness at The Nest in Anchorage offers comprehensive, individualized care for women navigating perimenopause and menopause transitions. We help you feel empowered and educated about your health, and offer a variety of treatment options to reduce symptoms and improve quality of life.
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Barbara Norton, CNM, APRN, is one of only 4 current NAMS-certified Menopause Practitioners here in Anchorage. Providers trained by the North American Menopause Society (NAMS) are better informed and more up-to-date on the latest science regarding the menopause transition.
We take our time and value yours.
Hormone Replacement
As Nurse Practitioners, we can prescribe any hormone replacement regimen, whether oral or vaginal, that a client needs. We schedule ample time to discuss risks and benefits of taking exogenous hormones, and/or other medications that have been shown to reduce hot flashes, and can also recommend many natural ways to reduce hot flashes and other perimenopausal symptoms that may be lowering your quality of life.
Vaginal Discomfort
Decreasing vaginal discomfort is a high priority, and we can help with that in a variety of ways. We can prescribe medications to be used vaginally to help with the genitourinary symptoms of menopause such as dryness, burning, itching, and discomfort or pain with intercourse. We also offer treatment with the MonaLisa Touch SmartXide laser, which creates tiny thermal injuries to the vaginal mucosa to stimulate new cell growth and rejuvenate those tissues to be more like they were before menopause.
Urinary Incontinence
We can help with urinary incontinence in several ways. Our pelvic floor physical therapist can help strengthen clients’ pelvic floors through neuro-muscular retraining and strengthening exercises. The MonaLisa Touch has also demonstrated amazing results at decreasing or eliminating many women’s stress incontinence, because of the way in which it thickens the vaginal walls through the regrowth of the tissue.
Osteoporosis
Women are at greater risk for osteoporosis after menopause, and we schedule ample time to discuss the risks and benefits of medications to prevent or treat osteoporosis, and to discuss lifestyle changes that can keep your bones and muscles as healthy and strong as possible.
Mental Health in Peri/Menopause
The hormonal fluctuations of this midlife transition - combined with subtle and not-so-subtle messaging from society on the value of middle-aged women who are past their reproductive capacity - can leave many women feeling depressed, anxious, 'ragey,' or many other kinds of ways. If you have sought care for mood disturbances in what may be your perimenopausal period, and been offered only an antidepressant, if anything at all, you may benefit from seeking care with a perimenopause expert. A skilled clinician who will take the time to tease apart potential mood disorders from potential hormonal issues and possible adverse life circumstances may be invaluable in helping you feel like yourself again.
About Menopause
The word “menopause” literally means a pause in the menses, only it’s not really a pause in menstrual cycles, like during pregnancy, but a complete cessation in monthly bleeding. It happens to 100% of all women by a certain age. The range is 40-60 years old, but the average woman stops menstruating around 50-51.
Why do women have annoying hot flashes, vaginal dryness and lack of libido when they are perimenopausal? It has to do with the hormone estrogen, specifically, lower levels of estrogen. Women don’t stop producing estrogen after menopause, but the estrogen they do produce is only 1/10th as strong as the estrogen women produce during their reproductive years.
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Some common symptoms attributed to perimenopause/menopause are:
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Hot flash/flush
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Sleep disturbance
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Vaginal dryness
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Skin/hair changes
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Urinary incontinence
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Bleeding irregularities
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Forgetfulness
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Headaches
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Fatigue
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Nervousness, anxiety, or depressed mood
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Joint & muscle pain
About Perimenopause
The years when the body is readjusting from a strong estrogen to a weaker estrogen is called perimenopause, and this period generally lasts between 3-5 years. Most women stop having hot flashes after this period of time, although about 10% of women have hot flashes into their 60s and 70s. The other symptoms listed above persist or decrease in varying degrees based on a woman’s general fitness level, body composition (how much muscle and fat she has), diet and hereditary factors.
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Racial Differences in Peri/Menopause
Genetics plays a strong role in determining the timing of perimenopause and menopause for you, as well as the severity of your symptoms. There, are, however, significant racial differences in the severity and duration of symptoms across populations. This is yet another reason why it can be especially important to seek out a NAMS-certified Menopause Practitioner, because they are aware of these differences, and are therefore more likely to offer you solutions that are appropriate for your needs, rather than being dismissive or gaslighting you. As it is, physicians - yes, even OB-GYNs - get a mere few hours in menopause training in medical school, some of which is even optional, in the form of elective lectures. Combine this with the fact that Black and Indigenous women generally receive lower quality care in all areas of health, regardless of income and education level - though the egregious obstetrical outcomes disparities capture the most headlines - and you've got a recipe for really sub-par care for menopausal symptoms in most clinical settings for these women. It's important to find providers who are familiar with concepts such as implicit bias, who are aware of the racial differences in the experience and presentation of menopausal symptoms, and who genuinely care about helping women regain or improve their quality of life.