The New Menopause: Navigating Your Path Through Hormonal Change with Purpose, Power, and Facts

In this part, Dr. Haver discusses the physical and emotional impacts of menopause, the benefits and risks of hormone therapy, strategies for navigating healthcare appointments, and how to empower oneself through education and advocacy to manage menopausal symptoms effectively.

Dr. Haver employs patients’ anecdotes to emphasize The Emotional and Psychological Impacts of Menopause, such as referring to Susan P.’s testimony about the emotional and psychological toll of menopause in Chapter 5. These personal accounts humanize medical information and provide a sense of solidarity for individuals who may feel isolated in their experiences. By emphasizing that menopause is not only a physiological phenomenon, Dr. Haver validates the mental strain menopause causes many women. In not only focusing on the biological alone, she provides a holistic understanding of changes women can experience during this stage of life.

Dr. Haver references scientific research to emphasize The Biological Changes of Menopause. For instance, in Chapter 5, she discusses how factors like early menarche or childbearing can influence menopausal timing, referencing studies that show women who never had children may be at a higher risk for early menopause. By integrating this research, Dr. Haver emphasizes the individualized nature of menopause. Similarly, in Chapter 6, Dr. Haver incorporates references to studies and expert opinions when discussing health risks such as osteoporosis, coronary artery disease, and neuroinflammation. She cites the Journal of Internal Medicine’s alarming statistics on hip fractures in postmenopausal women, grounding her arguments in empirical data to heighten the urgency of preventative care. Her references to Dr. Lisa Mosconi’s work on neuroinflammation and cognitive decline highlight the importance of timing in hormonal therapy, illustrating how cutting-edge research can be integrated into patient care. In Chapter 7, Dr. Haver directly confronts common myths surrounding MHT, especially its controversial history stemming from the WHI study. She references updated research to debunk these fears and advocate for a nuanced understanding of MHT. In Chapter 8, Dr. Haver cites the 2022 North American Menopause Society’s updated position on hormone therapy to emphasize the importance of current, evidence-based care.

Dr. Haver’s ability to balance clinical information with empathy is particularly evident, for example, in Chapter 5, when she discusses the systemic issues in women’s healthcare, such as the inadequate training of physicians regarding menopause and the long history of dismissive treatment toward women’s health concerns. She uses statistics from research surveys to demonstrate how many women have to visit multiple doctors over several years before they receive proper care, which underscores the importance of education and advocacy.

Dr. Haver introduces key concepts and medical insights to educate her audience, which reinforces the theme of Empowerment Through Education. For example, in Chapter 7, she provides an in-depth explanation of hormones like estrogen, progesterone, and androgens, breaking down their specific roles during menopause. By introducing each hormone group separately—like estradiol, estrone, and estriol—and explaining their varying biological impacts, Dr. Haver offers not only clarity but also empowerment. She intentionally avoids jargon-heavy language, opting instead for clear explanations that make complex medical processes understandable to a non-medical audience.

Dr. Haver consistently organizes her writing in a way that breaks down complex topics into manageable sections, allowing individuals to follow a logical progression of ideas. For example, in Chapter 7, when discussing hormone therapy, she presents different aspects in clearly defined sections—such as types of hormone replacement, delivery systems, and the risks versus benefits. After explaining the basics of hormone production, Dr. Haver moves into specific delivery systems for HRT—such as patches, creams, gels, and pills—carefully outlining the risks and benefits of each option. Similarly, Dr. Haver uses comparison and contrast to clarify the differences between synthetic and bioidentical hormones, compounded versus FDA-approved options, and systemic versus local delivery methods. For instance, her breakdown of FDA-approved bioidentical hormone therapy versus compounded bioidentical hormone therapy provides a balanced view of both, highlighting the benefits of bioidentical hormones while cautioning against the inconsistent regulation of compounded options.

Dr. Haver critiques the lack of standard diagnostic tools for perimenopause, stressing that many women are often left undiagnosed or misdiagnosed by clinicians. In Chapter 5, her critical examination of tests like the dried urine test for comprehensive hormones (DUTCH)—which she dismisses as unsupported by medical societies—reflects her commitment to evidence-based medicine. This skepticism toward ineffective or unproven methods positions her as a reliable source who advocates for informed medical decisions. At the same time, she introduces promising innovations like the serial form of urine testing, showing optimism for future diagnostic advancements.

Dr. Haver is deliberate in using a conversational tone, which makes her complex subject matter—such as hormone fluctuations and endocrine system changes—more relatable. For example, in Chapter 6, phrases like “our bodies are finite” and “it is what it is” communicate acceptance of biological change and motivate people to seek knowledge (72). She frequently employs metaphors, comparing the reproductive system to a symphony, where each phase of the menstrual cycle is described as a “note” that must be perfectly played for the body to function properly. Similarly, the use of visual aids, such as the diagram “How the Ovaries Work” and “Hormone Levels According to Menstrual Cycle Phase” (73, 75), is a practical tool that enhances comprehension by visually mapping out the changes in hormone levels. Dr. Haver also incorporates rhetorical strategies like direct address to engage readers more personally. Phrases such as “My goal with this chapter is to establish a foundation of information” create a conversational and reassuring tone (96). This direct communication style aligns with her larger goal of empowerment, as she encourages women to advocate for themselves in a medical system that often dismisses or underestimates their symptoms.

Additionally, Dr. Haver uses a practical framework to demystify the often intimidating experience of medical appointments. In Chapter 8, she provides a step-by-step guide on how to approach these interactions, including suggesting specific questions to ask healthcare providers and explaining the importance of personal preferences in managing menopause. This mirrors the non-fiction technique of using a guidebook-like tone, offering both theoretical and actionable insights. By asking people to actively participate in the preparation process—such as by keeping a symptom journal or compiling family medical history—Dr. Haver instills a sense of agency.

However, while Dr. Haver fosters empowerment by providing tools for women to take charge of their health, some may feel overwhelmed by the amount of self-preparation and responsibility she places on the patient, especially in a medical system that can be notoriously difficult to navigate. Moreover, Dr. Haver’s repeated emphasis on seeking specialized care and MHT could unintentionally marginalize women who either lack access to specialized providers due to material factors or structural inequities or prefer alternative, non-medical approaches to menopause. Her strong focus on hormone therapy might overshadow non-hormonal options, which she could have more thoroughly explored to offer an even more holistic view of menopause care.