Navigating Health Transitions with Cultural Wisdom and Support
This talk was delivered to the First Nations People at 2024 Seventh Day Adventist camp meeting 28 March - 1 April 2024, by Dr Purity Carr, GP & Menopause Doctor
Acknowledgement of Country
I’d like to begin by acknowledging the Traditional Owners of the land on which we meet today. I would also like to pay my respects to Elders past and present.
Many thanks to Darren Peakall the Aboriginal & Torres Strait Islander Ministries (ATSIM) director Western Australia. ATSIM is a department of the Australian Union Conference of the Seventh-day Adventist Church in Australia. The ATSIM Department of seventh day Adventist Vision Statement is To know, experience and share hope in Jesus.
This presentation is a story of a woman's journey, respecting the wisdom and strength that comes with age and the use of safe natural treatment to manage the transition into menopause.
What is menopause?
Menopause is a natural stage in a woman’s life when her menstrual periods stop permanently. This happens because her ovaries stop releasing eggs and producing certain hormones like estrogen and progesterone. Understanding these changes is important for managing menopause symptoms effectively and protecting women's future health.
Understanding Health Differences: First Nations Communities vs. Others
Health is essential for everyone, but First Nations communities face unique challenges that affect their well-being differently compared to others. Menopause adds to the health, financial and society challenges. If a woman is equipped with the right information and given an understanding of all the options available to her, she can make informed choices to effectively manage her current and future health. This has ripple effect in our family and communities. When our health is good, we can do more to support and educate our community. Together, we will do well.
Let's take a simpler look at some challenges that First Nations Womens uniquely face:
Life Expectancy: First Nations people may have shorter lives because they may have more unrecognised o poorly managed health problems like diabetes, heart issues, and certain cancers.
Chronic Diseases: First Nations communities may experience more health issues such as diabetes, heart diseases, breathing problems, and certain cancers. This happens because of lifestyle and genes.
Mental Health: Many First Nations people may feel sad, anxious, may use drugs more often than others. This is because of past traumas, feeling disconnected from their culture, and not having enough mental health support.
Infant Health: Sometimes, First Nations babies and moms have more problems during and after birth. This can be because they don't get enough care before birth, live far from good hospitals, or face other challenges.
Healthcare Access: It can be hard for First Nations people to see doctors or get good care because they live far from hospitals, some doctors may not understand their culture, and it can cost a lot of money.
To improve women's health outcomes, we must ensure that healthcare providers understand First Nations cultures, make healthcare more accessible.
Menopause and Its Significance
Menopause is a time when a woman's body goes through natural changes, signaling the end of her reproductive years. In Aboriginal cultures, elders hold a place of great wisdom and respect, much like the wisdom gained through life's transitions, including menopause.
Ovaries play a vital role in reproduction by producing immature eggs that require fertilization to create a baby. When these eggs remain unfertilized, we experience menstruation as the uterus sheds its lining. As we age and the supply of immature eggs diminishes, we gradually approach menopause, marking the end of menstrual cycles.
Perimenopause: The Lead-up to Menopause
Before menopause, women go through a phase called perimenopause. Perimenopause can start anywhere from 4 months to 10 years before menopause. In my practice, I see women as young as 33 with perimenopause symptoms. Think of perimenopause as a bridge connecting regular menstrual cycles to menopause; it's important to acknowledge and respect these changes but also understand all the ways that you can manage menopause. If you recognize your symptoms of perimenopause and menopause and seek help from a health professional, ask about the effectiveness of the treatment, side effects, and safety. Try to speak with a health professional who understands all the options for managing your symptoms.
During perimenopause and menopause, hormone levels in the body start to change, which can lead to symptoms like hot flashes, mood swings, irregular periods, headaches, weight gain, high cholesterol, diabetes, dry eyes, dry mouth, bloating, constipation, diarrhea, nausea, tiredness, poor memory, poor sleep, backache, joint ache, muscle aches, vaginal dryness, lack of sex drive, leakage of urine when we cough or sneeze, incontinence of urine, experiencing the urge to urinate, anxiety, depression, mood swings, irritability, anger, aggression, and lack of joy in life.
Genetically, First Nations women are likely to experience perimenopause and menopause early. Having access to information that helps women understand their hormone changes and get the right support will help improve their current health outcomes and lower the likelihood of chronic conditions like diabetes, heart disease, high cholesterol, strokes, heart attacks, heart failure, and cancer.
Hormone Replacement Therapy (HRT): Understanding Your Options
Hormone Replacement Therapy (HRT) is a treatment that can help manage bothersome menopausal symptoms as well as protect our future health from diseases such as diabetes, high blood pressure, high cholesterol, osteoporosis and dementia. It involves taking hormones like estrogen, sometimes with progesterone and Testosterone. For most women, HRT is safe to use, especially estrogen through the skin.
Heart Health during and after Menopause
Menopause can influence heart health due to changes in hormone levels affecting blood vessels and cholesterol. Maintaining a healthy lifestyle with regular exercise, a balanced diet, stress management, and avoiding smoking can significantly lower heart risks during menopause and beyond.
Final Word!
Respecting Cultural Wisdom and Support
First Nations cultural beliefs and support systems are significant. Seeking advice from elders, community health workers, and culturally aware healthcare providers can offer valuable insights and personalized support aligned with cultural values and practices. However, it's also important to recognize that there is new information and understanding about safer and more effective ways to manage women's health.
Empowering Your Health Journey
Empowering women during menopause means understanding cultural values, accessing reliable support from community sources, and making informed decisions about health options. Each woman's experience with menopause is unique, and culturally sensitive healthcare ensures respectful and effective support for overall well-being.
Here is a simple and practical list of ways to improve access to menopause care for First Nations people:
1. Culturally Competent Healthcare: Train healthcare providers to be culturally competent and aware of First Nations beliefs and practices regarding menopause.
2. Community Education: Conduct workshops and outreach programs within First Nations communities to educate individuals about menopause, its symptoms, and available healthcare options.
3. Accessible Healthcare Services: Ensure that menopause care services are easily accessible, especially in remote or rural areas, through mobile clinics or telehealth services.
4. Empowerment through Knowledge: Empower First Nations individuals with knowledge about menopause and available treatments through culturally relevant educational materials and support groups.
5. Holistic Health Approaches: Incorporate traditional healing practices and holistic health approaches into menopause care plans, collaborating with traditional healers and Indigenous health practitioners.
6. Address Socioeconomic Barriers: Advocate for policies and programs that address socioeconomic barriers such as poverty, inadequate housing, and food insecurity, which can impact access to healthcare.
7. Respect and Dignity: Create safe and welcoming healthcare environments that respect the privacy, dignity, and autonomy of First Nations individuals seeking menopause care.
8. Research and Data Collection: Support research initiatives and data collection efforts focused on menopause experiences among First Nations populations to inform tailored interventions and policy changes.
Implementing these practical strategies can help improve access to menopause care and promote better health outcomes for First Nations individuals.
By Dr Purity Carr
GP & Menopause Doctor
Harvey, Western Australia