Teaching and Dancing with Menopause

Approximately 5,000 women in the U.S. enter menopause each day, yet most are reluctant to talk about this important transition in a woman’s life. Hot flashes, night sweats and mood swings are just a few of the feared symptoms. The good news is that the right lifestyle choices, before and during menopause, can make the process much more bearable. Even better, your dance teaching career may protect you from many of the discomforts and health risks of menopause. In fact, studies at both Stanford and Emory Universities have shown that the more physically active you are during this transition, the less bothered you are likely to be by the symptoms.

The formal definition of menopause is the period marking the end of menstruation and childbearing years, characterized by the decreased production of certain hormones that leads to a spate of changes in a woman’s body. The average age of women who enter menopause is between 51 and 52 years old. The transition lasts approximately two to four years, but the experience is different for each woman. There are three distinct phases: perimenopause, menopause and postmenopause. Each phase brings with it unique physical and emotional challenges.

During perimenopause, which usually begins in the mid-40s, you may notice changes in your menstrual periods—they may be longer, shorter, heavier or lighter—and you may experience more or fewer cramps. Menstrual periods may also become very unpredictable. “I never knew when to expect my period once I hit 40,” says Barbara*, who teaches ballet in Arizona. “More than once I was caught unprepared while conducting a class.”

Hot flashes are one of the most common complaints of menopausal women. Occasional hot flashes may occur during the perimenopausal phase, but will become more common during menopause. Estrogen, the hormone responsible for regulating body temperature, is produced in smaller amounts after menopause, leading to sudden surges in body temperature. Spicy foods, alcohol and stress may also trigger hot flashes, which can occur at the most inopportune times—while teaching a class, for instance.

Mood swings, including anger, irritability, frustration and sadness, are another common symptom of perimenopause. Emotions can change rapidly from one extreme to the other. “I was amazed at my reactions sometimes while teaching a class,” recalls Janice*, who teaches jazz in California. “It felt like I had no control over what was coming out of my mouth. I would often feel frustrated when demonstrating a new combination that I thought was quite simple, but my students weren’t getting it. I would snap and, the next thing I knew, students were in tears. Of course, then I would feel awful. It was a very frustrating time for all of us.”

During perimenopause, decreased production of progesterone can cause difficulty getting to sleep and staying asleep, which leads to chronic fatigue. (Progesterone is the master hormone that controls the manufacturing of estrogen and other vital hormones.) Other physical symptoms include difficulty concentrating, heart palpitations, weight redistribution, as well as headaches, joint pain and muscle stiffness.

The next phase of the transition is menopause. Menstrual periods may cease  completely, while hot flashes and night sweats increase, leading to more difficulty staying asleep. Mood swings, decreased libido, vaginal dryness and discomfort, difficulty concentrating and weight redistribution continue into this phase.

Postmenopause is the final phase of menopause, when the body has completed the transition. Most symptoms will disappear as the body readjusts to lower hormone levels. Lingering symptoms can include vaginal dryness and a resulting difficulty with intercourse due to this dryness, which can be alleviated with localized hormone replacement therapy. (For more on whether to seek hormone replacement therapy, see “Hormone Controversy.”)

Although the symptoms of the menopausal transition get most women’s attention, it is the accompanying health issues that are of real concern. While these include diabetes, thyroid dysfunction and cancer, the two biggest are cardiovascular disease and osteoporosis. Both stem from the decrease in estrogen production, which has been in abundant supply since puberty. Estrogen wards off heart disease by keeping arteries dilated and free from plaque buildup. It also helps to keep blood pressure and good cholesterol at healthy levels. When women reach menopause and estrogen levels naturally decline, these forms of protection decline as well.

Estrogen also protects from osteoporosis by regulating the amount of osteoblast and osteoclast activity. Osteoclasts clear away the old bone while osteoblasts build up new bone. When menopause occurs, and estrogen begins to be in short supply, osteoclasts become more abundant than osteoblasts. Therefore, old bone is cleared away faster than new bone can regenerate. (For more on how to prevent osteoporosis, see “Bare-Bone Facts About Bone Health” in DT March 2004.)

The best ways to prepare for menopause are to know what to expect and to be aware of the health issues associated with the changes taking place in your body. An honest assessment of your lifestyle is a must.

Recent findings suggest that women whose weight has remained stable throughout midlife are at less risk for breast cancer. The Nurses’ Health Study, an ongoing project that has followed 120,000 women for almost 30 years, reported that women who gained more than 20 pounds from 18 years of age to midlife doubled their risk of breast cancer, compared to women whose weight has remained stable. In addition, if you have not smoked and your blood pressure and cholesterol levels are within normal limits, you are at lower risk for heart disease.

Continuing to teach dance several times a week throughout your adult life, including during menopause, will help ward off osteoporosis. Maintaining a healthy lifestyle that includes weight-bearing exercise, such as tennis, dancing, walking, hiking, and running, helps protect bones from weakening. It is important to assess your activity level in the dance studio. A dance teacher with a long career may have excellent body conditioning, but if you are spending more time managing your studio or choreographing dance routines than demonstrating in class, you may need to supplement your physical fitness regime to ensure that your bones stay healthy. You should be dancing or teaching for at least 45 minutes, three times a week to maintain adequate bone mass.

In addition to regular exercise, a healthy diet high in fiber, low in fat and rich in fruits, vegetables and plant-based proteins (such as beans, lentils, legumes and soy) will provide protection against diseases. Make sure to include calcium, magnesium and vitamin D for your bones. Although opinions are mixed, some studies indicate that a daily intake of 25 to 30 milligrams of soy can provide relief from hot flashes. Soy also helps to lower cholesterol, which in turn protects your heart.

Karen Soroca, who teaches yoga and dance in Berkeley, California, encourages teachers not to give in to the temptation of discussing their menopausal symptoms with students. “Ten-year-olds would not be very interested,” she says. “If the dance class is for adults and there are middle-aged women in the class, you can answer questions and talk about the benefits of dancing while going through menopause.”

To make yourself more comfortable, wear layers so you can remove or put on clothing as necessary. Select loose items made of cotton and other natural fabrics to provide the ventilation you’ll need, but keep in mind that students need to see your body when you demonstrate steps, so stick to clothing that is comfortable but not oversized. If you are suffering from hot flashes, keep an extra change of clothes at the studio in case of extreme perspiration. Be sure to drink lots of water, and open up the windows for a refreshing breeze. A spray bottle is excellent to keep on hand as well. And remember, there’s nothing to be embarrassed about: Dancing is a physical activity, so your students expect to see you sweat.

Unlike many careers that require more sedentary lifestyles, the stress that teaching dance has put on your body can actually safeguard against heart disease and osteoporosis. But don’t let this be an excuse to avoid getting annual dental, eye and skin checkups and complete physicals. Remember that health and longevity do depend on the choices you make each day. Keeping up with all your medical appointments can keep you dancing and teaching far beyond midlife. DT