How To Get It All Done

Balancing work and family life has never been easy. Often a woman’s health and other personal concerns are easily overlooked as she cares for everyone around her. While no woman’s life is identical to the next, we all could learn something from those who have more than a handle on the high-stakes scenario. We talked to several such women who gave us a peek into how they stay cool and keep it together—mostly. We also chatted up physicians who challenge everyone to add themselves to their agendas. What’s more, we selected a few key wardrobe pieces to demonstrate how styling doesn’t have to be stressful or prohibitively pricey.

By Lexi Gray, Natalie Kaar, Lynn Norusis and Jennifer Pullinger with Matt Basheda, Buzz McClain and Lexie Ramage

Photography by Jonathan Timmes

WORK/LIFE
Women Find Balance Through Patience, Perseverance.

Many women who struggle to balance career and personal responsibilities have found that the solution might change day to day, which means it’s necessary to plan ahead and remain calm when the daily grind becomes overwhelming.

By Lexi Gray

The way women balance responsibilities is often an individualized process, making it sometimes irrelevant to compare coping methods with other female co-workers. Since each person has their own preferences and limitations, sacrifices that seem worthwhile for one woman might make another person miserable. This struggle affects women both with and without children, though the two groups face somewhat different issues.

Working moms may feel penalized at the office if co-workers or supervisors believe they are focusing too much on their home lives. Similarly, they may also feel guilty at home for focusing too much on work.

Rene Syler, author of the book “Good Enough Mother” and host of www.goodenoughmother.com, says there are times when women need to accept they won’t always be perfect as mothers.

Syler, a former co-host of CBS News’ “The Early Show,” says, “For instance, I’m not a good cook—but that doesn’t make me a bad mom. It’s important for mothers to admit that they are human, and sometimes they should work on their own needs, even if this means spending time away from their children. When women become moms, it doesn’t automatically mean they lose all their dreams, goals and aspirations. It’s fair for us to continue to learn and grow as women.”

Syler says her inspiration for the “Good Enough Mother” book and website came from several of her friends who were constantly stressed out by their own commitments at work and at home.

Kristen Quackenbush
Master Matchmakers is a powerful force in reality TV. “Tough Love,” starring the company’s founders, is now in its fourth season on VH1. Kristen Quackenbush leads the Matchmakers’ efforts in the D.C. area, cultivating healthy relationships and doling out advice, all while balancing her endless duties as a wife and mother to five, ages 1- to 17-years old.by Matt Basheda

When and how did you make the transition from hobbyist to full-time professional? I guess I’ve always sort of been just a natural matchmaker … my stepmother was my chemistry teacher in high school when I introduced her to my dad. In my prior life I was a high school biology teacher and I actually have a master’s degree, so it’s not like I went to school to be a matchmaker or anything.What are some keys to being a professional matchmaker these days, especially since the dating scene is moving more and more online? People are coming to us mostly because they’re busy and picky, and they refuse to meet someone, actually, online.

Obviously you have to be extremely social to be a matchmaker, but you also have family concerns. How do you balance work with all the family schedules? It’s tough. … It’s definitely a delicate balance, and certainly I don’t juggle it all perfectly. It does definitely cut into family time, when I’m supposed to be making dinner and hanging out with the family, and I’ve got clients that also want to talk. … but I just have to make it all work, and schedule everything, and everything in moderation. Sometimes I don’t know how I do it, I literally feel like it is a juggling act, and I’m constantly, instead of juggling three balls, I’m juggling like eight balls on fire all up in the air at the same time.

What is one mantra you seem to live by when it comes to creating a happy work/life balance? It can’t all be about the kids; it can’t all be about work. It has to be a little bit of both at all times. I’m the queen of multitasking [laughter].

“I was seeing so many women act like it was a tragedy to work overtime—like they deserved to have their kids taken away from them for working too much. Women can be so hard on themselves when it comes to family,” Syler says. “I just want to convey the idea that you don’t have to be perfect to be a good parent. It’s all right to be good to yourself, as well as everyone else. Working moms tend to put themselves at the bottom of the to-do list, but you can’t take care of other people unless you’re also taking care of yourself.”

The stress of work-life balance is certainly not reserved for working mothers, says Julie Gray, who offers organizing and coaching services through her company Profound Impact, in Arlington. “Regardless of whether or not you are a mother, I believe there is a certain type of woman—one that is driven, ambitious and type-A—who tends to work more, in the house or out of it.”

She adds, “I think some of us feel compelled to ‘do it all’ before we can give ourselves a break, before we feel we deserve a break. I think this can keep us endlessly searching for that blissful moment when our to-do list is completed.”

Single women without children may fall victim to a work environment where long overtime and travel hours are expected of them, even when they’re burned out. They may feel pressured to work and travel more than married moms, since they don’t have children at home. As a result, these women could end up working considerably longer hours than co-workers with children.

Bella DePaulo, Ph.D., is a social scientist and author of two books on the subject of “singlism”—a phrase she coined to describe how single women are stereotyped in the workplace and beyond.

DePaulo says, “When President Obama first floated the name of Janet Napolitano—a woman who has always been single—as Secretary of Homeland Security, Pennsylvania Gov. Ed Rendell said that Napolitano would be perfect for the job, because she has no life and could therefore spend 19 hours a day at work.”

DePaulo adds, “That was a bold-faced statement of a stereotype, one that a politician didn’t realize he should never have uttered.”

A National Focus on Women at Work and at Home
The National Partnership for Women & Families is a Washington, D.C.-based nonprofit focused on creating a society “where nobody has to experience discrimination and all workplaces are family-friendly,” according to the organization’s website.

Vicki Shabo, the National Partnership’s director of work and family programs, says that though the issue has been discussed in the media for years, it is critical to recognize the struggle women encounter when trying to take care of their families while also meeting responsibilities at work.

“Most companies don’t have paid family leave or even paid days off when they are sick or they need to take care of a sick family member,” she explains. “As workplace culture changes, an increasing number of companies understand how retention improves their bottom line, so they begin to offer flexibility in various forms. My hope is we will see it become a standard to offer paid maternity leave and telecommuting options. Employers should offer flexibility so that workers don’t feel like they might be risking their job if they can’t work overtime.”

Addressing concerns like those voiced by the National Partnership, the White House Council on Women and Girls and the National Science Foundation (NSF) announced a 10-year plan designed to provide greater workplace flexibility to women and men in research careers. Under the “NSF Career-Life Balance Initiative,” researchers in need of time off to care for a newborn or newly adopted child would be allowed to delay or suspend grants for up to one year to fulfill those duties.

Subra Suresh, NSF director, explains the need for the initiative: “Too many young women scientists and engineers get sidetracked or drop their promising careers because they find it too difficult to balance the needs of those careers and the needs of their families. This new initiative aims to change that, so that the country can benefit from the full range and diversity of its talent.”

The government also recognized the need for more workplace flexibility in early 2010, when the President’s Council of Economic Advisors released a report stating that allowing employees more flexibility is shown to contribute considerably to a company’s success.

Sacrificing for the Future
Sarah Chi, a Fairfax resident, is a government researcher who makes significant sacrifices to sustain her career while caring for her toddler son. As her husband finishes a Ph.D. program in another state, Chi lives with the couple’s son so that she is able to keep her full-time job here.

“I was awarded my current position at the same time I graduated with my Ph.D. and found out I was pregnant,” Chi says. She continues, “It was a great opportunity, but my husband was still a Ph.D. student and couldn’t quit to move with me. We thought if we could make it through this period of time until he finishes his degree, the outlook for both of our careers would be good.”

Though Chi says the decision to live apart from her husband while taking care of their son full time makes sense, it has been a struggle. “To be honest, we were quite naïve and very brave to come up with this decision. We’re first-time parents and didn’t expect all the difficulties and chores that come with childcare at the very beginning. But on the other hand, being too rational sometimes will cause people to lose great opportunities.”

“I clearly define my schedule into several time slots, then I prioritize tasks within each slot. After work and until my son goes to bed, the priority will be all about him. If he’s fully satisfied, there will be less of a chance he’ll be cranky—which means I can have a more peaceful night after he goes to bed,” Chi says.

Positive attitude and calm demeanor aid Chi in motherly duties. “Sometimes I feel like dealing with kids is just like dealing with an emergency issue or annoying boss. When the situation is bad, it requires more emotional control. If we can keep ourselves calm, the problem will usually be solved with less effort.”

Chi does get the sense that her co-workers, friends and family are aware of the time and effort she spends on maintaining balance. However, says Chi, “It doesn’t mean they can fully understand or appreciate it.”

A Nice Balance, Despite the Challenges
Gray says that recognizing the signs of being overwhelmed will help increase balance and satisfaction. One sign of an imbalanced life, according to Gray, is “the feeling of not being able to stop because things will start falling apart. This is a pretty clear sign to me that your to-do list is running you instead of the other way around.”

Another sign, Gray suggests, includes “the feeling that you don’t have energy or time for anything other than work—that everything is an urgent priority and must be done immediately. These are classic signs of burnout and overwhelmed thinking.”

Viola Chen, of Springfield, works as an antitrust economist at the Federal Trade Commission. In March of 2010, she had her first child, a son, and took five months off to care for him. Maternity leave for Chen meant combining her paid sick and vacation days; however, after those ran out, it was mostly unpaid.

She returned to work with the goal of pumping milk daily until her son was a year old. “When I returned to work, I was lucky enough to be able to pump milk for him at the nurse’s office at my workplace. As much as I hated pumping—seriously, who would enjoy it?—I continued until my son was 11-months old.”

Chen’s efforts to balance work and home continued when her request to telework one day per week was granted. Though she was the first person in her division to request a regular telework schedule, it was already fairly common in other departments at the FTC, so Chen says: “I am not that revolutionary.”

Another challenge Chen faces is finding time to spend with her husband. “It’s not that we have any problems, but rather in the balance of child, work, housework, catching up with friends, parents/in-law visits and alone time.”

Chen adds, “One struggle I face isn’t necessarily a work/home sort of struggle but an internal one between my feminist self and my mother self. The two are unable to be reconciled.”

Yet sometimes finding the balance between work and home just takes time and practice. “I feel that at this point in my life, my family has come to a nice balance in terms of work and home life,” Chen says.

Helping Other Parents
Dr. Jennifer Canter is a board-certified, child abuse and general pediatrician, and also a mom to twin boys and twin girls. Dr. Canter hosts her own website, “Play this Way with Dr. Jen,” and in 2008 invented the U-Play Mat, a learning tool designed to promote language and social developmental play.

With all of that on her plate, Dr. Canter’s No. 1 priority is family. She lives with the expectation that an unplanned child-related issue will occur, whether it’s a sick child, a forgotten lunch, or another duty.

Dr. Cantor, who lives in Westchester County, NY, says, “I don’t see [work and life balance] as a black and white decision. There are times when mommy mode kicks in 100 percent. For example, one time my son was in the hospital with Lyme meningitis, and I made sure to stay in touch with my office but drop anything that wasn’t critical.”

According to Dr. Cantor, the purpose of her website is to create a platform that makes parents feel good. After sharing a story about how in one week she dropped her phone in the toilet, broke her toe, and then locked her keys in the car, Dr. Cantor says, “We are all balancing and juggling. I’m just open to sharing how I attempt to do it, and by no means is it easy.”

Cynné Simpson
Most might recognize Cynné Simpson as an ABC7 news anchor. But some may not know that this Howard University graduate is living her dream. Since childhood Simpson has wanted to be a news anchor, often doing interviews with a Fisher-Price tape recorder. Originally from suburban Detroit, she now lives in Arlington. Simpson came to the Metro-D.C. area to “watch history unfold” and cover the 2008 presidential race. Though she has been here for a relatively short time, Simpson has had a great impact. By Lexie Ramage

What have you learned about balancing work and social life? Well, that it’s a challenge. I’m not someone who has this completely figured it out yet. For me, work isn’t just a 9-5. This is more of a lifestyle, and so a lot of my socializing is tied into my work, and sometimes my work is tied into my socializing. So, I’ve learned how to blend the two.About what percentage of your time do you devote to work and to a social life, respectively? Are you happy with those percentages or would you like to change them? I’d say I do about 85 percent work, 15 percent downtime. And one day, not anytime soon, I hope to reverse that. But for right now, I love the work that I do. I’m so passionate about news; this is a dream come true for me doing this work. As I explained, it’s something I wanted to do since I was really young. So I feel privileged to be able to do this, and this is what I want to do. I’m not one of those people like, ‘Oh, it’s another day at work’; this is my lifestyle. This is who I am. This is what I do.

When you aren’t working, how do you prefer to spend downtime? I love to travel. I spent a lot of time traveling, and my family is spread out all across the country, so luckily they love to travel, too. We usually do three or four international trips, vacations, a year.

What keeps you going throughout the day? I’m a person of faith, and I think that gives me a lot of motivation. In this business I think that every day [you’re] working with a lot of hurdles and challenges and things that come up. I have faith in the order of things. That I don’t have to control everything, that there’s order to the universe.

Satisfaction, Not Balance
Attaining satisfaction in life starts with identifying traits of the ideal work-life balance, Gray says. “What do you want—peace of mind? A healthy body? What is satisfying for you?”

Once those main goals have been identified, they can be reached by putting new systems and rituals in place. “Most often this involves developing a practice that centers people, gives them patience, and gets them out of their heads for at least a few minutes a day,” Gray says.

Cindy Simpson, director of programs and external relations at the Association for Women in Science, says that satisfaction is the key to maintaining efficiency at home and at work.

“Balance implies that both sides have to be in equilibrium, which is really difficult to achieve. It is important to feel satisfied with the amount of time that you give to both your career and your personal life, with the understanding that this will change over time,” Simpson says.

Simpson, who lives in Alexandria, says she loves being a working mom, and frequently shares work scenarios with her children to get their perspectives. Being a working mom makes her feel like a well-rounded individual, and this brings a great deal of satisfaction to her life.

“Some days the focus will need to be on work, while other days the focus will need to be on your family, depending on your circumstances,” Simpson says. “You can tell when you’re not satisfied, and when that happens it’s important to access your priorities to determine how you can achieve satisfaction. And remember, nothing lasts forever!”

WOMEN’S HEALTH

Prescription for Well-Being
What every women needs to know to maintain her health through the ages

One day, the headlines tell women they need take a vitamin supplement, drink eight glasses of water, and get a mammogram every year, among other health prescriptions. The next day, supplements could cause vitamin toxicity, eight glasses of water has become six, and mammograms are only required every other year. So what’s a woman who wants to optimize her health to do? And to whom should she listen?

First, let a little common sense and a dash of precaution prevail when it comes to good health. Maintain a healthy weight. Consume a balanced diet. Get regular exercise. Don’t smoke. Everything in moderation.

It’s often as simple as that, yet it’s easier said than done for most of us who can’t resist the plate of chocolate glazed donuts, down their third diet soda of the day, skip their regularly scheduled gyno appointment, or opt for a nap instead of a jog or walk around the park.

“From 20 and above, if you had to pick one thing that was common amongst every female in every age category, its weight,” says Dr. Barry Rothman, M.D. with Alexandria’s Physicians for Women.

According to the Centers for Disease Control, approximately one-third (33.8 percent) of all adults in the U.S. over age 20 are obese, with obesity defined as having a body mass index equal to or above 30.0. Another one-third (34.2 percent) over the age of 20 are overweight, but not technically obese. Let’s add this up and repeat this heart-racing statistic—a full two-thirds of Americans are either obese or overweight.

Obesity increases the risk of stroke, heart disease, high blood pressure, diabetes and endometrial, breast cancer and colon cancer, plus a host of other diseases and conditions, including infertility.

The 20s and 30s are the peak child-bearing years, so reproductive health, especially if children are desired, is something young women should guard and protect. That’s even truer for women approaching their late 30s and early 40s, as fertility rates decrease and pregnancy complications increase.

“Patients are deciding late to get pregnant, which is OK. We have in-vitro specialists who are helping these ladies in their 40s,” says Rothman. But even though they can conceivably get pregnant later in life, they are at risk because reproductive organs deteriorate with age. “So a lot of these ladies are overweight, and now they are getting pregnant, which is going to compound the problem,” adds Rothman.

Denise Austin
To see fitness maven Denise Austin in a yoga pose is to see a body balanced, with every chakra along her spine in perfect alignment. She manages to do that in her life, too, despite the swirling activity: She’s closing in on 100 fitness DVDs (“Shape Up and Shed Pounds” is new in stores); she’s national spokesperson for Idaho Potatoes and Skechers; she stays in touch with some 1 million fans via her robust DeniseAustin.com website; and she does a weekly segment on Lifetime’s appropriately named “The Balancing Act.”

Now that the Alexandria resident’s two daughters are older—Kelly is 21 and at college in Southern California; Katie is 18 and in high school—Austin can reflect on how she managed to get to where she is, and give advice to those who need more balance. By Buzz McClain

You’ve been making DVDs since 1988 and been married 27 years. Does your husband, sports agent Jeff, ever complain about being neglected? I have a great husband who is helpful and supportive; that always is important. But I make my family first; that’s probably the biggest thing about balance. I work around their schedule; I’ve already looked at Katie’s entire spring lacrosse season, and I know when I can and can’t go out of town. I’m blessed that I’m able to do that; years ago I couldn’t.

What’s a day like with you? I wake up at 6:30 on most days, have warm water and lemon, eat breakfast, get Katie up and make a big breakfast for her because I’m a true believer in breakfast. I make her lunch, then jump up on the treadmill, do yoga or walk with my girlfriends. I like to walk the Parkway to Mount Vernon, Arlington Cemetery or the C&O tow path. When the kids were younger, I didn’t answer the phone between 3 and 6 when the kids were home, because at 3 I turn into a mom. On Fridays I make dinner for my daughter’s friends; I love to hear everything that’s going on in school.

What’s most important about balancing your life? Finding 30 minutes a day for yourself. We’re awake 16 hours, so 30 minutes is not that much. You deserve it, and you feel better.

Two other major health and nutrition concerns for women involve calcium and vitamin D intake. Some women might think that only older ladies need to pay attention to their daily dose, although young women in their 20s do, too. Bones continue to build until about age 25, says Dr. Preston Sacks of Columbia Fertility Associates.

STD prevention is another health issue young women need to be mindful of, with consideration given to getting the HPV vaccine, which prevents certain types of the human papillomavirus that cause most cervical cancers. The Centers for Disease Control say the vaccine can be given as early as age 9 and up to age 26.

When a woman hits her 20s, she should also schedule regular visits to her gynecologist for a pap smear, and consider having them done every one to two years until age 30. “If you have three consecutive normal pap smears and are beyond age 30, then you can get them every three years,” says Sacks. HPV testing is done whenever there is an abnormal pap smear to help guide the treatment, he adds.

“Once you get HPV, the virus, you always have it. It never goes away,” Rothman reminds his patients. The vaccine doesn’t protect against all HPV types—roughly 30 percent of cervical cancers are not prevented by the vaccine, according to the CDC. “So I tell patients, condoms are the best form of protection against that until you are with the sexual partner you are going to be with for the rest of your life. Don’t depend on the vaccine to prevent anything,” says Rothman.

How often women should get a mammogram has been up for debate by in the medical community for many years. The National Cancer Institute says when women reach 40 years of age, they should get a mammogram every one to two years. The CDC recommendation suggests getting them every two years if you are age 50 to 74 years of age.

Another important test for women in their 50s, typically the time of menopause, is a bone density test, performed to assess for osteoporosis. Getting enough calcium and vitamin D can help improve bone health, as can cardio and weight bearing exercise, says Sacks.

One of the biggest health concerns for women of menopausal age and beyond is cardiac disease, with more women over age 60 dying from it than any other disease. “It’s not breast cancer, it’s not uterine cancer, it’s cardiac disease. Sometimes we don’t treat females as aggressively as we treat males,” Rothman says. Women over 50 who have a family history of cardiac disease or strokes should make a special point of talking with their doctor.

Nobody knows your body—and the health of your body—better than you. To stay healthy as one ages, women should above all listen to their bodies and talk to their doctor if they feel something isn’t quite right. While treatment guidelines exist, the prescription for good health isn’t one size fits all.

Overcoming infertility
Young and “older” women experience difficulty in conceiving.

There was once a time when a woman reached her early 20s, it was expected she would find a mate, settle down and start a family. Today, women, thankfully, have more options than that—and they are taking advantage. More often, women are delaying motherhood, perhaps to focus on their careers or until they find a man they truly wanted to marry. Yet with pregnancy coming later in life, sometimes in the late 30s or early 40s, women need to recognize that the risk of fertility complications increases.

“Women have been given an opportunity to make life choices that are more appropriate for where they are in their life than they were in the past,” says Dr. David Saffan of Shady Grove Fertility. “And if for them, family, at this moment in their life, is second to their career, well, there’s a cost to that.” But there is hope for them.

Infertility isn’t just a natural phenomenon of women who postpone motherhood beyond age 35, however. Women in their early 20s and 30s can also experience difficulty in conceiving. The Centers for Disease Control report from 1970 to 2006, the average age of first-time mothers increased by 3.6 years, up from 21.4 to 25 years, while 12 percent of women of childbearing age will end up seeking out the services of an infertility clinic.

Women in their prime reproductive years—20s and early 30s—don’t necessarily experience different symptoms of infertility than women past 35-years old, which is commonly believed to be the age that fertility rates start falling. Women who have regular cycles, some reasonable frequency of sexual relations, and don’t get pregnant within a year are considered infertile. For women over 35, the barometer drops to half that: six months.

By age 40, over half of couples seeking to have a child will be infertile, says Dr. Preston Sacks of Columbia Fertility Associates. Women are born with all of the eggs they will ever have to conceive. Naturally, fertility declines with age because the “longer you store an egg, the more it deteriorates,” adds Sacks.

In addition to age, other potentially problematic signs include irregular menstrual cycles, excessive menstrual pain or bleeding, bleeding in between the periods, or pain with intercourse, says Sacks. For those patients have had a sexually transmitted disease, experts also advise against waiting a full year to seek treatment.

“If you are 38 or older—and some people would even say 35 or older—and you’re not pregnant within six months, then you should start looking into things because you don’t have enough time if there is a big problem to fix it, or at least attempt to fix it,” says Saffan.

Any patient, no matter their age, who is struggling to conceive will be given a routine evolution, including blood tests, to check hormone levels as well as ovulation tests and ultrasound tests for uterus and ovarian function. Patients may then have a hysterosalpingogram or HSG to check the fallopian tubes and if the uterus is a normal shape, says Saffan. The partner may also be asked to do a semen analysis, since men experience fertility problems, too.

Depending on the condition, treatments may be medical or surgical, ranging from fertility drugs to stimulate ovulation and injectable hormones for intrauterine insemination (IUI) and in-vitro fertilization (IVF). With patients who have irregular ovulation cycles, 80 percent will respond to ovulation-inducing pills like Clomid. “Those that do not will require the injectable medications, and they are highly effective at inducing ovulation. Whether pregnancy occurs is then related to other factors present,” says Sacks.

For women who ovulate regularly, ovarian reserve testing can reveal the quantity and quality of a woman’s remaining eggs and in turn how well they will respond to medications. “The goal is to increase the number of eggs available to offset the decline in egg quality. Obviously the side effect is multiple pregnancy,” says Sacks.

For women in their early 40s, ovarian function decreases significantly, as does the opportunity for them to get pregnant with their own eggs. “Nobody gets the pregnancy rate in their 40s that they had in their 30s or 20s,” says Saffan. One treatment option is using a donor egg and, in the case of male infertility, using a donor’s sperm.

Egg preservation is another route to extending the life of your fertility. “With newer freezing techniques, with six eggs, most women who are 38 will have a pregnancy rate of about 50 percent,” says Saffan.

Kathy Houser of New Market, Md., sought out the help of Shady Grove’s Baltimore office after two years of attempting to conceive. She was 37-years old at the time and had a normal cycle. “For me, it was two years of trying and just complete frustration, and the fact that things just weren’t working,“ says Houser. “My husband has two children from his previous marriage, so I was pretty sure it didn’t have anything to do with him.”

Houser also believed she had genetics on her side; her mom had become pregnant at 42-years old. “I was completely astounded to find out that I was considered old, so I think more and more women are coming to the realization that after 35 it becomes more difficult,“ she says.

After testing, Houser’s doctor started her with IUI coupled with fertility medication. The first cycle wasn’t successful, but the second provided more hopeful results. “I guess I wasn’t responding very well to it, so they upped the dosage right towards the end where they would normally tell you it was time to take the trigger injection and release the eggs,” says Houser. “I had way too many follicles developed so the risk of multiples was really high at that point, so they wanted to cancel the cycle,” which she did.

“With the way I had responded to the medication, they said I would be a great candidate for IVF,” Houser adds, which is ultimately what worked for her—her daughter just turned 2-years old.

Houser’s advice to those women who are having trouble conceiving is to reach out to a fertility specialist sooner rather than later, especially if you are over 35. Secondly, recognize that you are not alone. Approximately 6.1 million or 10 percent of women in the U.S. ages 15 to 44 have trouble conceiving, according to the CDC.

“You enter into it thinking you are the only person. It seems like everyone else you know is getting pregnant really easily, and that’s really not true,” she says.

Time Stops for No Man—or Woman
Women No Longer Want to Suffer Through the Symptoms of Menopause.

Milestones come and go as women age. The first time we get our period. The first time we have sex. The first time we get pregnant. The first time we begin to go through … perimenopause? That’s right—for some women, “the change” is something to actually anticipate. No more “time of the month“! For others, it’s a time of mourning—officially say goodbye to youth—and a time to start managing some unpleasant, flustering symptoms.

Of course, there are many variations in between in how women process the years leading up to menopause, but if Blanche from “The Golden Girls” has taught us anything, it’s that life can be good—maybe better—during and beyond “the transition.”

Perimenopause, the precursor to menopause, is when a woman officially stops having menstrual cycles, and her ovaries stop producing eggs. Perimenopause can begin as early as age 35 but typically hits in the mid 40s. Symptoms can include hot flashes, night sweats, tender breasts, difficulty sleeping, anxiety, low energy and libido, and irregular, painful, heavy or spotty periods.

“Back in the old days, patients may have just dealt with it as, ‘That’s what happens to ladies.’ Today’s modern patient just doesn’t want to put up with that anymore … she wants to do something,” says Dr. Barry Rothman of Physicians for Women in Alexandria.

The birth control pill can be prescribed as a way to alleviate the symptoms of perimenopause, and it‘s safe to take up to about age 54. “There’s no increased risk of breast cancer. There’s no increased risk of cardiac disease, and there’s actually a decreased risk of uterine and ovarian cancers,” says Rothman. “Patients who are smokers over the age of 35 cannot be put on the birth control pill, so it’s dangerous for that category only.”

Clearly, the pill isn’t just for preventing pregnancy. “I have more patients today over the age of 35 who have had tubal ligation or their husbands have had vasectomies—so obviously they are not using it for contraception—on the birth control pill. They are on the low-dose birth control pill because it’s safe and they need menstrual regulation,” adds Rothman.

Uterine or endometrial ablation, which is an outpatient surgical procedure, is also an option for women who experience heavy bleeding. This is where a doctor destroys the lining of the uterus so the lining doesn’t grow back, and the patient no longer has menstrual bleeding. A third and the most severe option for treating heavy bleeding is removal of the uterus, or hysterectomy.

Hormone replacement therapy, or HRT, is a treatment option for women going through perimenopause, but is more common and recommended for women just entering menopause. HRT has become a controversial treatment over the years, especially since the National Institutes of Health released results from its Women’s Health Initiative in 2002. The study indicated that women on HRT were at a higher risk of stroke, heart disease and breast cancer. Many physicians, including Rothman, have come to view the data as flawed, however, because the study largely only tested HRT on women in their 60s, and not women in their 50s when menopause typically occurs. HRT is most beneficial when started within the first two years of menopause, says Rothman, something perimenopausal women should be sure to keep in mind.

Mood swings can also pose a problem for perimenopausal women. “Patients may find that their moods are changing,” says Rothman. “Their children may notice it, their spouses may notice it, co-workers may notice it—that you are a little bit more on edge as you get closer to your period, or your personality really has changed or they’ve noticed a difference in your personality to be more on the depressed or anxious side,” Rothman says. Some of the milder antidepressants like Zoloft and Wellbutrin can be prescribed for mood swings, anxiety or chronic irritability.

Rene Welton of Kingstowne, 51, says her first menopausal symptom was a heavy period, so she went on birth control. Rothman’s wife, Tara McCarthy, 54, says one day, her period stopped, so she went on HRT, and “because of that, I think I’ve missed a lot of the symptoms. The only thing I really have are night sweats, but they are not as bad as some of my friends might have,” she says.

Welton says HRT may be for some women, but it’s not for her. She prefers natural methods of treating symptoms. “My mom never used any estrogen replacement therapy, and she’s 76 and got through it fine, so I’m hoping I can be the same way,” she says. Alternative treatments include black cohosh tea, evening primrose oil, wild-yam root and omega-3 fish oil. Other non-medicinal remedies include getting regular exercise; yoga or meditation can be helpful in dealing with certain physical—and mental—discomforts.

The hot flashes and night sweats that accompany perimenopause are especially disruptive, says Welton. “It’s the chief complaint that perimenopausal and menopausal women have … the hot flashes and the insomnia and the irritability,“ she says. “And some women can handle them … and then some are just not happy at all.”

Women today should know there are remedies available to help them navigate the sometimes rocky road of perimenopause.

“A lot of women of my generation know what their mothers went through—their mothers just suffered through it until it passed. This is a different era. … We’ve got plenty of treatment options. You can go on a very low-dose hormone replacement therapy, you can go on a higher dose, you can find the right dose for you, but to me, it’s just not worth suffering for,” says McCarthy. “You want to try and have a reasonable degree of peace and serenity.”

(January 2012)