Certain topics just don't lend themselves to casual conversation _ and most of them involve the human reproductive system.
Take, for instance, erectile dysfunction. Until Bob Dole started shilling Viagra, impotence was not a topic that was discussed in polite company.
Now you can learn all about it during the Super Bowl's commercial breaks.
But women's reproductive issues haven't become nearly as mainstream.
Mention menstruation, its complaints and its hygiene products, and you can clear most of the men out of the room.
Even the women _ nearly all of who will have some personal experience with the subject _ don't want to chit-chat about it.
More taboo, however, might be talk about menopause.
Yet every woman who lives long enough will go through it, unlike, say, men and erectile dysfunction.
Our culture's distaste for the subject is so ingrained that women going through "the change" that I approached for interviews about the subject didn't want to have their names attached to "menopause" in a small city paper.
"A lot of women worry that they're past their prime," says the Mayo Clinic's Dr. Mary Marnach.
At its most basic, menopause simply means that a woman hasn't had a period for one year. The average age of onset is 51, according to the Mayo Clinic. But like anything involving humans, menopause gets significantly more complicated.
Menopause comes in stages.
"Perimenopause" refers to the years leading up to menopause itself. This stage can last up to six years.
"Postmenopause" is the rest of a woman's life after menstruation stops for 12 months.
"Induced menopause" is the result of a medical procedure; such as when a woman has her ovaries removed or undergoes some cancer treatments.
For many women, the only sign of perimenopause is irregular periods. Then, with little fanfare, they stop. But that experience might be more the exception than the norm.
According to Marnach, typical symptoms include "hot flashes, night sweats and disrupted sleep. The changes in hormones also increase the risk of some chronic health conditions, such as heart disease and stroke. And heart disease, not cancer, is the No. 1 killer of American women."
Also during menopause, a woman's vaginal walls will thin, which frequently leads to discomfort. She may also experience mood swings, a decreased sex drive and headaches.
As for cures, time is really the only remedy.
Still, there are other ways to manage the symptoms: with hormone replacement therapy, alternative therapies such as soy or black cohosh supplements, or a combination of the two.
The jury is still out on which is the best approach. Your doctor can help you figure out what might work the best for you.
Still, some techniques for taking the edge off of the upheaval of perimenopause require no medical intervention. The North American Menopause Society recommends five things that anyone can do. Take some time for deep breathing, they suggest, and take a mini vacation where you close your eyes and relax. They also recommend that women make "me" time as well as set realistic limits on their time.
"You can change the way you feel in a stressful situation by changing the way you interpret that situation. This concept is called `reframing.' It is a technique that allows people to replace an unwanted behavior or bad habit with a better alternative. For example, instead of becoming impatient while waiting in a long line at the grocery store, consider that extra time a well-deserved break from a busy day," NAMS says in its May 2007 newsletter.
Writer Jeanie Linders may be the perfect example of a woman who was able to reframe her change of life. Her "Menopause The Musical" opened in Orlando, Fla., in 2001. Since then it has played in more than 100 cities and 12 countries. Linders' message is that "menopause is a passage, but it should no longer be The Silent Passage. It is a stage in every woman's life that is perfectly normal," she writes.
Or, as Marnach says, "(Menopause) really marks the beginning of women's second adulthood, a chance to live life to the fullest."
Perhaps menopause just needs its Bob Dole.
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