My book Healthy Aging: Well-being and Sexuality at Menopause and Beyond comes from the clinical observations I made throughout my professional career (www.annaghizzani.it). Re-thinking about what happens during appointments is the best way for me to understand how medicine works and how to make it more effective. Writing down these considerations is a way to process a continuum of thoughts and expand my understanding. But privileged time is needed in order to do this; not the busy schedules that are common in Florence and everywhere else. Privileged time comes with the short but frequent sabbaticals that I spent in the medical library at Cornell – New York Hospital. Without gynecological shifts and clinical obligations, I can read, think and write about anything I have in mind.
Some time ago, I realized that a considerable amount of material had accumulated in my travel drives. Was I going to use it? Obviously yes. I felt most of my menopausal patients needed some guidance on issues of well-being and sexuality, and on how to deal with the inevitable symptoms. Menopause is normal and unavoidable unless you die young, as my grandmother used to say, so you better come to terms with it!
The menopause is not an illness and needs to be embraced with common sense and a smile. But some of its symptoms can be quite disturbing, such as changes in metabolism, osteoporosis and mood swings. All of these are brought about by the diminishing concentration of estrogens, the quintessential sign of the menopause, but depend also on lifestyle. The quality and quantity of food, the type and frequency of physical activity, and the intellectual interests one pursues in life can make a dramatic difference in how each of these conditions affects the individual. The metabolism slows down and results in weight gain, even with reduced food intake. A loss in calcium and weakening of the skeleton is a fact, and blues and difficulty to concentrate are common. In addition, as an expert in sexual medicine, I see couples, who have been together for a lifetime, reporting shifts in their balance and sexual harmony due to social changes, imperfect sexual response, incidence of illnesses, and side effects of medications, which are more common now than at a younger age. How can we help all this?
At some point in time, rhythms and habits of a lifetime can be changed for good. The right time is exactly around the years of stabilized menopause, which often coincide with a pause in hectic rhythms. Some people may retire, some may give up part of their responsibilities, some may go on sabbatical to be productive but relaxed, and some may wish to travel the world.
Foreigners who choose Tuscany, Chiantishire, Lucca’s villas and Florence above all, for a period of sabbatical enjoyment can easily find new ways of life to better suit these new needs. Seasonal produce with no preservatives help to keep the body fat increase at bay, while the endless choice of gourmet Italian cheese (the mozzarella and parmigiano here have nothing in common with what is found in foreign food marts) enhances the intake of calcium to fortify bones and counteract osteoporosis. We need to think of physical activity to fight slow metabolism and calcium loss alike. What could be more enticing than long, brisk walks in the countryside, which is safe but never dull, punctuated with towns and farms worth visiting?
Will this be a new start for couples? Most likely, yes. Enthusiasm can be worn out by the daily demands of life even for well-bonded and affectionate couples, while a change in your surroundings can spark new shared interests. Tuscany, a region filled with artistic masterpieces that denote human history and the development of modern civilization, provides something that everyone can relate to. In this time of pandemic, I am thinking of Boccaccio’s Decameron, written in 1350 when the plague hit Florence. The feeling that basic human needs remain the same with the passing of centuries is something that everyone can experience in our cities filled with history. Anyone can become curious and willing to explore not only the major museums, but also the lesser-known gems overlooked by the crowds. I am thinking of places like the Opificio delle Pietre Dure, which has existed since the time of the Medici and of which I am a proud member.
Writing this book was a task, but never a burden. I offer my labors to women as a tool to navigate the odd time of menopause and make it rewarding, and to the men with whom they share the path of life.
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