Have you heard of a menopause doula?

Throughout history, American women have gone through the perimenopause and menopause transition alone, without much help or information. Once shrouded in stigma, shame, and secrecy, it was not something that women were comfortable discussing.

Today, 50 million women in the U.S. are navigating menopause, and it’s an experience that impacts a person’s life in physical, mental, sexual, and even spiritual ways. What was once an unspoken secret is now becoming an opportunity for growth and enhanced well-being. As health insurance plans expand their women’s health offerings, menopause support is a key component in supporting their full continuum of care. Menopause guides—or doulas, as they are known in childbirth—are here to help.
  
To celebrate National Doula Week, we met with Elektra Health’s Menopause Guide, Grace Veras Sealy, to understand more about menopause and how she helps her clients through this transition in life. Grace encourages her clients to reimagine menopause as the beginning of a new chapter, one that is powerful and transformative.

Menopause was unmentioned for many generations before this one. Can you explain why?

Until recently, women’s health has been focused mostly on procreation. Women experiencing menopause usually kept it to themselves and/or assumed there was something wrong with them. Because no one talked about it, and because it was associated with getting older, it was more of a personal shameful secret than an acknowledgement that you're moving on to a different stage of life; that you're transforming into something else.

What’s different that it’s okay for women to talk about it now?

Today women going through menopause are likely to be Generation X, the first generation to have been exposed to the Internet. We grew up knowing that if you need answers, the Internet is the place to go. As a result, now there’s almost an overabundance of information. Part of what I do is help my clients to understand what’s real, evidence-based, and relevant to their situation.

How can a menopause doula help?

Can you imagine if you never told a child that they were going to go through puberty?
If they only saw somebody as a child… and then as an adult? It would be traumatizing to go through a period of life where they didn’t know what was happening with their body.

Part of my work is helping women to understand that it’s okay, that this is a normal stage of life, albeit uncomfortable at times, and there are things that you can do about it.

What do you find is the most useful way you can help your clients?

One, I think it’s very helpful that I’m experiencing these transitions myself and I can talk about it with both empathy and knowledge. But what’s the most helpful thing? Honestly, it's validation that what they're going through is real. And that it's hard. And that they're not going crazy. I find that people are very relieved to learn that what they’re going through emotionally has a lot to do with what was happening to them physically and hormonally—and that it is having an effect in every part of their lives. I think that's the first most useful thing.

Next, it’s assuring them that there are things you can do about it. And there are people like me who can help support them throughout the transition. A lot of people, they don't have that.

How do you start the engagement so it's most productive?

It’s important for a client to gain trust in me and the information I’m providing them. It works when they help discover the answers for themselves. So, I start by finding out what their most bothersome symptoms are, and we work from there. I start by asking questions like, how’s your movement, how’s your diet, how’s your brain working these days? How’s your libido? I make it light, so it feels, not like I’m their friend, but someone who understands where they are coming from. Then I try to figure out what level of knowledge they already have, so I can usefully fill in the gaps where they need more, or better, information.

So, it’s not a one-size-fits-all approach?

We have all kinds of folks that come our way. We have people that are ultra marathoners, and we have people who never ate a vegetable and now they’re in their 40s and all of a sudden, they’re putting on weight. You have people that are deeply knowledgeable and that spend a lot of time trying to figure this phase of their life out. And those that have no knowledge at all.  

What’s one thing you find most patients struggle with?

Things like sleep and stress management tend to be the hardest ones for someone to focus on. Most people going through this stage are at the point in life where they have both aging parents and children, so prioritizing themselves is a struggle. They are giving out a lot of energy to others, so telling them that they actually have to focus on oneself to make changes can be really hard. I help them to understand that they are just as important as the people that you're taking care of. That you can't take care of them if you don't take care of yourself.

Is there anything all your clients have in common?

We all have the same basic needs; good nutrition, good sleep, moving your body, being part of a community, managing your life’s stresses. Much of the work I do centers around improving a client’s health in these areas.

You help different people, differently. How does that work?

Usually, it starts out with someone filling out a history of their symptoms. So by the time I connect with them, I’m able to see what their individual challenges and needs are. Over Zoom, we talk about everything that is of consequence in their life right now. Not just their menopause symptoms, but also how their menopause symptoms are creating other issues. Issues like, if somebody can't sleep very well, they're probably having brain fog, too. After we have the conversation, and as we are talking, I try to give them tidbits of advice on what they should focus on. At the end of the call, I'll send that client a written plan of activities or resources that fit their lifestyle and give them options they can do right now in order to be healthier. Because our Elektra platform has a wealth of knowledge and resources, I’m able to offer what fits the client and their concerns.

Is there a secret to a successful plan?

Manageable and doable. That’s the key. Making small habit changes that a client can stack and feel good about achieving. Giving them options to be healthier, but with a focus on what’s doable. If they have five major things, we try to hone it down to two or three that are the most important so they can make the most changes and then come back for the rest.  

What makes a good menopause doula?

Really paying attention to where a client is at, being as open-minded as possible, getting an understanding of their level of knowledge, and checking in with them throughout the engagement, asking, “Is this helpful for you?” All of that is very important. Then, presenting information and advice in a way that’s approachable. Doable. Little things they can do in their life to be healthier. Giving them a plan they can be successful at. That’s what I try to do.

Grace Veras Sealy is a Menopause doula for Elektra Health, a platform that offers evidence-based education, care, and community for the 21st-century woman. Eligible employer-sponsored plan members of Mass General Brigham Health Plan have no-cost access to Elektra’s many resources, including 1:1s with certified clinicians and doulas like Grace. Eligible members can easily join. Get started today.