Understanding Menopause

Menopause is defined as the absence of a menstrual cycle for at least twelve months. The average age of menopause is 51.  While many women dread menopause, we should remember that it can also be a time of great relief. Menopause brings relief from painful or heavy periods, PMS symptoms, and hormonal headaches. Worrying about which contraceptive to use is a thing of the past!  Menopause is a natural transition in a woman’s life and we can look at it as a new beginning.

Symptoms of Menopause

Symptoms are caused by fluctuating hormone production from the ovaries. Many women begin to notice intermittent symptoms as early as ten years before their periods come to an end.  

  • Common early symptoms of menopause include menstrual irregularities, night sweats, flushing, and insomnia.  
  • Women also may notice more mood irritability, weight gain, libido changes and vaginal dryness.  
  • Difficulty with concentration is often referred to as “brain fog” during menopause.  
  • Abdominal bloating, thinning hair and skin changes are also reported.  

It all sounds horrible! In fact, back in the 1700s, menopause was considered a disease that was described as the worst of all “calamities.” Fortunately, not all of us experience this full range of symptoms. Each woman experiences menopause in her own distinct way.  Some women do not experience any symptoms at all. The symptoms are often self-limited, lasting for two to three years. Of course, there are always exceptions, as some women report hot flashes even into their 70s. The bottom line is that these symptoms will not last forever.

Treatments

Your gynecologist is a good resource to discuss your symptoms and possible treatment options.  

  • Lifestyle changes can often help us manage our menopause symptoms.  
  • Exercising regularly can improve our physical and mental health.  
  • There are certain foods that mimic the effects of estrogen in the body.  Consuming these types of foods can help alleviate our symptoms.  Foods that mimic estrogen include soybeans, tofu, flaxseeds, sesame seeds and beans.  
  • Avoiding sugar and high carb diets has been shown to improve our mood and alleviate fatigue.  
  • Avoiding certain foods that trigger hot flashes may help us feel better. Trigger foods include caffeine, alcohol, and very hot beverages.  
  • Some natural over the counter supplements are also available to help with symptom relief.  

Hormone Replacement Therapy

If more natural lifestyle remedies fail to alleviate your symptoms, hormone replacement therapy (HRT) is an option. HRT has recently gotten a bad reputation because of its potential risks. The risk of using hormones increases with longer years of use. Risks may include increased risk of breast cancer, blood clots, stroke, heart attack, and even dementia.

You may ask why we even still consider using hormonal therapy in light of the risks, but when hormones are used in the appropriate way and for the appropriate length of time, severe symptoms can be alleviated with very little risk. 

Hormones should be used to treat only severe symptoms and should not be used for long periods of time.  

Hormone medications come in various forms. Low dose oral contraceptive pills are often used as a type of hormone replacement. Other forms of hormone therapy include creams, patches, and vaginal inserts, and pellet therapy. You and your gynecologist will discuss these options, taking into consideration the ease of use, the effectiveness of symptom relief, and the cost. 

Non-Hormonal Treatment Options

If a non-hormonal treatment option for menopause is desired, there are multiple options that can provide significant symptom relief.  Open communication with your doctor regarding your specific symptoms will allow a more tailored approach to your particular situation. Remember, menopause symptoms are extremely variable.  They are not long lived, and they are manageable.    

Changes in Your Body After Menopause

Even women who navigate through menopause without the need for medications should be aware of some of the potential changes in our bodies after menopause.  Your gynecologist can advise what screenings are recommended and how often you should have them. 

Our risk of breast cancer increases as we age.  Yearly clinical breast exams and breast cancer screening are an important part of our health care.  

Women experience bone loss as we age. Osteoporosis, or severe bone thinning, makes us at increased risk for bone fractures.  Bone density testing is another recommended screening exam.  If osteoporosis is diagnosed, there are medications that will decrease our risk of a dangerous fracture.  

Vaginal changes are also common in menopausal women, leading to vaginal irritation, dryness, painful intercourse, and urinary issues such as urgency, incontinence, and frequent urinary tract infections. Fortunately, there are remedies for these symptoms.  

Menopause happens to literally every woman in the world and we shouldn’t be embarrassed about it. We shouldn’t have to just suffer through it. Talk to your gynecologist or health provider.  Tune in to your bodies and embrace this new chapter.