Health System Services | Menopause

Menopause

Menopause is the transition period in a woman’s life when her ovaries stop producing eggs, her body produces less estrogen and progesterone, and menstruation becomes less frequent, eventually stopping altogether.

In some women, menstrual flow comes to a sudden halt. More commonly, it slowly stops over time. During this time, the menstrual periods generally become either more closely or more widely spaced. This irregularity may last for 1 – 3 years before menstruation finally ends completely.

Common symptoms of menopause include:

  • Heart pounding or racing
  • Hot flashes
  • Night sweats
  • Skin flushing
  • Sleeping problems (insomnia)

Other symptoms of menopause may include:

  • Decreased interest in sex, possibly decreased response to sexual stimulation
  • Forgetfulness (in some women)
  • Irregular menstrual periods
  • Mood swings including irritability, depression, and anxiety
  • Spotting of blood in between periods
  • Urine leakage
  • Vaginal dryness and painful sexual intercourse
  • Vaginal infections

Menopause is a natural event that normally occurs between the ages of 45 and 55.

Once menopause is complete (called post menopause) and you have not had a period for 1 year, you can no longer become pregnant.

The symptoms of menopause are caused by changes in estrogen and progesterone levels. As the ovaries become less functional, they produce less of these hormones and the body responds accordingly. The specific symptoms you experience and how significant (mild, moderate, or severe) varies from woman to woman.

Treatment with hormones may be helpful if you have severe menopause symptoms such as hot flashes, night sweats, or vaginal dryness.

Discuss the decision to take hormones thoroughly with your doctor, weighing your risks against any possible benefits.

HORMONE REPLACEMENT THERAPY

Several major studies have questioned the health benefits and risks of hormone replacement therapy, including the risk of developing breast cancer, heart attacks, strokes, and blood clots.

Current guidelines support the use of HRT for the treatment of hot flashes. Specific recommendations:

  • HRT may be started in women who have recently entered menopause.
  • HRT should not be used in women who have started menopause many years ago.
  • The medicine should not be used for longer than 5 to 7 years.
  • Women taking HRT should have a low risk for stroke, heart disease, blood clots, or breast cancer.

To reduce the risks of estrogen replacement therapy and still gain the benefits of the treatment, your doctor may recommend:

  • Using estrogen or progesterone regimens that do not contain the form of progesterone used in the study
  • Using a lower dose of estrogen or a different estrogen preparation (for instance, a vaginal cream rather than a pill)
  • Frequent and regular pelvic exams and Pap smears to detect problems as early as possible
  • Frequent and regular physical exams, including breast exams and mammograms

ALTERNATIVES TO HRT

There are some medications available to help with mood swings, hot flashes, and other symptoms. These include low doses of antidepressants

 

LIFESTYLE CHANGES

The good news is that you can take many steps to reduce your symptoms without taking hormones:

  • Avoid caffeine, alcohol, and spicy foods
  • Dress lightly and in layers
  • Eat soy foods
  • Get plenty of exercise
  • Perform Kegel exercises daily to strengthen the muscles of your vagina and pelvis
  • Practice slow, deep breathing whenever a hot flash starts to come on (try taking six breaths per minute)
  • Remain sexually active
  • See an acupuncture specialist
  • Try relaxation techniques such as yoga, tai chi, or meditation
  • Use water-based lubricants during sexual intercourse

Menopause is a natural and expected part of a woman’s development and does not need to be prevented. However, there are ways to reduce or eliminate some of the symptoms of menopause.

You can reduce your risk of long-term problems with menopause such as osteoporosis and heart disease by taking the following steps:

  • Control your blood pressure, cholesterol, and other risk factors for heart disease.
  • Do NOT smoke. Cigarette use can cause early menopause.
  • Eat a low-fat diet.
  • Get regular exercise. Resistance exercises help strengthen your bones and improve your balance.
  • If you show early signs of bone loss, talk to your doctor about medications that can help stop further weakening.
  • Take calcium and vitamin D.

Are there “natural” treatments available for menopause?

Some women try herbal or other plant-based products to help relieve hot flashes. Some of the most common ones are:

  • Soy. Soy contains phytoestrogens (estrogen-like substances from a plant). But, there is no proof that soy  —  or other sources of phytoestrogens  —  really do make hot flashes better. And the risks of taking soy  —  mainly soy pills and powders  —  are not known. The best sources of soy are foods such as tofu, tempeh, soymilk, and soy nuts.
  • Other sources of phytoestrogens. These include herbs such as black cohosh, wild yam, dong quai, and valerian root. Again, there is no proof that these herbs (or pills or creams containing these herbs) help with hot flashes.

Products that come from plants may sound like they are safe, but there is no proof that they really are. There also is no proof that they are helpful at easing symptoms of menopause. Make sure to discuss these types of products with your doctor before taking them. You also should tell your doctor about other medicines you are taking, since some plant products can be harmful when combined with other drugs.

What is “bioidentical” hormone therapy?

This term means different things to different people. It’s really manmade hormones that are just the same as the hormones the body makes. There are several products with hormones like this that are on the market and are well-tested. But this term is most often used to mean drugs that are custom-made from a doctor’s order. These custom-made products are also known as bioidentical hormone replacement therapy (BHRT). Despite product claims, there is no proof that BHRT products are better or safer than MHT drugs approved by the Food and Drug Administration (FDA). BHRT also can be expensive as many insurance and prescription programs do not pay for these drugs because they are viewed as experimental.

How much physical activity should I do?

An active lifestyle can lower your risk of early death from a variety of causes and help you maintain a healthy weight. It also might improve your mood and help you to sleep better. For older adults, activity can improve mental function. Health benefits are gained by doing the following each week:

  • 2 hours and 30 minutes of moderate-intensity aerobic physical activityor
  • 1 hour and 15 minutes of vigorous-intensity aerobic physical activityor
  • A combination of moderate and vigorous aerobic activityand
  • Muscle-strengthening activities on 2 or more days of the week

If you are not active, ask your doctor what’s okay for you. Activity is important for everyone.

Contact your physician if :

  • You are spotting blood between periods
  • You have had 12 consecutive months with no period and suddenly vaginal bleeding begins again

If you need more information on menopause the internet is a great source of information on this subject and many, many more. You may also want to search the internet for social networking sites about menopause.  Many of the social network sites can connect you with people who have gone through or are going through what you are experiencing.

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