What to Expect and How to Find Relief
Menopause is a time of natural change for women. Hormones and chemistry are shifting because of lower levels of estrogen and progesterone produced by the body as middle age approaches. These changes can cause unpleasant symptoms, although not every woman experiences them. The most common complaints about menopause symptoms are hot flashes and vaginal dryness, followed closely by changes in libido.
The good news is that modern medicine continues to develop approaches that can help address these concerns, and women can continue to be healthy, vital and sexual after menopause.
Below are some common questions women may have about menopause, along with answers and advice.
When Will I go Through Menopause?
The clinical definition of menopause is one full year without a menstrual period. For most women, menopause occurs in the late 40s or early 50s, with 51½ as the average age in the U.S. But, menopause can occur at other times, for example if a woman has had cancer, chemotherapy or certain gynecologic surgeries.
The age of the onset of menopause is affected by many factors, such as ethnicity, whether you smoke, have heart disease or have ever had a baby. Some of these factors are controllable, though some are not.
How do I know if I’m nearing menopause?
Women typically begin to experience certain symptoms when they’re entering perimenopause—the time leading up to a woman’s last period. This phase can last for months or years. In addition to symptoms like hot flashes, vaginal dryness and changes in libido, women may also experience irregular periods, night sweats, sleep problems, fatigue, hair loss and dry skin, loss of breast fullness, mood changes, difficulty concentrating and weight gain.
If you’re experiencing these symptoms, it’s important to visit your doctor and get a physical exam. While these are common perimenopausal symptoms, they’re also common in other conditions like thyroid disease.
What are some of the most effective treatments for menopause?
It’s important to remember that you can’t treat menopause—you can only treat the symptoms associated with menopause. With that in mind, here are some tips to cope with some of the most common symptoms.
Hot flashes and night sweats: Dress in layers so you can remove your sweater or jacket when you feel a hot flash coming on. If you smoke, stop because smoking worsens hot flashes. And if you can identify what triggers your hot flashes (caffeine, spicy food, alcohol, warm rooms), you can try to avoid those things.
For perimenopausal women, low-dose birth control pills may be helpful. If these symptoms continue once you reach menopause, hormone therapy may be an option.
A few words on hormone therapy. There are two types of hormone therapy used for women in menopause—estrogen therapy and estrogen/progesterone/progestin therapy. Estrogen-only therapy is reserved for women who’ve had a hysterectomy and don’t have a uterus. Methods that contain estrogen, progesterone and progestin (synthetic progesterone) are used for women who do have a uterus.
If hormone therapy begins close to the time of menopause, the risk of it causing heart disease in a healthy woman is minimal. The issue of breast cancer is more complicated, as there are many factors that contribute to developing that type of cancer. Remember, if you’re considering hormone therapy, it’s important to consult your physician, as these medications can pose special risks to some women.
For women who can’t or prefer not to use hormones, other treatment choices for hot flashes range from medications used to treat anxiety and depression, the seizure medication gabapentin (Neurontin), and cognitive behavior therapy.
Vaginal dryness: Over the counter vaginal moisturizers are available and can be used daily. Water- or silicone-based lubricants can alleviate pain with intercourse (note: some women are sensitive to lubricants with glycerin). Prescription medications are also available and include estrogen that’s used vaginally by cream, tablet or ring; an oral, nonestrogen medication that’s taken daily; and vaginal DHEA (the hormone dehydroepiandrosterone), which will be available soon.
Loss of libido: Menopause should not be the end of a woman’s sexuality. Instead, it should be an opportunity for women to have an open discussion about their fears and to take greater control of their sexuality. Addressing vaginal dryness, talking with your doctor about menopause treatments—topical treatments, behavior modifications, hormone and non-hormonal therapy—and discussing your physical and emotional changes with your partner, are all critical to maintaining a healthy sex life.
Mood swings: These occur primarily during perimenopause. Effective strategies to minimize mood swings include maintaining a healthy diet, staying physically active and getting enough sleep. It’s also important to reduce stress and to discuss your concerns with your doctor if you’re feeling depressed. Seeing a therapist or joining a support group to openly discuss your feelings and problems are more options.
Memory issues: Some changes in memory are age-related and not menopausal. It’s normal, though frustrating, to forget a word or someone’s name. Getting mental exercise for a healthy and stimulated brain is important. Keep your mind active doing crossword puzzles, number games or learning something new. It’s also important to stay active socially. Keep in touch with family and friends, and participate in community activities.
Weight gain: This is also commonly associated with menopause but again is more closely related to aging. As your metabolism slows, you need fewer calories. Staying active and maintaining a balanced diet can help avoid weight gain. It can help with staying mentally sharp, too.
Talk to an expert!
Navigating menopause isn’t always easy, so be sure to turn to your physician or a therapist to help sort through your physical and emotional changes. And because the risk of certain health conditions—like osteoporosis, urinary incontinence, and heart disease, the leading cause of death in women—increase after menopause, that’s added incentive for regular checkups. Plus, if you’re tempted to try alternative therapies for menopausal symptoms—like herbal and dietary supplements—talk with your doctor because these are not regulated by the FDA and can interact with other medications.
Today, there are many treatment options to alleviate menopause symptoms—from hormonal and non-hormonal medications to diet and exercise. Now you can embrace this new phase of life!
Beverly Vaughn, M.D., is a gynecologist with Main Line HealthCare Gynecology at Lankenau Medical Center. She received her medical degree from Temple University School of Medicine and has been in practice for more than 30 years. She’s been recognized as a “Top Doctor” by Philadelphia Magazine and U.S. News & World Report and is a member of many medical associations, including the North American Menopause Society.