When we think about menopause there are probably a few different things that come to mind when thinking about the topic.  Do you think about the hot flashes, insomnia, or mood swings?  None of those sound very exciting, right?  Here we will go over some of the symptoms and possible treatments. Yes, there are ways to treat your symptoms of menopause.  However, it is best to be fully informed before making any decision.

How will I know when menopause is happening to me?

Menopause marks the end of your menstrual cycles.  Think you are in menopause?  Once you have gone 12 months without a menstrual period – you are considered to have reached menopause. This can happen in your 40s or 50s, but the average age in the United States is 51.

Menopause is a natural biological process that women experience. But the physical symptoms can affect your life in different ways.  Hot flashes and emotional symptoms of menopause may disrupt your sleep, lower your energy or affect your emotional health. There are however many effective treatments available, from lifestyle adjustments to hormone therapy.

Symptoms

The months or years leading up to menopause are called perimenopause.  These symptoms listed below can start in the perimenopause phase and continue into the menopause stage.

• Irregular periods
• Vaginal dryness
• Hot flashes
• Chills
• Night sweats
• Sleep problems
• Mood changes
• Weight gain and slowed metabolism
• Thinning hair and dry skin
• Loss of breast fullness

Irregular Periods

Each woman is different and each individual might experience these symptoms in various ways.  But most likely, you will experience irregular periods before they actually end.

Skipping periods during perimenopause is common and is often expected. Menstrual periods can skip a month and return.  Or even skip several months and then start monthly cycles again for a few months. Periods can become shorter cycles, so they are closer together. Despite irregular periods, pregnancy is still possible. If you’ve skipped a period but aren’t sure where you stand in your menopause timeline you may want to consider a pregnancy test.

Hormones

The decline of hormones starts for most women in their late 30s.  That is when your ovaries start making less estrogen and progesterone.  These hormones regulate your menstruation and that is also when your fertility declines.  When you are in your 40s, your menstrual periods can become shorter or longer, heavier or lighter, and could also be more or less frequent.  Eventually, your ovaries stop releasing eggs and you will not have any more periods.  

There are other ways that menopause can occur.  If you have an oophorectomy (removal of the ovaries) you will begin menopause immediately.  Chemotherapy and radiation therapy can also induce menopause.

Treatment

Generally, medical treatment is not required for menopause.  However, there are treatments that alleviate your symptoms.  Here are some ways your symptoms can be managed.

• Hormone therapy. Estrogen therapy is one of the most effective treatment options for relieving menopausal hot flashes. Depending on your personal and/or family medical history, your healthcare provider may recommend estrogen in the lowest dose and the shortest time frame needed to provide relief from your symptoms. If you still have your uterus, you will need progestin in addition to estrogen. Estrogen also helps prevent bone loss. There are risks that come with long-term use of hormone therapy.  Those risks include cardiovascular and breast cancer risks, but starting hormones around the time of menopause has shown to be beneficial for some women. Talk to your doctor about the benefits and risks before making the decision.
• Vaginal estrogen. Estrogen can be administered using a vaginal cream, tablet or ring to treat vaginal dryness. This treatment releases just a small amount of estrogen. Which is absorbed by the vaginal tissues. It can help relieve the vaginal dryness or discomfort you experience during intercourse and some urinary symptoms.
• Low-dose antidepressants. There are antidepressants related to the class of drugs called selective serotonin reuptake inhibitors (SSRIs) that may decrease menopausal hot flashes. A low-dose antidepressant for management of hot flashes may be useful for women who can’t take estrogen for health reasons or for women who need an antidepressant for a mood disorder.
• Gabapentin (Gralise, Horizant, Neurontin). Gabapentin is known to treat seizures, but it also helps to reduce hot flashes. This drug is useful in women who can’t use estrogen therapy and in those who also have hot flashes at night.
• Clonidine (Catapres, Kapvay). The pill or patch called Clonidine is typically used to treat high blood pressure. It might provide some relief from hot flashes as well.
• Medications that prevent or treat osteoporosis. Depending on the needs of the individual, the doctor may recommend medication to prevent or treat osteoporosis. Several medications are available that help reduce bone loss and the risk of fractures. Your doctor may also prescribe vitamin D supplements to help strengthen bones.

Talk To Your Doctor

Be sure to review these treatment options with your healthcare provider.  You will want to know all of the risks and benefits prior to selecting a treatment that is right for you. Review these options annually if you see a change in your needs.

There are things to look forward to after menopause.  The experiences may vary for some. However, it is important to look at the positives too. Keep an eye out for part two of this blog next month.

If you are feeling as though the symptoms are becoming overwhelming, be sure to discuss them with your doctor.  OB-GYN Women’s Centre is here to help you during this time of your life. We will help to find ways to relieve your symptoms.