It’s no longer commonly referred to it as “The Change,” but menopause is still a topic many women dread.
There are the minor concerns, like the dreaded hot sweats, particularly uncomfortable during the summer months, but there are also more serious concerns, like how these hormonal changes can affect a woman’s risk profile for osteoporosis and breast cancer.
"Menopause is a complicated time because many women who have never had health issues are now faced with new health concerns,” says Dr. Nina Ali, a gynecologist with The Menopause Center at Texas Children’s Pavilion for Women.
Beyond the medical consequences, menopause is also a time of shifting identity and sense of self for some women, particularly if it affects their sex lives. When you add in the conflicting advice about hormone therapy and society’s often harsh opinions about aging, it’s no wonder that some women find the experience upsetting or confusing altogether.
"My hope is that with more education, women feel comfortable communicating with their doctors and seeking effective treatments for these important issues,” Ali says.
Here are 11 things that all women should know about menopause, at any age:
What Is It?
Menopause is when a woman’s menstrual periods cease because the ovaries are no longer producing estrogen and progesterone (a hormone). Once menopause starts, a woman is no longer able to become pregnant. The time period leading up to menopause, when estrogen and progesterone levels are changing and periods can become irregular, is called perimenopause. According to the Office on Women’s Health in the U.S., a woman is considered to have gone through menopause if she has not had a menstrual period for one year — cancelling out other reasons that would cause menstruation to cease, like illness, pregnancy and breastfeeding. Menopause can occur over a wide range of ages, but early 50s is the average, and the menopausal transition can take from two to eight years.
Know The Symptoms
Common symptoms of perimenopause and menopause include irregular or absent menstruation, sleeplessness, hot flashes, night sweats, vaginal dryness, painful intercourse, mood changes, and increased vaginal or urinary tract infections. Some of these symptoms may continue for months or years after a woman stops menstruating, the Office of Women’s Health notes. Tracking symptoms can provide your doctor with helpful information on handling them, and give you a way to anticipate when they might occur.
But There Are Unusual Symptoms As Well
"Patients are often surprised to learn that mood swings, depression and sexual dysfunction can also occur,” says Dr. Nina Ali, a gynaecologist with The Menopause Center at Texas Children’s Pavilion for Women. "Joint aches and pains and skin changes are sometimes present as well.” Some women may also experience weight gain around their midsections, or lose muscle and gain fat. Changes in sexual desire and drive (up and down) are also possible.
Take A Deep Breath
Some women find relief from hot flashes through relaxing exercises like paced breathing training or meditation, Ali says. When a hot flash starts, practice your preferred mindfulness technique to get some relief from the symptoms.
Exercise And Eat Well
Staying active during menopause is important, because it helps maintain bone density, muscle mass, and metabolism, Ali says. It’s also important to make sure you get enough calcium to maintain healthy bones: the Office on Women’s Health recommends 1,200 mg of calcium daily for women older than 51, along with 600 IU (international unit) of vitamin D and 800 IU if you are older than 70. If you have experienced menopause but still have vaginal bleeding due to hormone therapy, you may need iron supplements as well.
Staying cool overall can help make hot flashes a lot more bearable. Dr. Robert S. Wool, an OB/GYN with Women’s Health Associates suggests adding air conditioning and cool baths to your daily routine.
Consider Herbal Relief
Some non-hormonal treatments have been shown to provide relief, Dr. Wool says, including a black herb called cohosh. There is some preliminary clinical evidence that black cohosh can provide short-term relief from menopausal symptoms, according to the National Institutes of Health in the United States. Be sure to let your physician know about any herbal supplements you take, in order to avoid harmful interactions with medication.
Hormone Therapy May Be An Option For Some
Though it has been very controversial, for some women hormone therapy is safe and provides more benefits than risks, Ali says. "Women who are good candidates for hormone therapy are close to menopause, typically ages 50 to 59, are in good health, do not have cancer, liver disease, unexplained vaginal bleeding, or a history of heart disease or blood clots,” she says. The risks vary with age, she adds, and the therapy is more beneficial when you start at a younger age. "Hormone therapy can effectively relieve hot flashes, vaginal dryness and night sweats,” she says. "Hormone therapy can also protect the bones from osteoporosis, lower the risk of type 2 diabetes, and help with mood and memory.”
But Be Aware Of The Cautions
Wool also advises that hormone therapy can be relatively safe in most patients, but gives a few warnings. "There are certain concerns and that would be an increased risk of stroke, an increased risk of VTE or venothrombotic events such as a blood clot in the legs or lungs,” he says. "Plus, the data on breast cancer is not out. There’s mixed feelings on whether or not hormone replacement increases breast cancer.” Each individual patient should speak with her physician to outline her own profile for risks and benefits.
It May Not Be Menopause
It’s important to pay attention to changes in your body because the symptoms associated with menopause can have other causes as well. Hot flashes could also be a result of thyroid dysfunction, medication side effects, stress, or fever, Ali notes. For younger women, night sweats could be a sign of infection, lymphoma, or leukemia, Wool says, adding that vaginal dryness should be addressed at any age. And when it comes to the lack of sleep many menopausal women experience, it could be related to environmental factors like stress and anxiety, Ali says.
Take Care Of Your Medical Business
Preventive care becomes even more important during and after menopause, Ali says, and this includes screening for breast, cervical, and colon cancers. Talk to your physician about your personal risk profile for these conditions and go over the current screening recommendations to find out what you need to have checked. Also, keep up your yearly medical exams, Dr. Wool says, so you have a forum for discussing concerns about menopause with your physician. "There’s a lot of misinformation out there in addition to a lot of different opinions,” he says. "It is important that every woman has this discussion with her own practitioner."
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