Menopause

What is Menopause?

During the menstrual cycle, ovaries produce estrogen which causes the lining of the uterus to thicken. About 14 days later, one ovary releases an egg and progesterone levels increase, called ovulation. If the egg is not fertilized, estrogen and progesterone levels decrease signaling the uterus to shed its lining. This shedding is your monthly period.

When menopause nears (around 50 years of age), the ovaries make less estrogen and periods become less frequent. You may experience more or less bleeding for a shorter or longer period of time. Eventually the ovaries cease making enough estrogen to thicken the lining of the uterus and menstrual periods stop.

Though irregular periods are normal during this time, consult your doctor if you experience any of the following symptoms:

  • Have a change in your monthly cycle
  • Have very heavy bleeding with clots
  • Have bleeding that lasts longer than normal
  • Bleed more often than every 3 weeks
  • Bleed after sex or between periods

What are symptoms of Menopause?

Menopause is a natural part of aging experienced differently by every woman. Some women may notice difficult changes to their bodies and moods during this time while others will experience little difference. The following is a list of symptoms common during menopause:

Hot Flushes (Hot Flashes)
Hot flushes are the most common symptom of menopause, experinced by 75% of women in the United States. A hot flush is a sudden flash of heat particularly affecting the face, neck and chest and lasting from a few seconds to several minutes. Hot flushes can occur any time of day and be mild or severe. Some women experience hot flushes for several months or years, but they are not harmful to your health.

Sleep Problems
Hot flushes can affect sleep by making it difficult to fall or stay asleep during the night. Lack of sleep can affect your mood, health and ability to cope with daily activities.

Vaginal and Urinary Tract Changes
The decrease or loss of estrogen can cause the vagina lining to become thin and dry, resulting in pain during sexual intercourse. The vagina may become more prone to infection leading to uncomfortable burning and itching.

The urethra of the urinary tract may also become dry, inflamed or irritated causing more frequently urination and an increased risk of bladder infections after menopause.

Bone Loss and Other Body Changes
At menopause, the rate of bone loss increases resulting in Osteoporosis, the increased risk of breaking bones in older women. The bones of the hip, wrist and spine are affected most often.

The decrease in estrogen during menopause also decreases a women’s protection against heart attacks and stroke.

Emotional Changes
Changes in hormone levels during menopause may cause a woman to feel nervous, irritable or very tired. These feelings can result in an increased level of stress and when linked with other factors in life, can cause sudden mood swings or depression. Talk to your doctor or a close friend if you experience such emotions.

Decrease in Sexuality
Lower hormone levels and vaginal problems resulting from menopause may cause a decrease in a woman’s sex drive. The use of vaginal lubricants can moisten the vagina and help ease vaginal discomfort.

How can symptoms of Menopause be relieved?

Hormone Therapy (HT)
The symptoms of menopause (most commonly hot flushes) can be relieved by replacing female hormones no longer made by the ovaries, called Hormone Therapy. Women with a uterus are most often given estrogen and progestin (a synthetic version of progesterone). These hormones are used together to reduce the risk of cancer lining the uterus that occurs when estrogen is used alone. HT may be given before menopause depending on your situation and is often prescribed in the form of pills, injections, vaginal rings or skin patches.

Using Hormone Therapy may increase the risk of breat cancer, heart attack, stroke, blood clots and the start of bleeding again. Please discuss the benefits and risks of Hormone Therapy with your doctor.

SERMs
Selective estrogen receptor modulators (SERMs) can be taken to prevent bone problems during menopause. They do not relieve hot flushes. SERMS are a type of medication that strengthens tissues of bones and decreases total cholesterol levels to help reduce the risk of heart disease. SERMs therapy can be beneficial to women who can’t or don’t want to take hormone therapy due to risk of breast cancer, negative side effects of HT or don’t need relief from symptoms of menopause.

Ask your doctor about additional options available for women if you do not want to take hormone therapy or SERMs for preventing bone loss.

How can I stay healthy during this time?

To stay health before, during and after menopause, eat a low-fat, low-cholesterol diet with calcium to maintain strong bones. Women over 50 should be getting 1,000 mg of calcium a day if taking hormone therapy and 1,500 mg if they are not. Consider calcium supplements in addition to eating dairy products and vegetables. Calcium cannot be absorbed with out vitamin D which can be obtained from milk, sunlight or vitamin D supplements. 400-800 IU (international units) is the recommended daily amount for women.

Exercise is also important to slow down bone loss and improve overall health. Participate in regular weigh-bearing exercises such as waling and aerobics.