How to Manage Your Menopause
By Sharon B. Diamond, MD
February 06, 2015
Category: Health
Tags: Menopause  

Generations of women have called menopause "the change," and for good reason. A woman's body undergoes some dramatic changes during this mid-life time, but that does not mean life has to be miserable. Menopause can be managed, and any woman who is in or approaching this time of life can be confident that she has good choices to manage her symptoms.

Menopause and Its symptoms:

While every woman experiences menopause differently, there are also many commonalities. Perimenopause may occur for a few years or for many years before the complete cessation of ovulation and menstruation that defines menopause. Typically starting in the late forties, perimenopause is characterized by changes in the secretion of the hormones, progesterone and estrogen. Rather than an orderly and cyclic production, hormones may become erratic with large fluctuations, both surges and drops.  As a result, ovulation can be sporadic, and periods can be irregular, light in flow or even heavy. The absence of periods for several months can be misleading and it may be a good idea to have levels tested when this occurs.  Hot flashes, and other symptoms such as mood changes, can also begin at this time.

Menopause itself usually happens in the early fifties, when ovulation stops completely, and a woman has not had a period for a full year. Besides these obvious signs, other symptoms can include:

  • hot flashes and profuse sweating, particularly at night
  • difficulties with sleeping
  • fatigue and memory fogginess
  • mood swings or depression and anxiety
  • decreased libido
  • vaginal dryness and discomfort during intercourse
  • weight gain, particularly around the mid-section
  • urinary incontinence or other urinary symptoms
  • itchy skin
  • thinning bones (osteopenia or osteoporosis)

Severity of menopausal symptoms can vary widely, and every woman at mid-life should discuss her particular issues with her gynecologist to arrive at the best strategy for minimizing mid-life discomforts.

Your options for managing menopause:

The most difficult of menopausal symptoms may be relieved with hormone replacement therapy (HRT), but this is not an option for every woman.  Women with a history of breast cancer as well as certain other cancers or who are at high risk for these malignancies cannot take hormones.  Numerous studies suggest that while long-term HRT can increases the risk of breast cancer, heart attack, and stroke, small doses, carefully supervised by a physician, can reduce hot flashes, migraines and other troubling issues in appropriate women. The lowest dose of hormones needed to manage symptoms for the shortest period of time they are needed, is a reasonable approach for many.  Bio-identical hormones may have fewer side effects and you can discuss these with your doctor to see if you are a candidate for this treatment. Systemic symptoms of menopause may also be relieved with acupuncture but it is necessary to find a practitioner who has experience in this area.  

Low doses of estrogen in vaginal medications including creams, suppositories and a vaginal ring can help with dryness and urinary and sexual difficulties. Delivered in this way, estrogen has little or no effect on a woman's other body systems because very little if any of the estrogen is absorbed systemically into the body.  It acts almost exclusively on vaginal tissue only. There are other remedies for painful intercourse however and it is especially important to communicate with your doctor for advice about what might work for you.

After menopause, the drop in estrogen can also result in a loss of bone density which may increase the risk of fracture.  Supplemental calcium, vitamin D, and weight-bearing exercise can help counter this loss of bone,

Regular aerobic and weight-bearing exercise also may help to improve mood and assists with weight control. Since the metabolic rate tends to slow after menopause, making it easier to gain weight, it is especially important to maintain a diet rich in fibre, fruits, vegetables, whole grains and calcium

Women are living longer now with the potential for decades of active and satisfying life after menopause.

Having a physician with whom you are comfortable communicating will help you to understand your individual issues and empower you to take care of them.

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