Menopause / Perimenopause
Menopause literally means the “end of monthly cycles”. A natural part of aging, menopause is the time in a woman’s life when she stops producing estrogen and having menstrual periods. The years leading up to this point, when female hormone production and menstrual periods become irregular, are called perimenopause. Menopause usually occurs in women during their late 40s or early 50s. If you have questions, concerns or difficulties related to menopause or perimenopause, call our office. We can help you make sense of the changes occurring in your body and we may be able to help you cope with menopause symptoms that interfere with your lifestyle.
Symptoms of menopause and perimenopause
Menopause generally occurs gradually, unless it has been brought about by the surgical removal of your ovaries. As your body produces less of the female sex hormone estrogen, your body will experience changes. For some women these changes will be barely noticeable. Other women may have difficulty coping with their symptoms. These symptoms include:
Hot flashes (or hot flushes) are a sudden feeling of heat in the face and upper body. They may last from a few seconds to several minutes or longer, and can occur with sweating or reddened skin. Hot flashes can happen at any time of day or night and can be mild or severe. They can occur a few times a month or several times a day. Some women experience hot flashes for a few months, others for a few years, and others not at all. Hot flashes are annoying and can be embarrassing, but they are not harmful.
Sleep problems. Hot flashes and other factors related to menopause can keep you from getting enough sleep. This can affect your health, mood, and productivity.
Vaginal changes. Lower estrogen levels can cause the vaginal lining to become thin and dry. This can make the vagina more prone to infection and it can make sex without lubricants painful.
Urinary tract changes. Lower estrogen levels can also cause the urethra (the tube that carries urine from the bladder) to become dry or irritated. Some women may be more likely to get a bladder infection, while some women may need to urinate more often.
Bone loss. Loss of bone density is a normal part of aging, but after menopause the rate of bone loss tends to increase. Bone loss and osteoporosis, a related disease, can increase the risk of broken bones, especially the hip, wrist, and spine.
Other medical problems, such as heart attack and stroke, can become more likely as a result of lower estrogen levels.
Emotional changes. Changes to your hormone levels may make you feel nervous, irritable, or tired. These feelings may be related to other symptoms of menopause, such as lack of sleep.
Sexuality. Lower hormone levels may decrease your sex drive or make it more difficult for you to reach orgasm.
Treatment of menopause symptoms
If your perimemopause or menopause symptoms interfere with your day-to-day life, there are treatments that may help reduce or eliminate some or all of these symptoms. They include:
Hormone therapy can be used to replace female hormones no longer made by the ovaries. Hormone therapy can be taken in the form of pills, vaginal rings, or patches that are placed on the skin. Estrogen creams and tablets for the vagina can treat dryness, but are less effective for other symptoms. While hormone therapy can reduce the chance of some types of cancer and other conditions, it can increase the risk of others. It can also restart menstrual bleeding.
Other therapies, such as bisphosphonates, parathyroid hormone or selective estrogen receptor modulators (SERMs) can be used to increase bone density and reduce the risk of fractures. Calcium supplements may also help.
Gynecologic visits. While regular gynecologic visits are important for women of all ages, they are particularly important during perimenopause and menopause, when your body is going through major changes. During this period of your life, your OB/GYN visits may include:
- a review of your general health, medical history and dietary and exercise habits
- weight and blood pressure measurements
- an examination of your skin, breasts, abdomen, vagina and rectum
- a Pap test
- a cholesterol test
- a bone mineral density test
- a mammography (x-ray tests for breast cancer)
- colorectal cancer screening
- blood sugar testing (for diabetes screening)
- thyroid testing
- HIV testing