Each month during our childbearing years, women experience a menstrual cycle (period) that is often accompanied by cramping, mood changes, food cravings and breast tenderness. After decades of monthly menstrual cycles, we are likely looking forward to the day when periods are no longer part of our lives. One year after the last menstrual cycle and if your doctor confirms it, we can throw away our birth control and coupons for feminine protection! Our celebration, however, may be abruptly interrupted by hot flashes, insomnia, low libido, brain fog, weight gain, and vaginal dryness – the telltale symptoms that you are entering menopause. Women vary along the spectrum of severity, with some experiencing minimal symptoms, and others having years of dramatic, distressing symptoms. Most women are somewhere in-between; each with her own experience and interpretation.
During the reproductive years, a gland in the brain, the pituitary, sends signals to the ovaries to produce mature eggs and ovulate. Generally, these signals produce the desired effects in the ovaries and a woman experiences a regular monthly menstrual cycle. The main hormones for reproduction produced by the ovaries are estrogen and progesterone. The ovaries and adrenal glands produce testosterone. The time between the child-bearing years and menopause is referred to as perimenopause. During this time, the ovaries become tired. The signal from the gland in the brain keeps getting stronger in an attempt to “wake up” the ovaries. The ovaries respond erratically, often producing more estrogen than progesterone, which can result in:
- Irregular periods
- Heavy or prolonged bleeding
- Breast tenderness
- Weight gain
- Mood swings
It is important for your physician to evaluate you for underlying conditions; however, sometimes treatment is as simple as replacing progesterone or testosterone. The ups and downs of perimenopause are often more distressing than menopause, so women do not need to wait for menstrual periods to stop in order to seek medical advice.
Eventually, ovarian function comes to an end. This is a natural biological process called menopause and occurs at the average age of 51 years. Menopausal symptoms are often associated with estrogen, progesterone and testosterone deficiency and may include:
- Hot flashes
- Night sweats
- Painful intercourse
- Foggy thinking
- Memory lapses
- Fatigue (low energy)
- Joint & muscle aches
- Low libido
- Irritable or flat mood
The transition from the reproductive years through menopause is a unique journey for each woman. However, many women report some common symptoms while others have an individual perspective. Fortunately, there are ways to reduce symptoms and improve your quality of life.
- Eat a balanced diet. Choose a variety of colorful fresh fruits and vegetables.
- Limit processed foods, caffeine, and alcohol.
- If you are a smoker, try to quit. Smoking can trigger hot flashes, weaken bones, and irritate the bladder.
- Incorporate regular physical activity into your daily routine. Exercise improves bone density, reduces weight gain, and elevates your mood.
- Stress management techniques like meditation and yoga improves coping skills.
- Hormone therapy is an option for many women and is available in several forms including pills, patches, pellets, lozenges, creams, sprays, and rings. Your women’s health provider will help educate you regarding risks and benefits for each intervention and together you will decide on a treatment plan that is right for you.
- Even if you don’t opt for a systemic, or total body ” regimen, there are local vaginal therapies that are safe, and can help maintain vaginal function and health. Rewarding and enjoyable sexual intimacy can and should continue throughout menopause.
- Non-hormonal medications are available for women who choose not to participate in hormone therapy. Alternative therapies like acupuncture and hypnotherapy can also help.
Hormone therapy contains both potential risks and benefits. Schedule an appointment with a women’s health provider to review menopausal symptoms, medical history, family history and lifestyle. Your provider will work with you to tailor treatment options to meet your needs to reduce symptoms, improve quality of life and resume the celebration!