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| Every woman reading this has experienced or will experience menopause. It is not a disease, but an entirely natural occurrence in females. Ovaries stop producing hormones gradually over time, and periods cease. The average age is about 51 years old, but it may happen earlier, later, or even suddenly in the case of a hysterectomy. The few years preceding menopause are called perimenopause. How all this affects any given woman depends on a host of variables. The only certainty is that it will happen. One woman equates it to waiting at the dentist’s office because your turn is coming! We needn’t dread the perimenopause phase. Instead, we should arm ourselves with information so we’re prepared to deal with a little unpleasantness in the way of hot flashes, mood swings, sleeplessness, and/or irregular periods. Early menopause may be more problematic, as the sudden loss of hormones after surgery, for example, may trigger precipitous changes. The timing of natural menopause typically conforms to hereditary tendencies. Perimenopause is an ideal time to take stock of your health, have a complete medical exam, and be proactive. Your family physician, along with other members of your health care team such as a nurse practitioner or physician assistant, can likely handle many of your concerns. A specialist in gynecology may offer additional expertise in dealing with more difficult issues. Since 51 is the average age for menopause, many women start to see early signs in their 40s. If regular periods become irregular, if you experience “heat waves,” and/or if your normally even disposition ricochets up and down, chances are that your hormones are fluctuating in a prelude to menopause. Be sure to get plenty of calcium, taking supplements if necessary. Also get plenty of vitamin D since diminished estrogen is tied to osteoporosis. Exercise is one of the best things you can do for your overall well-being, and it is especially beneficial during these inevitable midlife changes. The top health concerns related to menopause are osteoporosis and heart disease. Regular weight-bearing exercise helps prevent both, relieves stress, and improves the mood too. As estrogen declines, fertility is diminished, although women should guard against an undesired pregnancy for a full year after their final period. Your doctor will want to take a closer look at what may be normal signs of perimenopause, such as irregular bleeding or heavy periods, to rule out possible disease. For a very heavy flow, hormone treatment (through the pill or patch) or surgical options can bring relief. The most common frustration is the hot flash, with two-thirds of women experiencing the signature wave of warmth that unexpectedly washes over them. This often causes the skin to flush and perspiration to flow. The phenomenon adds a new dimension to the term “red-hot mamma.” While a lucky few have none or only mild episodes, some women report a significant disruption of their lives and sleep patterns. When night sweats disturb sleep, irritability often follows. Besides hot flashes and irregular (or cessation of) periods, a decline of estrogen causes the vaginal tissue to become thinner and dryer. At this point women are more susceptible to vaginal infections and may experience discomfort during intercourse. For mild cases, try an over-the-counter water-based lubricant before sexual activity. No need to wear a headscarf and dark glasses the first time you buy it! It may be difficult, but we are mature adults. Vaginal moisturizers also relieve dryness and may help prevent vaginal infections. A third option is estrogen, which can be taken either orally or applied locally. It is said to effectively restore tissue and relieve dryness. Hormone Replacement Therapy (HRT) helps prevent some of the issues associated with perimenopause and menopause such as hot flashes, vaginal dryness, and osteoporosis. Hormones can be administered as a pill, patch, or cream. Estrogen can be taken alone (if you’ve had a hysterectomy) or combined with progesterone if you still have your uterus. Progesterone alone helps relieve hot flashes if estrogen is not an option. Each has risks and contraindications to consider. Besides traditional HRT, you may want to investigate natural hormone replacement. These bio-identical hormones are created from plants, and are an exact molecular match to human hormones. They’re available prepackaged, or a compounding pharmacist can tailor hormones to your unique needs. A prescription is required, and the same cautions apply as for traditional, manufactured hormones. Urinary changes can occur as well, but are largely due to normal aging. Although an estimated 30% of middle-aged women have mild to severe leakage of urine, many do not seek help. That is unfortunate when relief is possible through specific exercises, prescription medications, or surgery. On the positive side, remember that many women have only mild discomfort post-menopause, and those with more bothersome issues have plenty of options. It can be liberating to no longer plan events and trips around a monthly cycle, or to pack a suitcase full of tampons and maxi pads. If you experience significant memory or concentration issues or are more than a little blue or anxious, by all means seek professional help. I was surprised to learn that women are more likely than men to turn to alcohol when coping with midlife challenges including the loss of a spouse or an empty nest. Most of us will have to contend with expanding waistlines, and some will notice a decline in sexual pleasure. (Novelist Florence King once observed, “I’ve had sex and I’ve had food. I’d rather eat.”) Meanwhile, pharmaceutical companies are working to market a safe equivalent of Viagra for women. Sources for this story included: webmd.com, medicinenet.com, womenshealth.gov, and mayoclinic.com. |
Managing Menopause |
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