Menopause, what does that mean for you?
Menopause can affect women ages 45-55 years old. It is slow progression of symptoms characterized by irregular menstrual cycles and marked hormonal fluctuations, often accompanied by hot flashes, sleep disturbances, mood symptoms, and vaginal dryness. In addition, changes in lipids and bone loss begin to occur, both of which have implications for long-term health. Diagnosis of menopause is 1 year after the last menstrual cycle.
Symptoms of hot flashes come early in peri-menopause and can last up to 5 years. A small percentage of women may experience hot flashes for much longer into late adulthood. Other symptoms common for menopause include depression and cognitive changes. Women may report tearfulness, mood instability, trouble sleeping, anxiety and trouble concentrating,
Common but less talked about symptoms of menopause include sexual symptoms including; vaginal dryness, pain with intercourse, vaginal itching and urinary symptoms (including frequent urinary tract infections).
There are several treatments available for menopausal symptoms. The most common treatment includes combination hormone replacement. This can be provided as patch, cream, gel or pill. This is most effective for hot flashes and genitourinary symptoms. Estrogen replacement with or without progesterone, is indicated for treatment of menopausal symptoms to improve quality of life. Estrogen replacement should only be used for short-term management of symptoms and should not be used for longer than 5 years or over the age of 60. Contraindication for hormone replacement include a history of breast cancer, heart disease, a previous venous thromboembolic event or stroke, active liver disease, unexplained vaginal bleeding, high-risk endometrial cancer, or transient ischemic attack.
A relatively new treatment that provides less risk related to hormone replacement is a vaginal CO2 laser (MonaLisa Touch). This heat based laser can help stimulate vaginal collagen growth, improve vaginal dryness and painful intercourse as well as urinary symptoms (urinary frequency and urinary tract infections). This can be done in 3 treatments, improving symptoms for a year or longer.
Other peri-menopause and menopause treatments can include over the counter treatments, including natural supplement Black Cohosh for hot flashes. Daily exercise has also been proven to improve hot flahes if done on a regular basis. SSRI medications, included Lexapro and Prozac are also effective treatments for mood instability, hot flashes and sleep disorders related to hormonal changes.
If any of these symptoms have started to effect the quality of your life or the intimacy of your relationship, I would encourage you to talk about this with your provider. There is many options available to improve and smooth the transition through menopause and we are here to help.