When it comes to menopause, you probably have a lot of questions: How long will it last? Does it mean my sex life is over? Is it safe to consider hormone therapy?<\/p>\n
While half the world\u2019s population becomes menopausal, it\u2019s a phase of life that\u2019s often shrouded in myth and misinformation \u2014 and what you hear from your friends or relatives may or may not apply to your particular situation.<\/p>\n
\u201cOne of the most important things I tell patients is that your experience with menopause isn\u2019t going to be like anyone else\u2019s,\u201d says Terry Silvestrin, ARNP, a board-certified nurse practitioner and certified menopause clinician at MultiCare Health System.<\/a> \u201cYou may breeze right into menopause or you may have symptoms that interfere with your daily life. If that\u2019s you, there\u2019s no need to tough it out or suffer. There are options that can bring relief and help you feel like yourself again.\u201d<\/p>\n Hot flashes and night sweats are symptoms commonly associated with menopause, but this transition can bring other unwelcome symptoms, too: mood swings, insomnia, fatigue, forgetfulness, brain fog, decreased libido (sexual desire), weight gain and more. In the U.S., the average age for menopause is 51, but troublesome symptoms may appear years before \u2014 a time of life known as perimenopause.<\/p>\n \u201cDuring perimenopause, which typically begins when a woman is in her 40s, the ovaries are starting to shut down,\u201d says Catherine Hunter, DO, a board-certified physician who specializes in the care of menopausal patients.<\/a> \u201cThe ovaries no longer produce hormones like estrogen in a predictable pattern. These spikes and drops in hormone levels mean that some days you may feel OK and others you may not.\u201d<\/p>\n The first sign of perimenopause women often notice is changes in their menstrual cycle \u2014 periods may get heavier, lighter or more irregular.<\/p>\n \u201cThere are options for dealing with super frequent or super heavy periods, and typically that\u2019s with some kind of birth control, like an intrauterine device (IUD),\u201d says Leanne Zilar, CNM, ARNP, a certified-nurse midwife and nurse practitioner at MultiCare Rockwood Clinic.<\/a> \u201cHowever, prolonged irregular or heavy periods can also be a sign of a health condition, such as uterine fibroids or uterine cancer, so it\u2019s important to talk to your provider if you\u2019re experiencing this.\u201d<\/p>\n The transition to menopause is often defined as the absence of a period for 12 consecutive months. However, if you have an IUD or have had your uterus surgically removed, then your menstrual cycle will not indicate whether you are menopausal. When women enter menopause, it means their ovaries are no longer functioning \u2014 they have stopped releasing eggs and producing most estrogen and other hormones. Women then enter postmenopause and remain in that phase for the rest of their lives.<\/p>\n \u201cThanks to our longevity, women can spend about one-third of their life in some stage of menopause,\u201d says Silvestrin. \u201cIt\u2019s important to understand what this means for your body \u2014 physically, emotionally and mentally \u2014 so you can make informed decisions about how to manage changes and symptoms as they come.\u201d<\/p>\n According to the National Menopause Foundation<\/a>, 62 percent of women report that menopause symptoms interfere with their quality of life, but many women find it difficult to get their needs adequately met. Below we talk about options for symptom relief as well as ways to support your overall health and well-being.<\/p>\n Know your risk for health conditions.<\/strong> The presence \u2014 or absence \u2014 of estrogen in our bodies affects more than just fertility. This hormone plays an important role in women\u2019s overall health, regulating cholesterol, protecting the heart and blood vessels, and supporting healthy bones, among other benefits. As a result, when women enter menopause, their risk of some health conditions \u2014 such as heart disease and osteoporosis \u2014 goes up. This is one of the many reasons it\u2019s important to eat a nutritious, heart-healthy diet and maintain an active lifestyle during this phase of your life.<\/p>\n Learn the facts about hormone therapy.<\/strong> Hormone therapy refers to medications that contain hormones such as estrogen. It was the standard approach for treating menopause symptoms for many years until 2002, when a study suggested hormone therapy increased the risk of breast cancer and heart disease. We know now that there were flaws in how the study was set up and interpreted, and that hormone therapy is in fact beneficial for most women.<\/p>\n \u201cA whole generation of women has unfortunately gotten the wrong message about hormone therapy and they\u2019ve suffered as a result,\u201d says Dr. Hunter. \u201cThere\u2019s zero data to support that hormone therapy increases the risk of breast cancer. When women go on hormones early in menopause, it can relieve hot flashes, night sweats, brain fog and other symptoms. It can also help protect against osteoporosis, heart disease and other long-term risks associated with menopause.<\/p>\n \u201cWe should approach menopause the same way we approach medical conditions like hypothyroidism \u2014if someone has it, we give them thyroid medication. Giving estrogen to women in menopause is no different. It\u2019s really important for women to have the correct information about hormone therapy so they can make a decision they\u2019re comfortable with.\u201d<\/p>\n Consider vaginal estrogen to support your sexual and urologic health<\/strong>. It probably comes as no surprise that estrogen is key for maintaining healthy tissue in the vagina, bladder and urethra \u2014 the tube that urine passes through on its way out of the body. Declining estrogen levels during menopause can affect desire for sexual intimacy and contribute to uncomfortable urinary symptoms.<\/p>\n \u201cWithout estrogen, the vagina becomes dry and loses its elasticity, which can make sex painful, and the tissue in the urethra can shrink, making it easier for women to get bladder infections,\u201d Zilar says.<\/p>\n Vaginal estrogen is a treatment option that can relieve discomfort during sex as well as symptoms associated with the bladder and urinary tract. This treatment delivers a small amount of estrogen to the vaginal tissue, either through a topical cream or a ring inserted inside the vagina.<\/p>\n \u201cVaginal estrogen is often overlooked as a treatment option, but it\u2019s something that women can use for the rest of their lives without any increased risk to their health,\u201d Zilar says.<\/p>\n Talk to a provider about other treatment options. <\/strong>If you aren\u2019t a good candidate for hormone therapy or don\u2019t want to pursue hormone therapy, there are other options to consider, including medications, herbal remedies, acupuncture or lifestyle changes, depending on your symptoms.<\/p>\n \u201cWith menopause, you can\u2019t just throw a quick fix at someone and call it good. It\u2019s important to consider each patient as a whole person, listen to what their experience has been and chart a course forward based on their priorities,\u201d says Silvestrin.<\/p>\n Visit a provider who specializes in menopause<\/strong>. If you are experiencing troubling symptoms or have questions about changes associated with menopause, consider making an appointment with someone who specializes in this area of medicine.<\/p>\n At MultiCare, you can schedule a virtual video appointment with one of our menopause specialists<\/a>. Those who live in the Spokane area can also visit the OB\/GYN & Midwifery Center at MultiCare Rockwood Clinic<\/a>.<\/p>\nWhat happens during menopause<\/h2>\n
Living well in menopause<\/h2>\n