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Women & Infants Center for Reproduction & Infertility

Hormone Replacement Therapy  A Women's Guide to Menopause

The Division of Reproductive Medicine and Infertility has organized a specialized research and clinical focus on menopause. For women who are experiencing particular difficulty with menopausal or post-menopausal symptoms, the division's staff offers a variety of treatment options, including vaginal creams or hormone replacement therapy. Participation in research studies also gives patients access to some of the latest therapeutic interventions available.

The staff at Women & Infants' Menopause Center are obstetrician-gynecologists with further sub-specialty training in reproductive endocrinology issues. In addition to patient care responsibilities, the division's physicians teach medical students and residents, provide continuing medical education to other physicians through lectures and published articles, and engage in research projects.

For more information about the Women & Infants' Menopause Center and referral to an appropriate physician, please call the Physician Referral Health Line at 800-921-9299.

Menopause Symptoms and Treatment

For years, menopause has been the subject of rumor and myth. At one time, it was believed that menopause was a disease. It was also thought that menopausal women were constantly depressed and just stopped having sex. They were treated as if their lives had ended.

Thankfully, attitudes towards menopause are changing for the better. Today, menopause is seen as a perfectly natural part of life. It's also accepted that menopause is an easy transition for some, and a more difficult one for others.

Through a new openness to talk about menopause, there's more help available to women who are having difficulty coping with this time in their lives.

What is menopause?
Medically defined, menopause is said to have begun when a woman's menstrual cycles have ended for a year. The reason for this change is a decrease in the production of estrogen and progesterone. These are the hormones that control menstrual cycles and other functions of a woman's body.

Menopause is a completely natural process that occurs, on average, around age 50. Symptoms, however, often begin in the 40s and can last for up to a decade. Women whose ovaries have stopped functioning or have been removed surgically can experience what is commonly referred to as early menopause.

What bodily changes occur during menopause?
Menopause affects different women in different ways. Many of these changes are brought on by decreasing hormone levels.

The first signs of approaching menopause are changes in the menstrual cycle. Some women might menstruate more frequently, others less. Timing between each cycle can become unpredictable.

Hot flashes are the most common symptom of menopause. These are a sudden sensation of heat that spreads over all or part of the upper body.

Menopause is often accompanied by vaginal changes such as a decrease in moisture and elasticity resulting in discomfort during sexual intercourse.  Many women experience sexual dysfunction after menopause and it can have a significant impact on their lives.  The conditions associated with Female Sexual Disorder (FSD) do respond to treatment so please talk to your doctor about your symptoms.


How are emotions affected during menopause?
Emotional changes may vary in intensity from woman to woman. Some women experience nervousness, irritability, fatigue or mild depression. Hot flashes can cause trouble sleeping which, in turn, can result in memory loss and mood swings. But these emotional changes are a normal and natural consequence of sleep pattern disturbances.

Taking care of yourself during menopause
During - and long after - menopause, women need to develop a routine and keep a close watch on their health. It's important that women develop a trust and rapport with a doctor so he or she will be familiar with their medical history.

Complete gynecologic and breast exams should be done once a year so health problems can be discovered and treated early. The most serious of these - and most common among post-menopausal women - is heart disease.

There is also an increased risk of osteoporosis (a weakening of the bones) which could lead to fractures, posture problems or back pain. Women can improve their health and reduce the risk of osteoporosis and heart disease by eating a balanced diet, following a regular program of exercise and quitting smoking.

What is hormone replacement therapy?
If a woman is experiencing severe problems with menopause, her doctor might suggest hormone replacement therapy (HRT). This is a treatment that replaces the estrogen and progesterone lost through menopause. HRT can relieve hot flashes and other menopausal problems.

In studies, HRT has been found to help reduce the risk of heart disease, the leading cause of death for post-menopausal women. It has also been found to help prevent osteoporosis.

Estrogen treatments alone have been linked to uterine cancer. For women with a uterus, the addition of progesterone to their estrogen replacement will eliminate the risk of uterine cancer.

Although many women do not notice any side effects with HRT, they do occur in a few women. Side effects may include fluid retention, irritability, swelling of the body, breast tenderness and abdominal cramping.

For more information on menopause or treatments for severe menopause, or for the name of an appropriate physician, contact the Physician Referral Health Line at 800-921-9299.

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