Menopause and Midlife Care

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 menstrual cycles. Some women might menstruate more frequently, while others menstruate less. Timing between each cycle can become unpredictable.

Menopause is sometimes accompanied by vaginal changes such as a decrease in moisture and elasticity resulting in vaginal dryness and discomfort during sexual intercourse.

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.

As your body tries to compensate for its physical changes, there can be emotional changes too. Again, these symptoms vary in intensity from woman to woman.

Some women experience nervousness, irritability, fatigue or mild depression. Brain fog, or difficulty remembering things, is common. Many women report sleep disturbances, including both difficulties falling and staying asleep.

During - and long after - menopause, you'll need to develop a routine,and keep a close watch on your health. It's important that you develop trust and rapport with your doctor so she or he will be familiar with your medical history.

You should schedule a complete gynecologic and breast exam once a year so health problems can be identified and treated early. The most serious of these - and the 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.

You can improve your health, and reduce the risk of osteoporosis and heart disease, by eating a balanced diet, following a regular program of exercise, minimizing alcohol intake and quitting smoking. You might also consider hormone replacement therapy.

If you are having severe problems with menopause, your doctor might evaluate you for hormone replacement therapy (HRT). This is a treatment that replaces the estrogen and progesterone lost during menopause. HRT can relieve hot flashes and other menopausal problems.

In healthy women less than 10 years since menopause onset, or younger than 60 years, hormone therapy is a safe, effective treatment option for menopausal symptoms. Women who are 60 or older or at least 10 years postmenopausal are discouraged from starting HRT as this subset of patients appears to be at greater risk of developing cardiac disease.

If you and your doctor decide that HRT is an option, you should be aware that estrogen treatments alone have been linked to uterine cancer. Through the development of new hormone treatments, this increased risk has been eliminated.

Although many women don't notice any side effects with HRT, they do occur in a few women. These can include fluid retention, irritability, swelling of the body, breast tenderness and abdominal cramping.

Severe menopause can be helped. You should see your gynecologist and discuss the options that are right for you.