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Menopause

Menopause

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 have changed for the better. Menopause is seen as a perfectly natural part of life, and it 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.

Please be advised that this location is a provider-based clinic and both a physician and facility fee will be assessed, which may result in a higher out-of-pocket expense.

Contact Information:

Patients of the Women & Infants’ Menopause Program are seen at two locations, please call (401) 274-1122, extension 42721 for more information.

Obstetrics and Gynecology Care Center
2 Dudley street
5th Floor
Providence, RI 02905
P: (401) 274-1122, ext. 42721

Center for Reproduction and Infertility
90 Plain Street
4th floor
Providence, RI 02905

No Show Policy 
We have a policy for missed appointments at all Women & Infants physician practices. If you need to reschedule or cancel an appointment, please give us at least 24 hours notice.

Services

The providers in our Menopause Program offer the following services:

  • Evaluation and treatment of vasomotor symptoms such as hot flashes and night sweats
  • Evaluation and treatment of vulvovaginal problems such as vaginal dryness, pain, burning and painful intercourse
  • Preventative care for mid-life women including, breast health, bone health and osteoporosis screening, emotional health and cardiovascular screening
Appointments

Speak with your primary care provider or gynecologist. If you need the name of a provider, please call Women & Infants Physician Referral Health Line at 1-800-921-9299.

Your primary care provider or gynecologist can refer you to the Menopause Program, or call us directly at (401) 274-1122, ext. 42721.

Menopause FAQ

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.

How does your body change 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 menstrual cycles. Some women might menstruate more frequently, others 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 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.

How are your emotions affected during menopause?

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

You should schedule a complete gynecologic and breast exam once a year so health problems can be discovered 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, and quitting smoking. You might also consider hormone replacement therapy.

What is 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 through menopause. HRT can relieve hot flashes and other menopausal problems.

Depending on when HRT is started, it may increase a woman’s risk of developing heart disease. Women who are over the age of 59 or at least 10 years postmenopausal are discouraged from starting HRT as this subset of patients appear 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. Side effects include fluid retention, irritability, swelling of the body, breast tenderness and abdominal cramping.

What can you do if you have signs of severe menopause?
Severe menopause can be helped. You should see your gynecologist and discuss the options that are right for you.

Hormone Replacement Therapy

What is hormone replacement therapy (HRT)?

HRT is a treatment that is often prescribed to postmenopausal women to help relieve symptoms that accompany menopause: hot flashes, night sweats, vaginal dryness, and sleeplessness. HRT has also been prescribed to prevent some long-term health problems that can accompany menopause, such as cardiovascular disease and osteoporosis or bone loss.  

Hormonal treatment may consist of estrogen alone, prescribed for women who have had a hysterectomy, or a combination of estrogen and progestin (a synthetic form of progesterone), for women who still have a uterus and are going through menopause.  

In its study of estrogen plus progestin, the Women’s Health Initiative study investigated a popular brand name HRT called Prempro. The hormones taken by the women in the study were 0.625 milligrams of conjugated equine estrogens (daily) and 2.5 milligrams of medroxyprogesterone acetate (daily).

Depending on when HRT is started, it may increase a woman’s risk of developing heart disease. Women who are over the age of 59 or at least 10 years postmenopausal are discouraged from starting HRT as this subset of patients appear to be at greater risk of developing cardiac disease.

If you are a member of this subset and taking HRT, what should you do?  

This is a complex issue with individual risks and benefits. Women who are taking HRT should talk with their physician about continuing or ending their use of HRT in a timely but not emergent fashion to see how these results apply to them personally, and what is the best course of action for them.

Meet the Menopause Program Team

Renee R. Eger, MD, FACOG

Renee Eger, MD, is director of the Menopause Program and medical director of the Obstetrics and Gynecology Care Center. A graduate of Brown University and Tufts University School of Medicine, Dr. Eger completed her residency in obstetrics and gynecology at Women & Infants Hospital and is board certified in obstetrics and gynecology and a member of the North American Menopause Society. 

Kenneth K. Chen, MD

Kenneth Chen, MD, is director of the Division of Obstetric and Consultative Medicine. Dr. Chen received a MBBS degree, the equivalent of an MD degree, at the University of Sydney in Australia after which he completed a residency in internal medicine at Westmead Hospital, University of Sydney. 

Heather M. Hurlburt, MD

Heather Hurlburt, MD, is a cardiologist with Brigham and Women’s Cardiovascular Associates at Care New England and is co-director of Women’s Heart Health of Women & Infants. A graduate of Tufts Medical School, she completed her residency in internal medicine at New York Hospital Cornell Medical Center and her fellowship in cardiology at the University of Massachusetts.

Alice Y. Kim, MD, FACC

Alice Kim, MD, is a cardiologist with Brigham and Women’s Cardiovascular Associates at Care New England and is co-director of Women’s Heart Health of Women & Infants. A graduate of Wellesley College and SUNY Upstate Medical University, she completed her residency and fellowship in general internal medicine and cardiology at the Alpert Medical School/Rhode Island Hospital.

Jessica A. Pineda, MD

Jessica Pineda, MD, sees patients at Women & Infants’ Center for Primary Care and Center for Women’s Behavioral Health. A graduate of Luther College and the Medical College of Wisconsin in Milwaukee, she completed an internship and residency at the University of Cincinnati in psychiatry and family medicine.

Carol A. Wheeler, MD

Carol Wheeler, MD, is a reproductive endocrinologist in the Division of Reproductive Endocrinology and Infertility. A graduate of Jefferson Medical College in Philadelphia, she completed her residency in obstetrics and gynecology at Miami Valley Hospital in Dayton, OH and her fellowship training in reproductive endocrinology and infertility at the Hospital of the University of Pennsylvania.