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

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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. It's 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.

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.