By Jigna Patel, MD
Whether you experience the full range of symptoms or just a few, menopause can really change your life — at least until you make it through to the other side.
And even then, hormonal changes can increase your risk for certain health conditions, like osteoporosis and cardiovascular disease.
Fortunately, there are a number of things women can do to help alleviate symptoms and stay healthy and strong during their next phase of life.
Hot Flashes, Night Sweats Common
Menopause is defined as the absence of a menstrual cycle for 12 consecutive months and occurs when the ovaries stop producing estrogen, a hormone that helps control the menstrual cycle.
The average age of a reaching menopause is 51. However, for some women it occurs earlier and for others later.
Perimenopause is the transitionary period leading up to menopause and typically starts in the mid-40s. This is when hormone levels are changing and when symptoms may start to occur.
Changes in your menstrual cycle are among the main signs of perimenopause. Cycles may be longer or shorter, and in some months may be skipped altogether.
Other symptoms of perimenopause and menopause include:
• Hot flashes. Hot flashes are sudden feelings of heat that rush across to the upper body and face. They may last for a few seconds, minutes, or longer. Some women may experience hot flashes several times a day, while others may have them a few times a month.
• Night sweats. Night sweats are hot flashes that occur at night and can prevent women from getting a good night’s sleep.
• Vaginal changes, particularly vaginal dryness, that can result in painful intercourse.
• Frequent urinary tract infections, and incontinence issues, due to the declining level of estrogen.
While these are some of the most common symptoms of perimenopause and menopause, there are many other symptoms that may be linked to perimenopause and menopause, including mood changes, cognitive challenges, joint pain, and weight gain.
Some women find they have few or no symptoms, while others experience a total rollercoaster ride. Moreover, for some women, symptoms can continue for several years after menopause.
Bone Changes, Cardiovascular Disease
In addition to hot flashes and other uncomfortable symptoms, hormonal changes associated with menopause increase the risk for serious health conditions, especially osteoporosis and cardiovascular disease.
While men and women generally begin to lose a little bit of bone mass in their mid 30s, bone loss accelerates rapidly for women during the first four to eight years of menopause, according to the American College of Obstetricians and Gynecologists (ACOG). This can put women at greater risk for osteoporosis and consequently, bone fractures.
Moreover, as estrogen levels decrease, the risk for cardiovascular disease increases. This is because estrogen guards against heart attacks and strokes so, when it decreases, so do its protective properties.
And, as ACOG notes, midlife also is the time when risk factors for heart disease, such as high cholesterol, high blood pressure, and physical inactivity are more common. These factors combine to increase the risk of heart attack and stroke in menopausal women.
A Range of Treatments Possible
If you experience symptoms that impact your quality of life, including your relationships with friends and family or your work life, or are concerned about menopause, see your doctor for diagnosis and treatment.
Blood tests to measure your levels of estrogen and follicle stimulating hormone, which helps control your menstrual cycle, can confirm if you are in perimenopause or menopause.
Once diagnosed, a range of options to relieve symptoms are available.
For some women, certain lifestyle changes may be enough. These include exercise, meditation, yoga, acupuncture, and dietary changes such as eliminating caffeine and alcohol, which can trigger hot flashes.
If symptoms persist, hormone therapies may be temporarily prescribed to smooth out hormonal fluctuations so they are more manageable. Hormone therapy can be safely used by many women, though women with certain medical conditions, such as a history of breast cancer or cardiovascular disease, may not be candidates. If you are considering hormone therapy, talk with your physician about whether it is the right approach for you.
To help with vaginal issues, topical estrogen creams may be recommended.
Hot flashes, night sweats, and mood changes have also been effectively treated with non-hormonal therapies that have typically been used to treat anxiety, depression, and high blood pressure.
Staying Healthy After Menopause
So, you made it through the rough part. Now, how do you stay healthy after menopause?
• Eat healthy. Specifically, a diet that is rich in fruits and vegetables and includes enough calcium and vitamin D to maintain strong bones.
• Exercise. Weight bearing exercises can help keep your bones strong, while aerobic exercise is good for your cardiovascular health. Exercise can also help you maintain a healthy weight.
• See your doctor regularly. Routine healthcare visits, including an annual physical, can help detect and address problems early.
Remember, though menopause is a natural stage of life, you don’t have to suffer the symptoms. With a range of treatment options available, you and your doctor can find an approach that is best for you.
To find a physician affiliated with Penn Medicine Princeton Health, call 1-888-742-7496, or visit www.princetonhcs.org.
Jigna Patel, MD, is board certified in obstetrics and gynecology. She is a member of the Medical Staff at Penn Medicine Princeton Health.