What is Menopause?
Menopause is a natural process that women undergo when their menstrual periods stop. Once the ovaries stop making estrogen, the menstrual cycle gets disrupted. On average, women undergo menopause in their late 40s.
What is Perimenopause?
Before hitting menopause, women go through something called perimenopause, which begins in the late 30s or 40s. During this phase, the secretion of estrogen becomes fluctuant, starting an array of signs and symptoms. The most common sign of perimenopause is irregular menstrual cycles.
For instance, you may experience unusually long or short menstrual periods. In some cases, women even skip a few periods.
Note that the amount of bleeding during perimenopause remains normal. Therefore, if you experience excessive bleeding without an apparent cause, make sure to speak with your physician about it.
What are the other signs and symptoms of Perimenopause?
Aside from irregular menstrual cycles, you may not experience any symptoms. However, do not panic if you develop the following symptoms during perimenopause:
Hot flashes – This describes an abrupt feeling of heat that rushes through your face and neck. Each episode lasts for a few seconds to minutes. The cause of hot flashes is the massive vasodilation of your blood vessels. Most women report having these episodes at night.
Sleep problems – Insomnia is the most common sleeping disorder associated with perimenopause. There are two types of insomnia – Having trouble falling asleep or waking up too early. Hot flashes play an important role in disrupting your sleep.
Vaginal and urinary tract changes – Once estrogen starts to drop, the lining of the vaginal canal becomes less elastic and more dry. As a result, you may feel discomfort or painful sexual intercourse. We refer to this symptom as dyspareunia. You can also develop recurrent vaginal infections. Finally, the incidence of urinary tract infectionsincreases due to inflammation and irritation of the urethra.
Menopause and the risk of osteoporosis
Both women and men lose some of their bone tissues after 35 years old. This is a physiological process that requires no medical intervention. However, menopause starts a rapid osteolytic cascade that leads to significant bone loss. In fact, postmenopausal women are at a very high risk of osteoporosis.
The cause of these changes is estrogen decline. To address this condition, your doctor may prescribe hormone replacement therapy (HRT) to gradually adapt your body to new estrogen levels.
Other health risks of Menopause and Perimenopause
Estrogen has some cardioprotective properties that lower the risk of heart attacks in women. It also protects your brain from strokes. The steep decline of estrogen removes this protection, increasing the risk of cardiovascular events dramatically.
What makes things worse is the emergence of other risk factors at this age. For instance, high blood pressure, dyslipidemia, and sedentary lifestyles are more common in women over the age of 50.
Combining these factors together gives us the perfect recipe for heart attacks and strokes.
What is hormone therapy?
Hormone replacement therapy is designed to relieve the symptoms of estrogen decline. Doctors prescribe HRT for women with severe perimenopausal and menopausal symptoms.
The pills of hormone therapy may contain estrogen alone or estrogen plus progestin. The latter protects you from uterine cancer since taking estrogen alone is associated with a high risk of this cancer. In case you had a hysterectomy (i.e., removal of the uterus and ovaries), estrogen alone is enough. You may hear your doctor refer to this treatment as estrogen therapy.
How to administer hormone replacement therapy?
Hormone replacement therapy comes in several pharmacological forms. They include skin patches, gels, and pills. If you need to take estrogen and progestin, your doctor may recommend taking the drugs in different forms. For instance, you can take one pill of estrogen and place a progestin skin patch.
Systemic hormone therapy refers to oral drugs. As the pill enters your digestive system, the hormone is absorbed into the bloodstream where it finds its targeted organs.
If vaginal dryness is the only symptom you are having, using local cream, tablet, or ring may be more appropriate.
What are the benefits of hormone replacement therapy?
Estrogen therapy is the gold standard treatment for hot flashes and night sweats. These drugs help improve patients’ quality of life dramatically. When it comes to vaginal dryness, both systemic and local therapies can work well.
However, bone loss requires systemic estrogen. Combining estrogen with progesterone is more of a protective factor against cancer.
What are the risks of hormone therapy?
The risks of hormone therapy are not clear-cut. Some researchers believe that HRT increases the risk of certain types of cancer. For instance, HRT that only contains estrogen will increase the risk of uterine cancer.
Taking estrogen with progestin may increase your risk of coronary artery disease. However, this incidence may be due to other factors, such as dyslipidemia, high blood pressure, and diabetes.
Deep vein thrombosis is another feared complication of taking combined hormone therapy. The same hemostatic disturbances may cause a stroke. If you already have a high risk of hemostatic events, your doctor can prescribe patches or sprays instead of systemic hormones.
Additionally, some studies found a link between combined hormone therapy and a higher risk of breast cancer. Finally, estrogen therapy may contribute to the occurrence of gallbladder disorders.
Can other medications help with Menopause symptoms?
Besides hormone replacement therapy, there are a few medicines that help with the symptoms of menopause. These include:
Antidepressants – To address hot flashes.
Gabapentin – Used for hot flashes and insomnia.
Clonidine – Used for hot flashes and insomnia.
Selective estrogen receptor modulators (SERMs) – Relieve hot flashes and dyspareunia.
Can herbal supplements help with Menopause symptoms?
Herbal medicine may aid in the management of menopause symptoms. Some effective ingredients include black cohosh, soy, and a few Chinese remedies. However, the research that backs up the effectiveness and safety of these substances is scarce. Therefore, you should be careful when taking supplements from unknown sources.
We should also mention that this market is not regulated. This means there is no governmental institution that inspects these products to ensure they are safe.
Before taking herbal remedies to treat menopause symptoms, we highly recommend that you speak with your primary care physician or gynecologist.
Can bioidentical hormones help with Menopause symptoms?
Bioidentical hormones refer to plant sources that provide your body with hormones. These preparations are compounded by a pharmacist, following a doctor’s prescription. Keep in mind that compounded drugs are not regulated by the United States Food and Drug Administration (FDA). Therefore, it is best to ensure that the pharmacist is qualified enough for this task. Otherwise, you will risk taking an effective drug. In some cases, it may even cause severe side effects.
The American College of Obstetricians and Gynecologists says that hormone therapy is preferable over compounded hormones.
Can vaginal moisturizers help with Menopause symptoms?
Over-the-counter products can be useful for some signs of menopause, such as vaginal dryness. For example, vaginal moisturizers improve sexual health and lower the risk of pain during intercourse.
Note that these products are hormone-free. Instead, they temporarily replace the natural secretion of your vaginal canal.
What can I do to stay healthy after Menopause?
To effectively achieve optimal health after menopause, you need to follow these simple, yet challenging tasks:
Eat a healthy diet – Consuming a balanced diet that covers your nutritional needs during and after menopause is crucial. Make sure to include more foods with high levels of calcium and vitamin D.
Exercise regularly – There is plenty of research papers that advocate for the positive effects of exercise on menopause symptoms. This activity strengthens your bones by increasing bone mineral density. As a result, you are less likely to develop osteoporosis. It also promotes muscle hypertrophy, allowing you to stay independent as you get older. You do not need to lift weights and run marathons to achieve these goals; just do some physical activity that you enjoy on a regular basis.
Listen to your body – Vising your doctor once or twice a year is very important after menopause. Regular screening tests and physical exams will detect any health problem early. This gives your doctor the chance to act before it’s too late. The most concerning disease that regular checkups help with is cancer.
