From hot flashes to mood swings to changes in libido, Dr. Corinne Tuckey-Larus explains what’s going on throughout “the menopause years” and how you can find relief
Menopause. Wow, what can you say? Where to start? It could be mother nature’s sweetest action or cruelest hoax. Here’s what you can expect and how to adapt as your body waves goodbye to your reproductive years and hello to a new hormonal rollercoaster ride.
What is Menopause
There are only two singular events in a woman’s menstrual/reproductive life, and they are menarche and pregnancy. Menarche is the time of the first menses (when you start your period). Pregnancy is a defined episode: you can’t be almost or a little bit pregnant.
But how to describe menopause is a bit more challenging. Our medical literature notes “transitional years of the menopause,” which, to most of us, present gradual ongoing changes in our bodies. These changes occur as your body stops producing estrogen, the hormone that helps control the menstrual cycle. The final occurrences are natural infertility and no menses. In fact, the definition of menopause is no period/menses for one full year. Therefore, menopause is defined in hindsight.
For completeness of the definition, we must also consider age. The average age women experience menopause in the United States is 51, but most women experience changes years and months before the actual “event.” Many of us laughably feel like we are experiencing puberty in reverse!
What to Expect and When
Since menopause is a transition, women experience it over time; and that timing and degree of symptoms varies from woman to woman.
A lot of menopause symptoms start long before menopause, in your 40’s or even 30’s. This period leading up to menopause is called perimenopause. The amount of estrogen produced by your ovaries starts to fluctuate – and what follows can be confusing. You might experience changes in your periods (timing, flow, cramps), or you might skip a month here and there. Not to worry – these changes are common; but they are something to address with your doctor as abnormal bleeding could indicate a problem.
Menopause is heralded by moodiness, crying, anger, libido changes and infamous hot flushes or flashes, just to name a few. I like to refer to it as a “three-year-old who found a dimmer switch and is playing havoc with the lights in the room.” Many of us also experience hair in undesired places, nail, skin, and weight changes, too.
Finding Treatment That Works for You
I explain to many of my patients, there is no experience in “the menopause years” that is “normal,” but only “acceptable.” We need to look at complaints and concerns on an individual level. What may work for some does nothing for others.
Hormone Replacement Therapy
Our female tissues just love estrogen. When production of the hormone drops, tissues can become less moist and supple and more atrophic. The drop in estrogen and resulting tissue dryness can also lead to more pain with sexual contact. Hormone replacement therapy is medication to replace the supply of estrogen that has diminished.
Estrogen comes in many forms, and creams and topicals may be the answer for some. Small amounts of topical application, I believe, pose minimal threat. We do have to pick our battles. Life is full of risks, so systemic estrogens (prescription estrogen supplements) versus quality of life must be weighed.
I would love to dispel the estrogen myth here and now. With any other gland failure, we replace the missing hormone. The thyroid fails to produce thyroid hormones, and we replace them; the pancreas fails to produce insulin, and we replace it…just to name a couple. The ovaries are none-the-less a gland. Why should we not consider replacing the missing estrogen when the ovaries fail to produce it? There are many differing opinions on this, and we can’t speak to all the types of risks different individuals may have in one article. This is a conversation to have with your doctor so that together you can find an individualized treatment plan.
Other Treatment Options
Solutions don’t end with hormone treatment replacement. There are other options, including lifestyle changes and medication, that can address many needs and concerns. But no magic “little blue pill” exists for women as our bodies fail us in many ways. Our coping mechanisms seem aloof and our partners seem unable to comprehend us at times, but all in all we are individuals who experience our menopausal minutes, days, months, and years differently. It’s a recipe that requires a pinch of this and a dap of that…maybe just some reassurance and counseling.
Preventative Care and Finding a “New Normal”
Women should be seen on an annual basis. I don’t subscribe to skipping yearly visits because you heard we don’t need you to have a pap smear every year. That reasoning upsets me. Women need preventative care in the menopause years and beyond more than ever. Our needs change and our aging presents risks which need to be identified and assessed. We live a third of our lives in menopause (or post-menopause), and we can’t neglect our health during this time.
The term “new normal” in these pandemic times aches me to the pit of my stomach; however, we are women none-the-less, and we can adjust to our “new normal.” Come see us and give us a chance to help.