It’s a good idea to talk to your doctor about treatment options
by Maggie Ireland
As women approach the end of their childbearing years, they may experience symptoms of menopause but may not realize all of the treatments now available.
“Menopause is the lack of menses in a woman. Typically, this happens in her early 50s. The current diagnosis for menopause is that a woman has no periods for 12 months,” said Dr. Lindsy Alons, a physician at Cedar Rapids OB/GYN Specialists. “It’s different for every woman.”
In menopause, a woman’s body adjusts to changing levels of ovarian hormones — estrogen — as her cycles phase out. The uneven levels of estrogen can cause a wide variety of symptoms, with hot flashes and night sweats the most common.
“A lot of patients have night sweats, hot flashes, changes in libido, vaginal dryness, mood changes and other symptoms,” Alons said.
Quality of life
Eugenia Mazur, a physician in the Menopause and Sexual Health Clinic at University of Iowa Hospitals and Clinics in Iowa City, treats many woman for the effects of menopause, some more serious than others.
“Every woman goes through menopause without exclusion,” Mazur said. “Some of us have very mild or no symptoms and don’t require any intervention. Another group of women experience quite significant symptoms.”
Some women experience sleep disruption. Often, they experience fatigue, a lack of concentration or a “brain funk” the next day, Mazur said. Many gain weight.
Another common symptom is vaginal dryness, which “can lead to pain with intercourse,” Mazur said. “I’ve learned to always ask about this — if I don’t ask, a patient may be too embarrassed to bring it up herself.”
The combination of symptoms can drastically alter a woman’s quality of life, she said.
“On average, menopause symptoms will last seven years,” Mazur said. “So, if you have symptoms that are affecting your daily life, you should absolutely talk to your doctor.”
Estrogen or aging?
While more serious health concerns can develop during menopause, both physicians acknowledged it can be difficult to distinguish what is caused by changes in estrogen levels and what is brought on by aging.
For example, women tend to develop cardiovascular abnormalities more commonly in their 50s and 60s, whereas men tend to develop those issues sooner.
“It’s hard to say if it’s hormonal or aging,” Alons said.
In menopause, a woman’s cholesterol may jump, sometimes drastically, so it is important they get their cholesterol levels checked and talk to their doctor about heart health.
Bone health is another concern.
“Once the ovaries stop making estrogen, we see a lot more thinning of bones as women become postmenopausal,” Alons said.
Osteopenia and osteoporosis are both diseases of progressive bone loss that become more common in women after menopause. Prevention, including bone density tests, is key.
Treatment options
The good news is that the treatment options available are as diverse as the types and severity of symptoms accompanying menopause.
“We, of course, make lifestyle, health, diet and exercise recommendations when they are appropriate,” Mazur said.
The most common treatment for the symptoms of menopause is hormone replacement therapy — regulating the level of estrogen.
“There are lots of over-the-counter options out there, but they don’t usually have a ton of effect,” Alons said. “With hormone replacement therapy, there are many different formulations — pills, patches, topical lotions, vaginal preparations, laser therapy and more. So treatment can really be tailored to the needs of each woman and the severity of her symptoms.”
Adding estrogen back into a woman’s body carries the bonus of helping combat bone loss.
“There is nothing close to estrogen in prevention of bone loss,” Mazur said. “We do not prescribe estrogen for osteoporosis specifically — but if we start it for other symptoms, you also will get the added benefits of prevention.”
Many women, she said, “are scared of using estrogen due to possible side effects. But we will always assess a woman’s risk factors and health history before making a recommendation for hormone replacement. If you’re a good candidate for estrogen replacement, it can really improve your quality of life.”
Doctors also may prescribe antidepressants or sleep aids if a woman’s mood or sleep are drastically affected by menopause.
Do some research
When it comes to doing your own research on menopause symptoms and treatment, Mazur has some advice.
“Dr. Google is not always helpful and can be overwhelming,” she said.
But a “great” source of information, she said, can be found at the North American Menopausal Society website at menopause.org.
“Even if you are only approaching the age of menopause, it’s good to do some research,” Mazur said. “You can talk to your doctor about any questions you have.”
If concerns arise about treatment options, talk to your doctor for tailored, specific advice, she said.
Alons agreed — there’s no reason to go into menopause with unanswered questions or uncontrolled symptoms.
“More and more women are coming in with their concerns,” she said. “For a long time, menopause wasn’t talked about, so women suffered in silence. Now, there are lots of options for treatments available so you can live a healthy, comfortable lifestyle.”
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