Menopause is a time of great change for women’s bodies. It marks the end of your reproductive years, which leads to fluctuations in hormone levels that manifest themselves in a variety of ways, both physically and mentally. Practicing some menopause self-care can help you navigate this season of life.
You’ll likely experience a lot of different symptoms during menopause. Make an appointment with your gynecologist to manage those symptoms and discuss any treatment options you might have available to you.
What is menopause?
Menopause is a natural medical condition that occurs in a woman’s life when she is at the end of her reproductive stage of life. It officially begins when a woman has gone 12 consecutive months without a menstrual period.
Before fully entering menopause, women go through the menopausal transition, also referred to as perimenopause, which often begins several years before menopause. During this phase, you ovulate less frequently. Additionally, you start having hormone fluctuations that include decreases in estrogen and progesterone, as well as rises in follicle-stimulating hormone (FSH).
Common menopause symptoms
These changes lead to a number of physiologic symptoms. One of the most common is irregular periods – however, it is still possible to become pregnant when you are perimenopausal. Most women begin this phase in their mid-40s, but it can happen as early as their mid-30s.
Another common symptom that women in menopause experience are hot flushes. These are feelings of sudden, extreme heat in the upper body that can be accompanied by sweating, chills, palpitations and a feeling of anxiety. They often last about one to five minutes.
Nearly 87 percent of people experience hot flushes, and 33 percent even have 10 or more a day, says Jasmine Shah, MD, an OB-GYN in our Richmond market.
“We’re not completely sure exactly why these happen, but its thought to be due to the hormonal changes in addition to a change in your body’s thermoregulatory zone,” Dr. Shah says. “This becomes narrower in the menopausal transition, such that temperatures that used to feel normal to your body now fall outside that range. This increases sensitivity to subtle temperature changes results in the feeling of a hot flush. Estrogen helps because it widens this regulatory zone.”
Because menopause is considered a transitional period, many symptoms will overlap regardless of what stage you are in. Common menopause and perimenopause symptoms include:
- Heavier or lighter periods
- Irregular periods
- Mood swings
- Insomnia or difficulty sleeping
- Hot flushes
- Chills
- Incontinence and frequency of urination
- Loss of breast fullness
- Thinning hair and drying skin
- Vaginal dryness
- Night sweats
- Weight gain and slower metabolism
Once you have not experienced a period for at least 12 months in a row, you are considered menopausal or postmenopausal. The average age for women to experience this in the United States is 51, but you can enter menopause at either a younger or older age. Additionally, because your body produces very little estrogen, you are no longer able to become pregnant.
What causes menopausal symptoms?
Although it may not feel that way for some, symptoms of menopause begin gradually. Each woman’s body is different, so symptoms may be more or less noticeable – at least at first – depending on how your body reacts to the changes.
These symptoms are a result of your ovaries producing less and less estrogen, which has an effect on your menstrual cycle, lactation after pregnancy, bone health, skin, hair, pelvic muscles and even the brain. Low estrogen levels can also increase your risk of heart disease and osteoporosis.
Dr. Shah adds that about 10 to 40 percent of women will experience symptoms of vaginal atrophy.
“This happens because the decrease in estrogen leads to a loss of vaginal elasticity. This makes the vagina narrower, shorter and more fragile,” she says. “This can lead to pain and bleeding with sex. The decrease in estrogen can also change the pH of the vagina, increasing risk of infections such as UTIs and bacterial vaginosis. Adding estrogen back through a vaginal pill or cream can help these symptoms.”
Are there treatments for menopause?
While there are no treatments for menopause itself, your provider may recommend one or more medications to treat the unwanted side effects of the condition.
Some of these include:
- Bone protection: You lose bone mass as you approach and go through menopause, so you may be recommended ways to prevent additional bone loss or osteoporosis, which can put you at risk for fractures. These include a calcium and vitamin D supplement, as well as regular weight-bearing exercise.
- Hormone replacement therapy (HRT): Estrogen hormone therapy can be used to reduce many symptoms of menopause, thought it is most helpful for hot flushes.
- Hot flush medication: Not everyone is able to take hormone replacement therapy (HRT), but there are other medications, such as a low-dose antidepressant, that can also treat hot flushes.
- Vaginal estrogen: Using an estrogen cream or tablet may reduce vaginal dryness. Dr. Shah says that if you don’t want to jump right to hormones, an over-the-counter vaginal moisturizer may also help.
- Phytoestrogens: Soy products contain phytoestrogens, which are plant-based estrogen. There’s some evidence to show increasing your soy product intake through products such as soy beans (edamame), tofu, soy milk, tempeh and miso can help decrease menopausal symptoms.
- Vitamin E: The data is limited, but with a supplementation of 800 IU (international units) of vitamin E per day can lead to a marginal reduction in hot flushes.
What makes menopause worse?
You can’t avoid going through menopause. And while you can treat some of your symptoms to improve how you feel, you can also inadvertently make them worse. Things that can make menopause symptoms worse include excessive alcohol consumption, spicy foods, caffeine and processed foods.
Menopause self-care tips
While much of what you hear and read about menopause involves your physical health, your mental health is just as important as your body changes. Following a menopause self-care regimen may help you feel physically and mentally better.
- Stay cool: Hot flushes are one of the most frequent perimenopausal and menopausal symptoms women report experiencing. Choosing clothes that are breathable, dressing in layers that you can remove and replace and using a portable fan can provide relief while you’re feeling too warm.
- Stay hydrated: Drinking plenty of water cools you down during hot flushes.
- Exercise regularly: Moving your body has a list of positive effects on you physically and mentally. Getting regular exercise relieves stress, builds strength, gives you more energy, helps with weight maintenance and promotes good, restful sleep. Women should get at least 30 minutes of physical activity most days of the week.
- Get enough sleep: Similar to regular exercise, ensuring you get plenty of sleep is critical to taking care of yourself. Catching seven to nine hours of shut-eye each night helps prevent weight gain and boosts your mood.
- Stay connected with others: You’re going through a lot during menopause. That can take a toll on your mental health. Keeping in touch with friends, family and other acquaintances may make you feel less alone as you process these changes and help you to deal with any mood swings you might experience.
- Adjust your lifestyle realistically: As we age, our lives change. Many of us don’t have the same routines and interests in our late 40s as we did in our mid-20s. While you don’t have to completely overhaul your life just because you’re going through menopause, making some lifestyle choices like an exercise regimen, drinking less alcohol and eating better may help you feel better.
- Consider hormone replacement therapy: Many of the symptoms of menopause are caused by changes in hormone levels, specifically estrogen. Hormone replacement therapy infuses the body with these hormones that your body no longer produces at higher levels. This can lead to decreasing hot flushes and sweating, fewer mood swings, increasing vaginal moisture and risk of bone fractures.
Common menopause questions
While each woman’s experience with menopause is different, but many ask their OB-GYNs similar questions. Below are some common questions that Dr. Shah is asked by her patients.
If I’m already on hormone therapy, do I need to stop at a certain point?
No! Stopping hormone therapy results in a return of symptoms in about half of women, so it should be a discussion with your doctor about the risks and benefits of continuing. Many women continue on hormone therapy even over the age of 65.
Aren’t bioidentical hormones better?
Let’s get into what a bioidentical hormone is first – these are plant-derived hormones that are chemically/structurally identical to those produced by the body. Not all bioidentical hormones are FDA-regulated. This means that most of these, especially the compounded ones, do not undergo the rigorous safety and efficacy testing of FDA-regulated medications. This means a higher risk of both over and underdosing with these formulations, and that’s why we often don’t recommend these.
Do herbal remedies help?
There have been studies on black cohosh, ginseng, St. John’s wart, and ginkgo biloba. At this time, there’s not sufficient data to say these are beneficial, and they may have unwanted side effects or even interactions with other medications you’re taking. Talk to your doctor if you’re using these supplements.
How we can help
One of the most important ways you can practice menopause self-care is by talking to your doctor. While what you may be experiencing in menopause is normal, maintaining an open line of communication with your doctor can help you manage symptoms, prevent injury and identify any health concerns before they become a problem.
Make an appointment with your gynecologist if you think you might be entering menopause or if you want to discuss symptoms you may be experiencing.
Learn more about menopause as well as the obstetrics and gynecology services we provide at Bon Secours.
