MENOPAUSE FAQ

What is Menopause?

Menopause signifies a natural transition in a woman's life where menstrual periods cease. It occurs when the ovaries cease production of estrogen, a hormone essential for regulating the menstrual cycle and many other bodily functions. This stage marks the conclusion of the reproductive years, typically occurring around the age of 51, on average.

What is perimenopause?

The years leading up to menopause is called perimenopause. Beginning in your 30s and 40s, the amount of estrogen produced by the ovaries begins to fluctuate. A common sign of perimenopause is a change in your menstrual cycle. Cycles may become longer than usual for you or become shorter. You may begin to skip periods. The amount of flow may become lighter or heavier. Although changes in menstrual bleeding are normal during perimenopause, you still should report them to your health care professional. Abnormal bleeding may be a sign of a problem.

What are symptoms of the menopause transition?

Hot Flashes
A hot flash is a sudden feeling of heat that rushes to the upper body and face. A hot flash may last from a few seconds to several minutes or longer. Some women have hot flashes a few times a month. Others have them several times a day. Hot flashes that happen at night (night sweats) may wake you up and cause you to feel tired and sluggish during the day.

Sleep Problems
You may have insomnia (trouble falling asleep), or you may wake up long before your usual time. Night sweats may disrupt your sleep.

Vaginal and Urinary Tract Changes
As estrogen levels decrease, the lining of the vagina may become thinner, dryer, and less elastic. Vaginal dryness may cause pain during sex. Vaginal infections also may occur more often. The urethra can become dry, inflamed, or irritated. This can cause more frequent urination and increase
the risk of urinary tract infections.

Additional Symptoms Include:
Sexual problems
Mood changes
Forgetfulness
Weight gain
Headaches
Joint aches and pain



Why do menopause symptoms occur?

Menopause manifests uniquely for each woman. While some may undergo it with minimal symptoms, others might find themselves grappling with a myriad of menopausal signs. These symptoms, stemming from fluctuations in estrogen and progesterone levels, can persist for a few months to several years. Surprisingly, recent studies indicate that 15 percent of women experience bothersome hot flashes well into their 80s. These hormonal shifts arise from the natural aging process or can be induced medically through medications or surgical procedures.



What other health risks increase during perimenopause and menopause?

Before menopause, estrogen produced by women's ovaries acts as a shield against heart attacks and strokes. However, as estrogen production declines post-menopause, this protective effect diminishes. Additionally, midlife marks a period where risk factors for heart disease, such as elevated cholesterol levels, hypertension, and physical inactivity, become more prevalent. When these factors converge, the risk of heart attack and stroke escalates among menopausal women.



How is hormone therapy given?

Estrogen can be administered through various methods. Systemic options encompass pills, skin patches, and gels or sprays applied to the skin. If a progestogen is part of the treatment, it can be prescribed separately or combined with estrogen in a single pill or patch. Systemic therapy releases estrogen into the bloodstream, allowing it to reach the necessary organs and tissues. For women experiencing solely vaginal dryness, "local" estrogen therapy may be recommended, utilizing a vaginal ring, tablet, or cream. These forms dispense small doses of estrogen directly into the vaginal tissue.



What are the benefits of hormone therapy?

Research indicates that systemic estrogen therapy, whether with or without progesterone, is highly effective in alleviating hot flashes and night sweats. Additionally, both systemic and local forms of estrogen therapy provide relief from vaginal dryness and hormone therapy can also decrease the risk of heart disease. Systemic estrogen plays a crucial role in safeguarding against early menopausal bone loss and reducing the risk of hip and spine fractures. Moreover, combined estrogen and progestin therapy may contribute to a decreased risk of colon cancer.



What are the risks of hormone therapy?

As with all medications, HT is associated with some potential risks. For healthy women with bothersome hot flashes aged younger than 60 years or within 10 years of menopause, the benefits of HT generally outweigh the risks.

Estrogen-only therapy can lead to the thickening of the uterine lining, increasing the risk of uterine cancer. Progesterone helps to prevent this.

Both combined hormone therapy and estrogen-only therapy have been linked to a slight elevation in the risk of stroke and deep vein thrombosis (DVT). Non-oral forms of therapy (such as patches, sprays, and rings) may pose a lower risk of DVT compared to oral formulations.

Estrogen therapy, with or without progestin, may slightly heighten the risk of gallbladder disease, particularly with oral administration.

Synthetic estrogen and progesterone therapy has been shown to slightly increase the risk of breast cancer. Please inquire regarding bioidentical menopausal hormone therapy.



Can vaginal moisturizers and lubricants help with menopause symptoms?

These non-prescription products are designed to alleviate symptoms of vaginal dryness and discomfort during menopause, particularly during sexual intercourse. They are hormone-free, meaning they do not impact the thickness or elasticity of the vagina. Vaginal moisturizers can be applied every 2–3 days as necessary for ongoing relief, while lubricants can be used each time you engage in sexual activity. Vaginal estrogen or DHEA may be needed for long term treatment of vaginal and urinary symptoms or genitourinary syndrome of menopause



Is weight gain a common symptom of menopause?

Yes, weight gain is common during menopause due to hormonal shifts, slower metabolism, reduced lean muscle mass, and lifestyle factors. Hormone therapy may offer some support for managing weight. However, maintaining a balanced diet, staying physically active, and effectively managing stress are key strategies to help reduce weight gain during this stage.



How can I maintain bone health during menopause?

Maintaining bone health involves engaging in regular weight-bearing exercises, ensuring sufficient intake of calcium and vitamin D, and abstaining from smoking and excessive alcohol consumption. In some instances, healthcare providers may suggest bone-strengthening medications or supplements.