“The Change of Life” (Menopause) is an inevitable part of every woman’s life that can often be stressful and disruptive. It is defined as the absence of menses for a term of one year, provided other medical factors have been ruled out. In North America, the change begins at an average age of 52; abruptly for some, and slowly for others. It can be associated with irregular heavy or light bleeding and other symptoms include those notorious hot flashes, vaginal dryness, sleeplessness, fatigue, memory lapses, decreased sexual desire and response, as well as mood changes.
The majority of women in my practice seeks medical attention for hot flashes, known medically as “vasomotor flushes.” Characteristically, a flush of heat starts in the neck and takes over the face, and the redness and sweating can create an urge to stick one’s head in the refrigerator! At night, a cooling gel pillow can work wonders, as can breathable fabrics like all-cotton pyjamas and sheets. A ceiling or floor fan may help, as well as decreasing the room’s temperature. A good old-fashioned mug of warm milk or an over-the-counter sleep aid like doxylamine can also help. These vasomotor symptoms can be distracting, embarrassing and uncomfortable, so talk to your doctor about over-the-counter and prescription options that may be right for you.
Prescription remedies are the most effective management, but hormone-based treatment is not for everyone. Women with personal or family histories of blood clotting disorders, certain forms of cancer, and heart disease, for example, should look for alternatives. My patients frequently ask, “Why do some women take just estrogen, while other women have to take estrogen and progesterone?” The answer is simple: some women do not have a uterus. In other words, unopposed estrogen is a risk factor for uterine or endometrial cancer. Hormone replacement therapies (HRT), including pills, patches, vaginal rings, injections, and topical gels, will usually treat all menopause symptoms.
While some lucky women ease into menopause with minimal disruption, everyone’s experience is unique. Please talk with your medical provider about the best treatment plan for you when the time comes. You don’t have to suffer through the change. s