Menopause is defined as a year without a period. Perimenopause is the transition years leading up to that final period. Some women experience no changes in their cycles, but cycle irregularity is common and can be problematic. Periods that arrive less that 21 days from prior period need to be discussed, as does abnormally heavy flow. Most women experience menopause between their mid-forties up to 58 or so. The average age of menopause is 51.
The timing of menopause can be influenced by smoking, genetics, health, or surgical removal of the ovaries. The ovaries no longer produce estrogen. Symptoms are due to the lack of estrogen.
Some women have no symptoms of menopause other than the absence of a menses.
Most women experience a handful of common symptoms. The most common and problematic is hot flushes, night sweats which interfere with sleep. Quality of life is reduced when sleep is disturbed. Thinning of the vaginal tissue can affect intimacy by causing painful intercourse. Sexual desire may disappear. Weight gain particularly in the midsection is common. These changes are natural and normal. Many times, the symptoms may last from a few months to many years.
There is a plethora of options available to us to manage menopausal symptoms.
Estrogen replacement is the most effective. But not every woman is a candidate for HRT nor may she desire to take medication for many reasons. A personal history of breast cancer or high breast cancer risk, smoking, cardiovascular disease, a history of blood clot or diabetes are contraindications for hormonal therapy. Treatment may include lifestyle changes, and non-hormonal medications. There is a host of over the counter preparations. Some of these products work for some women some of the time.
There are non-systemic estrogen preparations for vaginal atrophy.
It does help to have an experienced provider help you walk through your options and choices of management of symptoms.
Currently, I am seeing my patients via telehealth visits. Should you need assistance, please call our office at (505) 843-6168 to schedule an appointment.