Menopause is a stage in the life of every woman. Beginning in her 40s or 50s, it is marked by the end of her menstrual cycles. The average age in the US is 51.
Strictly speaking, a doctor diagnoses it when she has gone 12 months without a period. As the chart shows, it is caused by a reduction in the production of estrogen by the ovaries.
It is a natural biological process. But the physical symptoms, such as hot flashes, and emotional symptoms of menopause may disrupt your sleep, lower your energy or affect emotional health. The chart here depicts symptoms and conditions associated with the change.
Menopause requires no medical treatment. Instead, treatments focus on relieving your signs and symptoms and preventing or managing chronic conditions that may occur with aging. There are many effective treatments available, from lifestyle adjustments to hormone therapy.
Today I want to discuss hormone replacement therapy.
In simplest terms it is the treatment, not of menopause, but of the symptoms of menopause, caused by dropping estrogen levels. For treatments that are systemic, taken orally or transdermally (that is, a skin patch), they consist of three kinds: estrogen only, a combination of estrogen and progesterone, and, rarely, progesterone only. For treatment of some “local” symptoms, such as vaginal drying, discomfort during intercourse, and some urinary symptoms, a vaginal cream containing estrogen can be effective.
If the dosing is appropriate then the “vasomotor symptoms,” hot flashes and night sweats, will be under control. In addition, because menopause leads to increased cardiovascular disease risk and to bone loss or osteoporosis, treatment can prevent or delay these important diseases and conditions.
Unfortunately there is a real increase in the incidence of breast cancer. There have been extensive studies but the most definitive was published in September 2019 by a group from the University of Oxford in England. They found four important findings:
Yes! You can reduce the frequency and/or severity of the hot flashes, night sweats, and other symptoms. Here are a few ideas:
Regular physical activity can reduce hot flashes and improve sleep. It’s also a good way of boosting your mood if you feel anxious, irritable or depressed. Weight-bearing exercises can help keep your bones strong
A balanced diet can help ensure you do not put on weight and can keep your bones healthy
Wear loose clothes and sleep in a cool, well-ventilated room if you experience hot flushes and night sweats
alcohol and spicy food, as they have all been known to trigger hot flashes
to improve mood swings, make sure you get plenty of rest, as well as getting regular exercise. Activities such as yoga and tai chi may help you relax
if you smoke – giving up will help reduce hot flushes and your risk of developing serious health conditions, such as heart disease, stroke and cancer
if you experience vaginal dryness – several different types are available to buy from shops and pharmacies