All About Menopause

What are peri-menopause and menopause?

Peri-menopause is the transitional time period before menopause occurs, when a woman still gets her period, but starts to experience changes in her menstrual cycle and some symptoms of menopause. Peri-menopause usually begins about 10 years before menopause. During peri-menopause, the amount of estrogen and progesterone, two essential hormones for women, gradually decreases. Menopause is a natural part of aging that occurs when a woman’s menstrual cycles have stopped for at least 1 year. Menopause occurs because the ovaries stop producing estrogen and progesterone, or because the ovaries are removed during hysterectomy. The average woman is 51 years old when this occurs

What are the Symptoms

A woman in menopause may have none or several of these symptoms, including:

  • Hot flushes or flashes (a sudden experience of intense heat and possible sweating in the upper body or face)
  • Vaginal dryness or burning
  • Pain or discomfort with sexual intercourse
  • Joint discomfort
  • Problems sleeping
  • Mood swings or depression
  • Urinating more often or feeling that you must urinate as soon as possible
  • Difficulty controlling when you urinate (you may feel that you need to
    wear a pad to catch any unexpected flow of urine)
  • Problems with memory

Possible Risks

  • ObesityObesity
  • Diabetes
  • Osteopenia or osteoporosis (thinning of the bones that can increase risk
    for bone fracture)
  • Osteoarthritis (a decrease in the amount of protective cartilage between
    bones that may cause crackling sounds and pain in the joints)
  • Cardiovascular risk, including high blood pressure, heart attack, stroke
    and blood clots
  • High LDL or ” bad ” cholesterol (a substance that carries fat in the blood
    vessels that may cause hardening of the arteries and can increase the risk for
    several diseases, including heart attack and stroke)
  • Memory loss
  • Increased risk for cancer, including breast, ovarian, uterine and colorectal
  • Difficulty breathing during sleep
  • Urinary tract infections

How can you stay healthy during menopause?

  • Regular gynecological and medical checkups
  • Annual blood work (to screen for diseases such as diabetes, cardiovascular
    disease, cancer and thyroid problems.)
  • Annual mammogram, Pap smear, screening for vaginal infections and STDs
  • Bone density test to assess bone density every 1-3 years.
  • Consider a sleep study if your partner notices you snore at night or hears
    you having difficulty breathing in your sleep.
  • Tests for growths or cancer in your colon: hemocult test to look for blood
    in the stool; sigmoidoscopy every 5 years; colonoscopy every 10 years
  • Regular sexual activity and/or masturbation; Kegel exercises, which are
    vaginal tightening exercises to prevent urine from leaking; and a lubricant for
    sexual intercourse
  • Report to your healthcare provider any vaginal bleeding that occurs after
    your menstrual cycles have stopped for 1 year.

Therapies to decrease risks, discomforts of menopause

Hormone therapy can help decrease the risk of fractures from osteoporosis, as well as reduce hot flushes, vaginal dryness and discomfort, urinary discomfort, and the risk of colorectal cancer.

However, because hormone therapy can increase the risk of heart attack, strokes, blood clots, breast cancer and Alzheimer’s disease in women who have not had a hysterectomy, you need to discuss your own use of hormone therapy with your healthcare provider.

Other therapies that should be discussed with your healthcare provider include:

  • Diet that includes a variety of green and yellow vegetables, fish, lean meats, whole grains, dairy products, soy products and plenty of fluids
  • Vitamins and minerals, including vitamins B, C, D, E, zinc, magnesium and calcium
  • Decreased intake of caffeine, alcohol, concentrated sweets, fats, highcholesterol foods and red meat
  • A combination of aerobic, weight strengthening and flexibility exercises
  • Weight management
  • Smoking cessation
  • Medications that increase bone density and reduce the risk of fractures
  • Herbal remedies
  • Psychotherapy for depression
  • Communication with your partner about your feelings and sexuality

Bobbie Posmontier is a certified midwife and owner of Newtown Midwifery, Huntingdon Valley, PA.

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