Every woman has to undergo menopause at a particular stage in her life. And even though women should be prepared for this stage, it sometimes comes with unexpected complications, for which you have to seek a doctor’s help. For instance, menopausal symptoms may be severe, or the menopause itself may be complicated by medical conditions you may have. If this happens, you need to see a physician as soon as possible.
At All Women’s Care, one of our many specializations is managing severe menopausal symptoms as well as menopause complicated by medical conditions. We help women in Los Angeles, California, transition to their menopausal stage without any difficulty, thanks to our doctors’ expertise. If you are experiencing any complications due to menopause, please don’t hesitate to contact us. In this article, we look at what menopause is, what signs and symptoms to expect when transitioning to it, and how you can manage these symptoms.
Menopause refers to the period that marks the end of a menstrual cycle in a woman. It’s a natural stage in a woman’s life when her ovaries don’t produce estrogen anymore. Menopause is diagnosed after you have gone one year without experiencing menstrual blood. The age of menopause varies across women. It can occur when one is in her forty’s or fifty’s. In the U.S, the menopausal age is averagely 51 years.
Before menopause, your ovaries naturally produce progesterone and estrogen, which makes the uterus ready for pregnancy. When you approach menopause, the decrease in the level of these hormones may lead to an irregular menstrual cycle. Irregular menstrual cycle includes lighter or heavier periods than what’s normal for you. A decrease in progesterone and estrogen levels may also cause skipped menstrual bleeding or menstrual bleeding that stops completely.
During menopause, you can no longer get pregnant. This is because the level of your hormones change as your body doesn’t produce them anymore. Also, the ovaries do not release eggs anymore at this point. Menopause is naturally a biological process. However, physical symptoms like hot flashes or emotional menopausal symptoms may disturb your sleep, affect emotional well-being, or reduce your energy. There are several effective treatments for menopause available, including hormone therapy and lifestyle adjustments.
Symptoms of Menopause
Menopausal symptoms are as a result of hormonal level changes in your body. The specific signs and symptoms experienced and the extent to which they’re experienced vary from one woman to another. These signs & symptoms start to become noticeable in the years or months just before entering menopause (the perimenopause stage). They include:
- Vaginal dryness
- No or irregular menstrual periods
- Hot flashes
- Sleep problems
- Night sweats
- Mood swings
- Dry skin and thinning hair
- Changes in sleeping patterns
- Joint and muscle pain
- Slowed metabolism and weight gain
- Having a difficult time getting sexually aroused
Symptoms that include changes in the menstrual cycle are different in every woman. It is most likely that you will experience a few irregularities in your menstrual bleeding before it comes to an end.
Skipping menstrual bleeding during the perimenopause stage is expected and common. Often, your periods will skip one month, then return, or fail to come for several months; then you begin menstruating again for some months. Menstruation also tends to occur on a shorter than usual cycle so that the cycles are closer together. Regardless of having irregular periods, it’s still possible to get pregnant. If you have missed your period but are not sure you have entered menopausal transition, you should consider testing for pregnancy.
When menopause is as a result of the surgical removal of ovaries, symptoms, and signs could be severe because of the abrupt hormonal level changes.
When You Should See a Physician
Continue with routine visits to your gynecologist for precautionary medical care and other health concerns. Continue going for the appointments during and even after menopause.
Precautionary health care as a woman ages might include health screening tests your doctor recommends, like mammography, triglyceride screening, and colonoscopy. Your physician may recommend other exams and tests, too, like thyroid testing in case your history, or pelvic and breast exams suggest that you undergo the testing. Always seek advice from a healthcare provider if you are bleeding via your vagina after entering the menopause stage.
Causes of Menopause
Menopause could be caused by:
Hysterectomy is a surgical procedure to remove part or your entire uterus. The removal of the uterus but not the ovaries, usually does not lead to immediate menopause. Even though you will not have periods anymore, still, your ovaries will produce progesterone and estrogen and release eggs. But, a surgical procedure to remove both ovaries and uterus does lead to immediate menopause. If you remove your uterus and both of your ovaries, your periods will immediately stop, and you are likely to experience hot flashes as well as other signs & symptoms of menopause. These signs & symptoms could be severe since hormonal changes take place abruptly instead of over several months or years.
- Radiation therapy and chemotherapy
Radiotherapy and chemotherapy are types of cancer therapies. They can be the cause of menopause, leading to symptoms like hot flashes shortly after or during your treatment. The stop to fertility and menstruation isn’t always permanent after chemotherapy. Thus, you may still need to use birth control.
- Natural reduction in reproductive hormones
In your late thirty’s, your ovaries will start producing less progesterone and estrogen, the hormones responsible for regulating menstruation. When this happens, your fertility will decline. In your forty’s, your periods might become shorter or longer, lighter or heavier, and less or more frequent, until ultimately, averagely by 51 years, your ovaries will stop releasing eggs. When this happens, you will not see your periods anymore.
- Primary ovarian insufficiency
Approximately 1% of women reach menopause before reaching 40 years. This is referred to as premature menopause. Premature menopause could be as a result of primary ovarian insufficiency. Primary ovarian insufficiency is when one’s ovaries fail to generate normal levels of reproductive hormones. This condition results from autoimmune diseases or genetic factors. For women experiencing primary ovarian insufficiency, hormone therapy is generally recommended until at least they reach the usual menopausal age to protect their heart, bones, and brain.
Complications Brought About by Menopause
After reaching menopause, the risk of various health conditions increases. Here are examples of these conditions:
Osteoporosis is a condition that leads to bones becoming weak and brittle, resulting in an increased danger of suffering from bone fractures. In the initial few years after you reach menopause, you could lose the density of bones rapidly, increasing the risk of developing osteoporosis. Women that are postmenopausal and have osteoporosis are mainly vulnerable to wrist, hip, and spine fractures.
- Blood vessel and heart (cardiovascular) disease
Once the levels of your estrogen reduce, it increases the risk of developing cardiovascular disease. Cardiovascular disease is the primary cause of death in women and also men. Therefore, it is critical to exercise regularly, maintain average weight, and eat a balanced, healthy diet. Ask your physician for advice concerning how you can care for your heart, for instance, how to lower your blood pressure or cholesterol if it is too high.
- Urinary incontinence
When your urethra and vaginal tissues lose their elasticity, you might experience intense, sudden, and frequent needs to urinate. As time passes, you may start experiencing urge incontinence (an involuntary urine loss), or urine loss when you laugh, cough, or lift heavy objects (stress incontinence). Also, you might contract urinary tract infections (UTI) more frequently.
Strengthening the muscles of the pelvic floor may help to relieve incontinence symptoms. You can strengthen these muscles through Kegel exercises or using a topical vaginal estrogen. Hormone therapy might also effectively treat menopausal UTI and other vaginal changes that can lead to urinary incontinence.
- Weight gain
Most women gain weight when transitioning to menopause, as well as after menopause due to metabolism slows. During this time, you might need to consume less food while exercising more so that you can help maintain your present weight.
- Sexual function
Dryness of the vagina due to a decreased production of moisture and its loss of elasticity could lead to slight bleeding and discomfort during sex. Also, a decrease in sensation can reduce the desire to engage in sexual activity.
Water-based vaginal lubricants and moisturizers may help. In case these are not enough, you can use local treatment of vaginal estrogen, which is available in the form of a vaginal cream, ring, or tablets.
Usually, menopausal signs & symptoms are enough to alert many women that they have begun transitioning to menopause. If you’ve any concerns about hot flashes or irregular periods, talk to your gynecologist. In certain situations, further evaluation might be recommended.
Generally, a gynecologist does not need to carry out tests to diagnose menopause. However, under given circumstances, blood tests may be recommended to check the level of:
- Thyroid-stimulating hormone (TSH). This is because an underactive thyroid can lead to the same symptoms as those experienced during menopause. This condition is referred to as hypothyroidism
- Estrogen and follicle-stimulating hormone (FSH). This is since the levels of estrogen decrease, and those of FSH increase when menopause occurs
Home tests that help to check the levels of FSH in urine are also available over-the-counter. These tests can tell whether your FSH levels have increased and might be in menopause or perimenopause. However, since the levels of FSH increase and decrease during your periods, home tests for FSH cannot tell whether you are definitely in a menopausal stage or not.
Menopause doesn’t require medical treatment. Rather, treatment focuses on relieving the signs & symptoms and managing or preventing chronic conditions that arise with aging. Menopause treatments include:
- Vaginal estrogen
For you to reduce the dryness of your vagina, estrogen may be administered to your vagina directly by the use of a vaginal tablet, ring, or cream. This treatment discharges only a little estrogen amount, which your vaginal tissues get to absorb. Vaginal estrogen can help to relieve discomfort during intercourse, vaginal dryness, and various urinary symptoms.
- Hormone therapy
Undergoing estrogen therapy has proven to be the most effective option for treating menopause. It helps to relieve hot flashes. Based on your family and personal medical record, your physician might recommend for you estrogen in the shortest timeframe and lowest dose needed to help relieve menopausal symptoms. In case your uterus is still intact, you will need progestin to add to estrogen. Also, estrogen helps to prevent the loss of bones.
Using hormone therapy for a long time may result in breast cancer and cardiovascular risks. However, starting hormone therapy around the period of reaching menopause has been of advantage for several women. You will discuss with your doctor the risks and benefits of undergoing hormone therapy. Your doctor will also inform you whether the therapy is a safe option for you.
Gabapentin has been approved for the treatment of seizures. But, it’s also been proven to help in reducing hot flashes. Gabapentin is useful for women who cannot use hormone therapy as well as those who experience nighttime hot flashes.
- Antidepressants in low doses
Various antidepressants may help lower hot flashes, for instance, those that relate to the category of drugs known as SSRIs (Selective Serotonin reuptake inhibitors). Antidepressants administered in low doses for managing hot flashes might be useful for women that cannot take estrogen due to health reasons. Antidepressants may also be effective for the women that need them for a mood disorder.
- Medications to treat or prevent osteoporosis
Based on personal needs, physicians may recommend medications to treat or prevent osteoporosis. Several medicines are available, which help to reduce the risk of bone fractures and bone loss. Your doctor may recommend vitamin D supplements, which help to strengthen bones.
Clonidine is a patch or pill generally used for treating high blood pressure. Apart from treating high blood pressure, clonidine may provide a little relief from menopausal hot flashes.
Before you decide on any type of treatment, you should discuss with your physician about the possible options for you and the benefits and risks involved with them. Review your treatment options every year because your needs may change with time.
Home Remedies and Lifestyle
Luckily, most of the menopausal signs & symptoms are temporary. You may take various steps or adapt to a certain lifestyle in the comfort of your home to relieve them. The steps you can take to help prevent or reduce their effects include:
- Decreasing vaginal discomfort- You can use over-the-counter, water-based vaginal creams, or lubricants like K-Y Jelly and Replens. Silicone-based moisturizers or lubricants can also help relieve menopausal signs & symptoms. Opt for products that do not contain glycerin since they can cause irritation or burning sensations for women that are allergic to the chemical. Also, remaining sexually active helps since it increases the flow of blood to your vagina.
- Cooling hot flashes- Drink a glass of cold water, dress lightly and in layers, or go to a cooler place. Try pinpointing what causes your menopausal hot flashes. For several women, triggers might include caffeine, hot beverages, alcohol, spicy foods, stress, alcohol, warm rooms, and even hot weather.
- Getting enough sleep- Stay away from caffeine as it could make it difficult for you to sleep. Also, avoid consuming a lot of alcohol since it can interrupt your sleep. Exercise in the day, though it should not be right before bed. In case hot flashes interrupt your sleeping, it may be necessary to look for a way of managing them before getting adequate rest.
- Strengthening the muscles of your pelvic floor- Kegel exercises, which are the exercises of the pelvic floor muscles, can help reduce urinary incontinence.
- Practicing relaxation techniques- Relaxation techniques like paced breathing, deep breathing, massage, progressive relaxation of muscles, and guided imagery may assist in relieving menopausal symptoms. There are several books, online offerings, and CDs on various relaxation exercises.
- Do not smoke- Smoking elevates the risk of stroke, heart disease, cancer, osteoporosis, and several other health issues. It might also lead to earlier menopause and increase menopausal hot flashes.
- Eating a nutritional diet- Include fruits, whole grains, and vegetables in your diet. Also, limit oils, sugars, and saturated fats. Inquire from your provider whether you need vitamin D or calcium supplements to assist you in meeting your daily requirements.
- Exercising regularly- Exercise or do regular physical activities more often. This will help protect you against osteoporosis, diabetes, heart disease, and other different conditions linked to aging.
Several methodologies have been endorsed as ways of managing menopausal signs & symptoms, but only a few have scientific proof to corroborate the claims. The various alternative and complementary treatments that are being or have been studied include:
- Bio-identical hormones
Bio-identical hormones originate from plants. The word ‘bio-identical’ means that the hormones present in a particular plant are chemically similar to the ones your body generates. However, even though we have various commercially available hormones of this kind that the FDA approves, most preparations are compounded. That is, they are mixed as per the doctor’s prescription. FDA does not regulate compounded bioidentical hormones, so risks and quality could vary. Also, there is no scientific proof to substantiate that bio-identical hormones function any better compared to hormone therapy when it comes to relieving menopause symptoms
- Phytoestrogens (plant estrogens)
Plant estrogens are naturally found in certain types of foods. We have two major types of plant estrogens. They include lignans and isoflavones. Lignans can be found in whole grains, flaxseed, and various kinds of vegetables and fruits. On the other hand, isoflavones occur in lentils, chickpeas, soybeans, and any other legumes.
It still has to be proven whether or not the estrogens found in these types of foods can ease menopausal hot flashes or other symptoms of menopause. However, many studies have shown them to be effective. Isoflavones contain weak estrogen-like effects. If you have had breast cancer, consult your healthcare provider before you using isoflavone pills to supplement your diet.
It is thought that this herb sage contains compounds that have estrogen effects, and there is good proof that it could effectively relieve menopause symptoms. You should avoid this herb together with its oils in case you are allergic to them, are breast-feeding or pregnant. And if you have epilepsy or high blood pressure, you should use it carefully.
There is no proof supporting that practicing yoga reduces menopausal symptoms. However, balance exercises like tai chi, yoga, or mediation can improve coordination and strength and might help in preventing falls that can result in broken bones. Consult with your physician before embarking on balance exercises. Enroll in a class so you can learn how proper breathing skills and postures are done.
- Black cohosh
This plant is popular among most women experiencing menopausal symptoms. There is little proof that it’s effective. However, black cohosh supplements could harm your liver and might be unsafe for you if you have suffered or are suffering from breast cancer.
Hypnotherapy might help reduce hot flash symptoms for a few menopausal women. This is according to studies by the National Center for Complementary and Integrative Health. According to this study, hypnotherapy also assisted women to decrease interference in their day to day life and improve sleep.
Acupuncture could have various temporary advantages in helping to relieve hot flashes. However, research has not shown consistent or significant improvements. Perhaps more research needs to be done.
You might have tried or heard of other diet supplements like red clover, dong Quai, kava, DHEA, or wild yam. Scientific proof of how these supplements are effective is lacking. Also, these products might be harmful. Consult with your healthcare provider before using any dietary or herbal supplements to relieve the various symptoms of menopause. FDA doesn’t regulate products from herbs, and some could be harmful or interact with other medicines you use, subjecting you to health risks.
Consult a Competent OB-GYN Near Me
If transitioning to menopause is causing you a lot of discomfort or affecting your health, you are not alone. Several other women across the world are going through what you are experiencing; therefore, you should not shy away from asking for help. Consulting a doctor about your situation will give you ways to manage your discomfort or improve your health. It will also help you to know what symptoms to expect if you haven’t already experienced them and how to prepare for them. If you are in Los Angeles, CA, contact All Women's Care at 213-250-9461 for a consultation. Our doctors will help you to regain the quality of life with regular menopausal therapies that will help ease your complicated condition.