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Menopause

Menopause signals a major change in a woman’s health. To address this shift, a woman must first understand the facts. Menopause marks the time when a woman’s menstrual periods stop and her reproductive years end. The ovaries no longer produce the same levels of the female hormones estrogen and progesterone, and a number of significant changes result in a woman’s body. The symptoms of estrogen loss may include hot flashes, insomnia, fatigue, difficulty concentrating, urinary incontinence, and vaginal dryness. Over time, the loss of estrogen in the body can also lead to an increased risk of diseases such as osteoporosis. Women’s Health Connecticut is committed to helping women find a menopause specialist to facilitate this transition in their lives.

The average age a woman experiences menopause is 51, but generally it may occur as early as 40 or as late as 55. Menopause that develops before the age of 40 is called premature menopause. Besides age, menopause may also be triggered by surgical removal of a woman’s ovaries, or damage to the ovaries from treatments such as chemotherapy and radiation. Removal of a woman’s ovaries can result in severe symptoms because of the abrupt and total decrease in hormone levels. Surgical removal of the uterus through hysterectomy will end a woman’s menstrual periods, but menopause will not occur unless the ovaries are also removed.

Here are some of the most common health topics relating to menopause.

  • Staying healthy during menopause

    During the years around menopause, as with all other stages of life, it is important to maintain healthy habits. Women should focus on the following to maintain optimal functioning as they age:

    • Eating well.
    • Being active. 
    • Quitting smoking.
    • Taking care of their gynecological health. 
    • Staying current on immunizations and screenings. 

    If you have further questions, contact your Women’s Health Connecticut provider today. We can help you manage this change in your life and stay informed and on top of your health.

    Sources:
    http://www.acog.org/Patients/FAQs/The-Menopause-Years
    http://www.womenshealth.gov/menopause/

  • Emotional & sexual health during menopause

    Along with hot flashes, there may be some sleep disturbances. Changes in sleep patterns can be very disconcerting and challenging to one’s emotional health. When sleep is significantly interrupted, women may experience increased “blues” or anxious feelings. 

    Similar to adolescence, pregnancy, and the postpartum period, menopause is a time when the body is adapting to changing levels of hormones and our emotions are affected. Emotions are an expression of how we are experiencing the environment – changes in our hormones change how we feel. Increased sadness or anxiety may be accompanied by irritability and tiredness. If you experienced mood swings before your monthly periods or suffered from postpartum depression, you may face similar issues during menopause.

    Women may have a lower interest in sex around the time of menopause due to reduced hormone levels or the symptoms, such as vaginal dryness, that can make sex painful. They may also find difficulty reaching orgasm. Alternately, other women feel more comfortable in their sexuality following menopause.

    This stage of life, like all the others, has its challenges and opportunities. For many women, mid-life is the first time they’re able to focus attention on their health, career, hobbies, home, recreation, and romance. While there is great reward, mid-life may also be the time when you are caring for elderly parents and family members or when your children are leaving home. These are new stressors and you need to prepare yourself. 

    If you experience any of these symptoms, talk to your Women’s Health Connecticut OB/GYN today.

  • Urinary tract changes

    As estrogen levels decline during midlife, several body systems are affected, including the urinary system. The lining of the bladder responds to lower estrogen levels by becoming thinner and more easily irritated. This means that some women will experience problems with bladder infections or other urinary symptoms. During menopause, there is an increased chance of vaginal and urinary tract infections.

    If symptoms such as painful or overly frequent urination occur, consult with your physician or clinician. Infections are easily treated with antibiotics, but tend to come back in certain individuals. To help prevent these infections, urinate before and after intercourse, be sure your bladder is not full for long periods of time, drink plenty of fluids, and keep your genital area clean. Douching is not thought to be effective in preventing vaginal and urinary infections. 

  • Bladder health during menopause

    Women going through menopause can experience a number of physical changes, some of which can contribute to irritation of the bladder or bladder control problems.

    Among these changes are:

    • weakening of the pelvic floor muscles, which makes it difficult to prevent urine leaks caused by coughing, sneezing, or lifting heavy objects;
    • thinning of the lining of the bladder and urethra, which can lead to more frequent trips to the bathroom (frequency) or unusually urgent needs to urinate (urgency); and
    • decreased responsiveness of the bladder and urethra to nerves and hormones, which can make it difficult to control the urge to urinate.

    These changes are present in all women going through menopause and are responsible for many of the bladder control problems and urine leaks that some middle-aged and older women experience. If you have had multiple pregnancies or difficulties with bladder control in the past, you are more likely to experience bladder control problems during or after menopause.

    If you are having bladder control problems as you go through menopause, there are a number of treatments available to help. These therapies include prescription medicines and pelvic floor muscle exercises, such as Kegels.

    Even if you think that your bladder control problems are due to menopausal changes, you should discuss them with your physician or clinician. A medical evaluation will determine if these changes are being caused by another condition, such as an infection, heart problems, medicines, or nerve damage due to diabetes or stroke.

    It is important to take care of yourself and stay in control with sensible diet habits (limiting your caffeine intake and eating plenty of fiber) and by retraining your bladder to hold more urine (for example, trying to train yourself to only go to the bathroom once every three hours).

  • Hot flashes: The most common symptom

    Hot flashes, the most common of menopausal symptoms, are sudden feelings of heat that spread over the body, often accompanied by a flushed face and sweating. As many as three in four American women are estimated to experience this condition. During a hot flash, which typically lasts from one to five minutes, the heart beats faster and blood vessels dilate, causing a flush. Women may also sweat or suffer a wave of anxiety.

    In the not-too-distant past, a woman was told that hot flashes were “all in her head.” We now know that these uncomfortable waves of heat are the body’s response to declining estrogen. What is still uncertain is why hot flashes last only a few months for some women, and persist for years or never occur at all for others. Some women may experience night sweats, a drenching sweat that can often disrupt sleep. While these symptoms are disruptive, they’re usually temporary. Treatments are available to help alleviate these symptoms. A woman should talk with her Women’s Health Connecticut physician or clinician to determine if a hormone replacement therapy regimen may be right for her.

  • Signs and symptoms of natural menopause

    As a woman’s body prepares for menopause, there is a gradual change in her menstrual cycles over several years. A difference in a woman’s menstrual period is one of the earliest and most common signs that menopause may be approaching. This phase leading up to a woman’s last period is called perimenopause, or the menopausal transition, and may last between two and eight years. Menstrual cycles may become longer, with occasional missed periods, fewer days of flow, or lighter flow. Still, women should be aware that abnormal bleeding for them may also be a sign of a problem, and talk to their doctor if there is any concern. Women may still become pregnant up to one year following their last period.

    The symptoms of menopause may include hot flashes, insomnia, fatigue, difficulty concentrating, forgetfulness, urinary incontinence, depression, and thinning and dryness of the vaginal lining. Women may also experience weight gain, particularly around the waist, loss of muscle, and muscle and joint achiness and stiffness. Over time, the loss of estrogen in the body can also lead to an increased risk of heart disease and stroke, as well as osteoporosis. As the rate of bone loss increases, older women become more susceptible to height loss, thinning bones, and bone fractures, particularly of the hip, wrist, and spine. While many women have little or no trouble with menopause, others have moderate to severe discomfort.

    Women often experience flushing spells or hot flashes during this time. The degree to which these flashes make a woman uncomfortable is unique to the individual. Some women have intense experiences, while others have minimal physical discomfort.

    Other signs and symptoms of natural menopause include night sweats, decreases in the level of heart-protecting high-density lipoprotein (HDL) cholesterol, and rises in the level of harmful low-density lipoprotein (LDL) cholesterol. Changes in the vagina can cause pain during sexual intercourse, and can also ripen the conditions for infection. Vaginal burning and itching may occur as a result.

    If you experience any of these symptoms, talk to your Women’s Health Connecticut OB/GYN today.

  • Blood tests to check hormone status

    Perimenopause is a time of hormone fluctuation. You may find that your periods are irregular or changed in amount of flow or duration compared to earlier years. Some menstrual cycles are anovulatory (without ovulation). These changes in hormone levels may actually vary significantly from one week to the next. If a blood test shows a normal FSH, it doesn’t mean that it was normal five days earlier, or that it will be normal five days later.

    To accurately predict how the levels of FSH correlate to a woman’s perimenopausal status, the blood test needs to be repeated at least two to three times within one to two weeks. One signal that the midlife change is complete is when FSH levels are above 40 mIU per milliliter on two separate occasions, measured one week apart. See our section on hormone replacement therapy to learn more about managing the symptoms of menopause and talk to your Women’s Health Connecticut OB/GYN.

  • Postmenopausal bleeding

    Postmenopausal bleeding is characterized by any vaginal bleeding after you have become menopausal, generally defined as having been without a period for at least one year. This is not uncommon, occurring in 30% of postmenopausal women; however, no matter how light the bleeding is, you should always see a gynecologist if you develop any postmenopausal bleeding. 

    The most common cause of postmenopausal bleeding is that the lining of the uterus or vagina may be inflamed, causing sloughing and superficial ulcerations that lead to bleeding. Other benign causes include the presence of a cervical polyp, or overgrowths in the lining of the uterus. There is always a risk of cancer in the cervix or lining of the uterus, which is why it is so important not to delay seeing a gynecologist if you develop postmenopausal bleeding.

    Evaluations of postmenopausal bleeding include an examination and often an ultrasound. Additional testing may include a biopsy of the endometrial lining, a hysteroscopy to take a close look at the uterus, and dilation and curettage (D&C).

    Treatment for postmenopausal bleeding will be based on findings from the evaluation and oftentimes includes topical hormone replacement, D&C, or infrequently even hysterectomy.

  • Migraines and Menopause

    The prevalence of migraines is two to three times higher in women than in men. The character of the headaches also differs between the sexes. Women tend to report higher levels of pain, longer duration of headaches, and more associated symptoms, such as nausea and vomiting, though visual symptoms are less common in women.

    There is a long-recognized association between ovarian hormones and migraines. Over half the women who experience migraines report an association between their headaches and their menstrual cycle. The frequency and severity of migraines are often increased with the use of oral contraceptive pills and during menopause.

    Because migraines are affected by hormonal fluctuations, estrogen use during the premenstrual period is sometimes helpful. However, ironically, estrogen may also trigger migraines. Women should discuss with their physician or clinician the use of estrogen, such as through oral contraceptives and hormonal therapy, for migraines.

    Stress often triggers migraines, so women who are habitual sufferers should learn relaxation and stress management techniques. These are especially helpful in aborting headaches when warning signs are felt. Massage and relaxation exercises of the neck, shoulder, and jaw muscles may all be helpful. Resting in a dark room with cool compresses can prevent the headache. Foods such as alcohol, aged cheeses, chocolate, fermented or marinated foods, MSG, artificial sweeteners such as aspartame, and caffeine all may trigger headaches; diet should be monitored to reduce or eliminate intake of these. Nicotine may cause migraines as well. If you’re a smoker, consider quitting to reduce migraines.

    In summary, each woman’s migraine pain, her triggers, and her “headache calendar” (when headaches tend to occur) are unique. Treatments are also unique for each case. To properly plan treatment, individual triggers, lifestyle issues, stress levels, eating habits, and willingness to accept drug therapy must be considered.

    Women with moderate migraines may need prescription drugs for relief. These could include agents that affect neurotransmitters (the chemicals that are the messengers in the brain), such as sumatriptan and various antidepressants. Other drugs might include agents that dilate (widen) the blood vessels in the brain. In some cases, painkillers are prescribed.

    If you experience any of these symptoms, talk to your Women’s Health Connecticut OB/GYN today. 

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