March 30, 2020 - Monday


By Paula Greene, A.R.N.P.-C, Palm Beach Breast Institute –

MENOPAUSEFemale menopause is something that many women dread going through. It is a good idea for every woman to educate themselves about menopause to help calm the uncertainties when the inevitable happens. Rest assured that menopause is a normal change that every woman experiences when her menstrual cycle stops.  Generally between the ages of 45 and 55, there is a slow decrease in production of estrogen and progesterone. You are officially menopausal after 12 months without a period.

Once you stop having your period, your body will start going through the change and you will begin to recognize and learn how to deal with the symptoms you are experiencing.

One of the first things you need to know is that every woman is not the same and this means that menopause will affect each woman differently. Some women may even begin experiencing signs of menopause in their 30’s.

In the months or years leading up to that point, you might experience these signs and symptoms:

  • Irregular periods
  • Decreased fertility
  • Vaginal dryness
  • Hot flashes
  • Sleep disturbances
  • Mood swings
  • Increased abdominal fat
  • Thinning hair
  • Loss of breast fullness
  • Night sweats
  • Decreased libido
  • Difficulty concentrating

It is always wise to learn what the many signs of menopause are so you can easily determine which ones are affecting you. Knowing the symptoms will help you find an effective treatment for them and assist you in conquering the change you body is going through.

Menopause itself requires no medical treatment. Instead, treatments focus on relieving your signs and symptoms. Today, women find that dealing with menopausal symptoms is best accomplished with the combination of a healthy lifestyle and alternative (non-surgical) treatments.

Lifestyle changes. Physical activity, adequate sleep, consumption control, and relaxation and breathing techniques often offer many women desired relief from the unpleasant symptoms of menopause.

Hot flashes are impossible to avoid completely, however, certain triggers bring them on or cause them to be more severe.  Eliminating stress, caffeine, alcohol, spices, tight clothing, smoking and heat can help minimize the occurrence of hot flashes. Trying to stay cool with the use fans and light clothing made of natural fibers like cotton may help decrease their intensity as well.

For problems sleeping, decrease caffeine and alcohol and exercise 30 minutes before sleeping. Use mental exercises and get enough sleep and exercise for problems with concentration.

To control mood swings, exercise, getting enough sleep, relaxation exercises, some prescriptions and support groups may help.

Hormone therapy. Estrogen therapy remains, by far, the most effective treatment option for relieving menopausal hot flashes. Depending on your personal and family medical history, your doctor may recommend estrogen in the lowest dose needed to provide symptom relief for you. The benefits of hormone replacement therapy include the reduced risk of osteoporosis, relieving hot flashes, vaginal dryness, improved cholesterol levels, improving mood and wellbeing, and they may prevent the decline of mental abilities with age. However, there are also many side effects that can arise from hormone therapy.  Estrogen alone can increase your risk for uterine cancer.  It can cause bloating and breast tenderness.  Hormone replacement therapy can increase the risk of breast cancer, increase the risk of cardiovascular events including myocardial infarction and stroke and may increase triglycerides and gallbladder disease.

Bioidentical hormone therapy are custom made hormone formulas.  At this time, there are no meaningful clinical trials being done to document their effectiveness and they are not regulated by the FDA.

If you decide to use hormones, use them at the lowest dose that helps for the shortest time possible and re-evaluate the need for them annually.

Bisphosphonates. Doctors may recommend these nonhormonal medications, which include alendronate (Fosamax), risedronate (Actonel) and ibandronate (Boniva), to prevent or treat osteoporosis. These medications effectively reduce both bone loss and your risk of fractures and have replaced estrogen as the main treatment for osteoporosis in women.

Nonhormonal pharmaceutical agents including antidepressants have been shown to reduce hot flashes as well. They are not approved by FDA for this use and have side effects which include gastric distress, diarrhea, headache, nervousness, sleep disturbances and sexual problems.

Vaginal estrogen. To relieve vaginal dryness, estrogen can be administered directly to the vagina using a vaginal tablet, ring or cream. This treatment releases just a small amount of estrogen, which is absorbed by the vaginal tissue. It can help relieve vaginal dryness, discomfort with intercourse and some urinary symptoms.

Vitamins and Supplements. Some women report that taking over-the-counter medications such as vitamin B complex, vitamin E and ibuprofen offers relief. Vitamin E can rehydrate vaginal tissue and may increase sensation.  Use it several times a week, even if you are not having sex.  Zestra is a blend of botanicals that have been shown to increase arousal, desire, genital stimulation and the ability to orgasm.  There are also nutritional supplements like Argon Max, which provided L-arginine, ginseng, ginko, antioxidants and a multiple vitamin which increases sexual desire and satisfaction.

Although research is inconclusive, many women have found that consuming flaxseed and soy products, which have weak estrogen-like effects, reduces the instances of hot flashes. Soy foods, not supplements, are recommended, and you should check with your physician prior to increasing your soy intake.

Before deciding on any form of treatment, talk with your doctor about your options and the risks and benefits involved with each.

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