I can’t help but reflect on a women’s health issue that’s changed how we practice Medicine. It’s a subject that just over a decade ago sent women running to their doctor and still remains a subject of controversy, a source of fear and confusion for many. Can you guess it? – Menopause.
No matter your age, Menopause is a subject every woman should know about and should regard as not a source of fear, but a necessary transition as a woman, so please read on! Menopause has occurred when you have gone one full calendar year WITHOUT any vaginal bleeding. It is a time where getting your period no longer makes you feel relieved that you are not pregnant; it actually becomes a warning sign that something could be wrong – like cancer! Common questions I hear on a daily basis are, “How do I know I am going through it? What do I do? Or will I ever feel better?” We spend our entire lives as women monitoring our menstrual cycles, wishing it away, then a switch is flipped and we fear when it will disappear as we go through the dreaded “change of life.” It is important to be very careful where and how you obtain your information about Menopause, as the myths surrounding this enigma are endless and how to treat it is even more complicated.
If you are in your 20s, you may think, “Menopause? Oh not my issue.” I would challenge you to rethink this mentality. The menstrual cycle is a vital sign, just like your blood pressure or heart rate. If you are not having a period every month then this may be a sign that your physiology or your hormones are out of balance. Depending on the cause, this could set the stage for complications later in life. Hip fracture anyone? It is from adolescence to your 20s that you assure and maintain good bone health as an abnormal estrogen level at a young age will wreak havoc on your bones at time of menopause.
If you are in your 30-40s, you may think, “I only have a good decade left before I am on a downhill slide to a life of misery!” I would challenge this thought to the contrary as well. It is in your 30-40s that you may maintain, build and challenge your health and well-being. What happens with life after 40 you may ask? It is the first period where our fertility is no longer favored and is marked by many changes in our physiology at the brain and organ level. This period is called “Perimenopause.” The most common symptoms are irregular periods and hot flashes. It is a time to pay attention to your body and keep your Doctor on speed dial, as there are illnesses that imitate Perimenopause and should not be mistaken.
The average age in the U.S is around age 51, however onset may vary by one’s age, ethnicity, medical history or lifestyle. The most common symptoms of menopause are hot flashes and vaginal dryness. Hot flashes can be perceived as sweating, a surge of heat and skin changes to a ruby-red, instant chills, a panic attack and even heart palpitations. If chronic these symptoms can lead to sleep and mood disturbances that are perceived as having depression or anxiety. So who do you do? The answer to this question rests in an individualized assessment of your unique symptoms, medical history and lifestyle. The controversy came about when women thought they had found the fountain of youth in hormone replacement. Hormone replacement was being prescribed in hopes of protecting heart health, after menopause, however we now long-term use may be harmful. The myth that hormone replacement therapy should be avoided at all costs is not true. We know that hormone replacement is safe if used at the lowest dose, for the shortest amount of time and for the right reasons. It is important to consider that there are alternative treatments available to you. I caution you to review them with your health care provider to ensure safe and reliable treatment. Talking with your doctor and discussing your symptoms is the best approach to ensure a happy, healthy you at every stage of life.