Menopause Symptoms Return When Hormones Stop
More Than Half in Study Had Recurrence of Hot Flashes, Night Sweats
In the months following the unexpected halting of the now famous Women’s Health Initiative trial in July 2002, many of these older women were abruptly taken off menopausal hormone therapy. Now a look-back study involving WHI participants provides the clearest picture yet of how they fared.
The review found that more than half of the women who reported hot flashes, night sweats, and other menopausal symptoms when they started taking hormones experienced a recurrence of these symptoms after being taken off the therapy.
North American Menopause Society founder and president Wulf Utian, MD, PhD, tells WebMD that it is not uncommon for women to experience hot flashes and other symptoms associated with menopause for a decade or more. He says a small percentage of women have them for the rest of their lives.
“I have women in their 80s and even 90s who still experience hot flashes and other symptoms,” he says. “These women may need to stay on hormones indefinitely.”
The new study, which appears in the July 13 issue of The Journal of the American Medical Association, shows women taking estrogen or estrogen plus a progestin were six times more likely to report moderate to severe hot flashes and night sweats following discontinuation of treatment compared with women taking placebo.
These women were also more than twice as likely to report an increase in overall stiffness and pain.
Vaginal And Vulvar Atrophy
Postmenopausal atrophic vaginitis, or vaginal and vulvar atrophy , is the thinning of the walls of the vagina caused by decreased estrogen levels during menopause. As a result, the lining of the vagina may be more likely to bleed.
Vaginal and vulvar atrophy is caused by cellular changes during menopause. Changes in estrogen levels also cause a decrease in blood flow to the vaginal area, which further contributes to vaginal dryness and discomfort. Spotting during and after intercourse is a common symptom of VVA.
At least half of those who enter menopause have signs and symptoms of VVA, but only 20% to 25% seek medical attention from their doctor.
Hysterectomy With Ovaries Left Intact
People who have their ovaries intact, but without their uterus, won’t get their period anymore. They may, however, still experience premenstrual syndrome or premenstrual dysphoric disorder because the hormones made by the ovaries cause the body to continue to “cycle” monthly.
Occasionally, people whose ovaries were not removed during a hysterectomy experience hot flashes and other menopausal symptoms. This is mostly due to the disturbance of the blood supply to the ovaries during surgery.
In addition, some people may undergo menopause a few years sooner than they normally would if they never underwent a hysterectomy .
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Okay But What Is The Menopause
First up, what is the menopause? Quite simply, its when the ovaries can no longer produce the hormone oestrogen. Over a period of years or decades , they gradually become less active and efficient until, eventually, they fail completely. After this point, no more eggs are produced and there are no more periods. This is what is used to describe women going through this change, who are over the age of 45.
Premature menopause or premature ovarian insufficiency relates to women below that age threshold. Although it carries many of the same menopause symptoms, a big difference is that the ovaries may not have failed completely 5-10% of women with POI still conceive.
Can The Body Signal Potential Pregnancy To Postpone Menopause
Investigators looked at 2,936 women in the United States who were part of the Study of Womens Health Across the Nation , a multisite longitudinal, epidemiologic study thats designed to examine womens health during their middle years. At the start of the study, women were all between 42 and 52 years old and hadnt reached menopause yet.
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What Is The Menopause
The menopause is the stage of a womens life when she stops having periods and her ovaries stop releasing eggs. We say a woman has been through the menopause after not having any periods for one year. It commonly happens at around 50 years of age but every woman is different and it can occur earlier or later. The time leading up to the menopause is called the peri-menopause. During the peri-menopause a womans ovaries produce less and less of a hormone called oestrogen. Lower oestrogen levels can result in some woman experiencing a range of symptoms and most common are hot flushes and night sweats.
Kylie Minogue Says Having Cancer Means She’ll Go Through Menopause Twice
Imagine suffering through the hot flashes, mood swings, and brain fog that typically accompany menopause then imagine having to do it all over again, years later.
Australian pop star Kylie Minogue, 49, says shes preparing for her second round of menopause, after first experiencing the loss of menstruation during treatment for breast cancer 12 years ago.
Ive already done it once, she told the Daily Mailin an interview published over the weekend. The first was medically induced when they suppressed my for my cancer treatment. So at least I know what it will be like. Im ahead of the game with that experience.
Double menopause sounds shocking, but experts say Minogue isnt the only one to go through two sets of changes. Indeed, younger premenopausal breast cancer patients often undergo whats called ovarian suppression, in which the ovaries are targeted with a medication that stops them from producing estrogen, in order to halt tumor growth. Ovarian suppression typically ushers in the same symptoms as menopause: hot flashes, dry skin, mental fatigue, and more. But once treatment is complete, some patients ovaries will begin to produce estrogen again, reversing the early-onset menopause and setting the stage for what feels like a second menopause around the age of 50.
A post shared by Kylie Minogue on Feb 24, 2016 at 9:37am PST
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Do I Need Treatment For The Menopause
No the menopause is a natural stage of a womans life and although some women may choose to have treatment, not all women feel they need it. Some women make lifestyle changes to manage their symptoms such as regular exercise, wearing light clothing and ensuring good sleep hygiene. Other women see their doctor for medication such as Hormone Replacement Therapy . This is a personal decision that you can discuss with your doctor.
Trapped In A Never Ending Menopause: For Some Women The Misery Of ‘the Change’ Can Last For Two Decades
- Penny Jaquet began the menopause at 42
- Her hot flushes were preceded by terrifying panic attacks
- She still suffers more than a decade later
- Jackie Hogarty also went through the change at 42
- She had mood swings and felt hot all the time
- Lesley Tanner had symptoms for 13 years
- Experts says more needs to be done to help women
- Many will suffer in silence
18:03 EDT, 13 November 2013 | Updated:
Distress: Penny Jaquet has been battling symptoms for 18 years
When Penny Jaquet began the menopause at 42, her hot flushes were preceded by terrifying panic attacks. Several times a day, she would suddenly feel flustered and distressed as she struggled to catch her breath and her heart pounded.
For a few awful moments, shed lose track of where she was and what she was doing, before the flush kicked in, turning her scarlet and leaving her dripping with sweat.
The symptoms seemed to abate three years ago. But then, to her horror, they began again. Penny is 60, and an astonishing 18 years after her menopause started, she’s still suffering from hot flushes.
Once or twice a week, the jewellery designer from Cheltenham finds her entire body burning.
‘I can’t believe the hot flushes have come back,’ she says. ‘My menopause went on for 15 years and drove me to despair, which manifested itself in panic attacks. I’ve given up hoping it’ll ever end.’
Hot flushes are caused by hormonal changes that disturb the hypothalamus, a part of the brain known as the body’s thermostat.
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Are There Treatments For The Menopause
If your symptoms are severe, theres treatment available which could help. This includes hormone replacement therapy , which replaces oestrogen to alleviate symptoms, creams for vaginal dryness, and cognitive behaviour therapy to help with mood changes. Speak to your doctor about the risks and benefits of different treatments.
Or You Might Find That Youre Not As Interested In Sex And Be Totally Fine With That
A lot of my patients who are many years past menopause report that their lives have changed in that way: The emphasis on and impact of sexual intercourse arent what they were before, says Pizarro. When talking through potential treatment options, many of his patients decide its not a big enough deal for them to pursue a medical solution to lowered libido. Its just not something that concerns them. Their life has transitioned to a point where theyre more focused on spending time with their partner or traveling, he explains.
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How Do I Know When I Am Peri
The peri-menopause is associated with a change in your periods. Periods often become less regular. Approximately two thirds of women also experience other physical and/or emotional symptoms such as:
- Hot flushes
- Weight gain
- Leaking urine when you cough and sneeze
Every woman is different some women experience a lot of symptoms and others very few. Some womens symptoms are short-lived, lasting just a few months, but some women may have symptoms for many years.
Calcium And Vitamin D
A combination of calcium and vitamin D can reduce the risk of osteoporosis, the bone loss associated with menopause. The best sources are from calcium-rich and vitamin D-fortified foods.
Doctors are currently reconsidering the use of calcium and vitamin D supplements. The U.S. Preventive Services Task Force advises that healthy postmenopausal women don’t need to take these supplements. According to the USPSTF, taking daily low-dose amounts of vitamin D supplements , with or without calcium supplements , does not prevent fractures. For higher doses, the USPSTF says there is not enough evidence to make a recommendation. In addition to possible lack of benefit, these supplements are associated with certain risks, like kidney stones.
However, calcium and vitamin D are important nutrients. Supplements may be appropriate for certain people including those who do not get enough vitamin D through sunlight exposure and those who do not consume enough calcium in their diet. They are also helpful for people who have been diagnosed with osteoporosis. Talk with your doctor about whether or not you should take supplements.
The National Osteoporosis Foundation recommends:
Vitamin D is necessary for the absorption of calcium in the stomach and gastrointestinal tract and is the essential companion to calcium in maintaining strong bones.
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Predicting Natural Menopause: Why Does Age Matter
If theres not a lot that women can do to change when theyll experience menopause, why does predicting it even matter?
It would be helpful for every woman to know exactly when menopause will arrive. Beyond recognizing and addressing issues such as increased cardiovascular disease risk and risks related to bone health, if a woman knows her age of menopause and how long the perimenopause transition will last, it could help her make important health decisions, says Faubion.
If youre bleeding like crazy it would be helpful to know, she says.
As of now, research hasnt uncovered a way to determine when a women will go into menopause, but having that information could be useful in making decisions such as whether to have a hysterectomy or other invasive procedures, says Faubion. If menopause is going to be a few months or a year from now, you may choose to wait it out if it’s going to be five years from now, you might want to go ahead and have an invasive procedure, she says.
The ability to predict when menopause will occur could also help with managing menopause symptoms or deciding which type of birth control to use, adds Faubion.
What Age Is Considered Early For Menopause
If you reach menopause before age 40, that is considered premature menopause, says Faubion. This occurs in about 1 to 2 percent of women, she says.
Experiencing menopause at 40 to 45 years of age is called early menopause, and that occurs in about 5 to 7 percent of the population, so its safe to say that at least 7 percent of women are going to go through menopause early or prematurely, says Faubion. Menopause at age 46 or older is considered normal, she says.
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How Often Do I Need To See My Doctor After Menopause
You should still see your healthcare provider for routine gynecological care even though you aren’t menstruating. This includes Pap tests, pelvic exams, breast exams and mammograms. You should continue to schedule annual wellness appointments. Since you are at an increased risk for osteoporosis, providers usually recommend bone density screenings as well. Talk to your healthcare provider to determine how often you should make check-up appointments based on your health history.
Perimenopause: Rocky Road To Menopause
What are the signs of perimenopause? You’re in your 40s, you wake up in a sweat at night, and your periods are erratic and often accompanied by heavy bleeding: Chances are, you’re going through perimenopause. Many women experience an array of symptoms as their hormones shift during the months or years leading up to menopause that is, the natural end of menstruation. Menopause is a point in time, but perimenopause is an extended transitional state. It’s also sometimes referred to as the menopausal transition, although technically, the transition ends 12 months earlier than perimenopause .
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What Medications Are Used To Treat Postmenopausal Symptoms
Hormone therapy could be an option, although healthcare providers often recommend using it for a short amount of time and in people under the age of 60. There are health risks associated with hormone therapy like blood clots and stroke. Some healthcare providers do not recommend using hormone therapy after menopause has ended or if you have certain medical conditions.
Some medications your healthcare provider may consider helping with postmenopausal symptoms are:
- Antidepressants for mood swings or depression.
- Vaginal creams for pain related to sexual intercourse and vaginal dryness.
- Gabapentin to relieve hot flashes.
Oftentimes your provider will recommend lifestyle changes to help manage your symptoms.
Are There Any Health Risks Associated With Postmenopause
People in postmenopause are at an increased risk for several conditions:
Estrogen helps protect against cardiovascular diseases like heart attack, heart disease and stroke. It is also common for people in postmenopause to become more sedentary, which contributes to high cholesterol and high blood pressure. These factors combined can increase a womans risk for cardiovascular diseases after menopause. A healthy diet, not smoking and getting regular exercise are your best options to prevent heart disease. Treating elevated blood pressure and diabetes as well as maintaining cholesterol levels are also ways to lower your risk.
People lose bone more rapidly after menopause due to decreased levels of estrogen. You may lose up to 25% of your bone density after menopause . When too much bone is lost, it increases your risk of developing osteoporosis and bone fractures. The bones of the hip, wrist, and spine are most commonly affected. Bone mineral density testing, also called bone densitometry, can be done to see how much calcium you have in certain parts of your bones. The test is used to detectosteoporosis and osteopenia, a precursor to osteoporosis.
Mental health issues
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How Long Is Too Long For A Period During Perimenopause
The road to menopause comes with many changes. Night sweats, hormonal imbalances, and vaginal dryness are a few of the well-known symptoms of perimenopause. Heavy, painful periods are also a symptom thats quite common roughly 25 percent of women report experiencing them. Read on to learn the basics of perimenopause bleeding and how to manage extended perimenopause periods.
Are Women Who Arent Experiencing Menopausal Symptoms Still Fertile
No matter when you experience natural menopause, your chances of getting pregnant after the age of 40 are low, says Faubion. But you can still become pregnant as youre transitioning to menopause, and you still need to use birth control if you don’t want to conceive, she adds.
Streicher confirms, saying, Fertility and menopause are not the same thing there are plenty of women who are pumping out estrogen and menstruating and are not fertile. If youre sexually active, its important to consult with your doctor before making any decisions about birth control to avoid unwanted pregnancy.
On the other hand, dont assume that just because you are still menstruating that you can get pregnant. Women who are concerned that they may have trouble conceiving or think they may experience menopause early and still want children should discuss options such as egg freezing with their doctor, says Streicher.
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Sleep Problems May Be Worse When Menopause Is Hastened By Surgery
By Lisa Rapaport, Reuters Health
5 Min Read
– – Women who have surgery to remove their ovaries go through menopause abruptly, and a new study suggests this comes with an increased risk for the kinds of sleep troubles many women experience when they go through menopause gradually.
Women typically go through menopause between ages 45 and 55. As the ovaries curb production of the hormones estrogen and progesterone, women can experience symptoms ranging from vaginal dryness to mood swings, joint pain and insomnia.
Women who have their ovaries surgically removed, however, are thrust into menopause virtually overnight. This kind of procedure may be done to treat cancer or reduce the risk of tumors for women with a genetic risk for breast and ovarian malignancies. Surgery may also be done to remove cysts or treat endometriosis, or painful scarring in the reproductive tract.
In the current study, women who underwent surgical menopause were more than twice as likely to experience insomnia and reported lower quality sleep compared with women who went through natural menopause.
Menopause is a difficult transition for many women, both psychologically and physically, and is often not well-discussed in psychiatric or medical settings, said senior study author Sooyeon Suh of Sungshin Womens University in Seoul.
About 8 percent of women with surgical menopause and 4 percent of women with natural menopause used hormone therapy to ease symptoms.