Hormone Replacement Therapy For Menopause Symptoms
Hormone replacement therapy , also called hormone therapy, is sometimes prescribed during or after the menopausal transition to help relieve certain symptoms, like hot flashes, night sweats, and vaginal dryness. HRT involves taking synthetic or âbioidenticalâ forms of estrogen and often synthetic progesterone. âSystemicâ HRT goes throughout the whole body and can be taken in several forms, like pill, patch, gels, creams, and sprays. For people who are only experiencing vaginal symptoms, âlocalâ HT used inside the vagina in the form of a cream, ring, or tablet may be recommended .
Also, data suggest that systemic HRT lowers the risk of osteoporosis, coronary heart disease and overall mortality in people who take it around menopause, particularly for those who have had a hysterectomy and use estrogen-only HRT, but more information is needed (39.
Systemic HRT also carries risks, including an increased chance of developing breast cancer, stroke, and blood clots . Risks vary by whether your form of HRT contains a progestin or not . Also, the risk of negative effects increases when people begin taking it after menopause, particularly 10 or more years from menopausal onset . The U.S. Federal Drug Administration currently recommends that people who choose HRT take it âat the lowest dose that helps and for the shortest timeâ .
Responses To Loss Of Fertility
For some women, early or premature menopause can take away the possibility of becoming a mother. Some women have said, ‘I wasn’t sure if I even wanted children’, or, ‘I didn’t know if I wanted more children’, but when the power to make that decision is taken away, it can seem unfair. Early or premature menopause can mean the longed-for role of motherhood might not happen or, if it happens, it may not be in the way you anticipated. How this feels and the impact it has will depend on your individual circumstances, support networks and coping skills.
Some women with early or premature menopause feel they have to take on a role they did not expect until they were in their 50s that of a menopausal woman. They might even experience menopause before their mother.
Sometimes we have many roles, which we overlook when we focus strongly on wanting to fulfil one particular one. Some women forget they are also partners, daughters, sisters, friends, aunties, granddaughters, workers, neighbours, caregivers. Thinking about these other roles does not necessarily take away all the pain of loss, but it can help to shift the focus.
There are also other constructive ways to think about your role in life. For example, if you think your role is to be a mother, explore the steps you can take to achieve this perhaps donor eggs or adoption are options. It can be helpful to seek counselling to help you with your decision-making.
Is It Early Or Premature Menopause
Early menopause is menopause that begins between the ages of 40 and 45.
Premature menopause starts even earlier, before age 40. Many doctors now refer to premature menopause as premature ovarian failure or primary ovarian insufficiency. These terms reduce some of the stigma for younger women going through menopause.
Early menopause is relatively uncommon. Premature menopause is even less common, with only about
- change in diet or exercise
- response to a medication or contraceptive
The low estrogen levels associated with missed periods can lead to bone loss. Early treatment can help prevent bone damage.
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Addressing Sexual Problems Caused By Premature Menopause
A woman’s enjoyment of sex — even her sex drive — may also take a swan dive if she’s in early menopause, Shapiro says. Vaginal dryness occurs when the body’s estrogen levels are low, which can lead to painful intercourse. “Vaginal estrogen tablets work well,” he says, as does vaginal cream. “These don’t get into the body, only into the vagina.”
Women without working ovaries also suffer lower testosterone, the male hormone that women have in small amounts. Thereâs been a lot of attention in the media about testosteroneâs ability to boost libido in women as well as in men. But Shapiro says he doesnât think the evidence justifies testosterone treatment for most women. “There are so many factors in a woman’s sex drive,” he tells WebMD. “No one has ever shown that libido is solely related to male hormones.”
Hormone therapy can be a valuable tool in treating symptoms of premature menopause, says Shapiro. “We can re-establish normal menstrual cycles, implant fertilized eggs. It’s like there’s no difference.”
Talk to your doctor, says Shapiro. “We believe in giving patients the information they need — like whether to have ovaries removed or not. Don’t make that decision based on age alone. Discuss it with your doctor. Talk about your priorities. Make your decision based on information, not on what you’ve heard from a friend.”
Arthur Shapiro, MD, professor of obstetrics and gynecology at the University of Miami School of Medicine.
How Can You Alleviate Perimenopausal Symptoms
Some women deal with the symptoms of perimenopause, and some women seek treatment for specific health concerns. Women with heavy bleeding, periods that last longer than seven days, spotting between periods or cycles that are less than 21 days should contact a doctor.
Typically, perimenopause is a gradual transition, and no particular test indicates what is happening to the body. Hormone therapy, vaginal estrogen treatments and antidepressants can help treat perimenopausal symptoms.
Start by identifying what’s bothering you most and then working with your doctor to address it. There are steps you can take to feel better. Lifestyle changes that can make a big impact in easing perimenopausal symptoms and improving your overall health include:
Women’s Health Topics We Need To Talk About In 2020
Mood problems like depression can spike during perimenopause, especially among women who have previously experienced them. Many of our listeners wrote in to say that during perimenopause, they felt incredibly irritable and quick to anger in a way that they had never experienced before.
And of course, many â but not all â women experience hot flashes, though they may not recognize them. “It’s hard, because no one sits us down and teaches us, ‘Here’s what a hot flash feels like,’ ” Stuenkel says. “I’ve seen women who think they’re having panic attacks, or heart palpitations. That can be frightening.”
Other common symptoms include more frequent urinary tract infections, difficulty sleeping through the night, vaginal dryness that can make sex painful, night sweats and a decrease in libido.
What treatments are there for symptoms?
Some symptoms, like heavy or irregular periods, can be managed with an oral contraceptive, which can “shut down the body’s own erratic hormonal fluctuations,” says Stuenkel.
“This can kind of be a lifesaver,” she says. Such medication may help with hot flashes, too.
What Are The First Signs Of Perimenopause
Generally, the first sign of perimenopause is irregular periods. Most people will go from having fairly predictable menstrual cycles to unpredictable cycles. A lot of people also experience the most common signs of menopause like hot flashes and vaginal dryness fairly early into the menopause transition.
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What Is The Difference Between Early And Premature Menopause
Early or premature menopause happens when ovaries stop making hormones and periods stop at a younger age than usual . This can happen naturally or for a medical reason, such as when both ovaries are removed in a hysterectomy.
Early and premature menopause can have the same causes. The only difference is the age at which it happens. Menopause that happens before age 45 is called early menopause. Menopause that happens before age 40 is called premature menopause.
Women who have gone through early or premature menopause cannot get pregnant.
Which Part Of Female Body Attracts The Most
Contrary to popular opinion, women seem to much more concerned with the body below the neck than men are. Only 2% preferring the face above all else. Taking the lead is the chest at 24%, closely followed by hair at 22% and arms at 19%. These preferences suggest the importance of muscles in making a man more attractive.
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Why Does Menopause Occur
- Natural menopause occurs when levels of oestrogen and progesterone decline naturally.
- Premature menopause is when periods stop before the age of 40 years. This can be due to many reasons including medical conditions such as diabetes or underactive thyroid , and surgery or medications that have affected the blood supply to the ovaries. Genetic factors may also play a part as premature menopause can run in families. Women who smoke are also more likely to go through premature menopause. Sometimes, however, there is no identifiable cause.
- Artificial menopause is a consequence of surgical removal of both ovaries or destruction of the ovaries by some cancer treatments. With artificial menopause there is a sudden drop in hormone levels and menopausal symptoms begin abruptly. Often the symptoms experienced are more severe than those experienced with natural or premature menopause.
Dealing With Early Menopause
What is early menopause?
As women age, their bodies produce less estrogen and progesterone, the main hormones involved in female reproduction. When these hormones reach a low enough level, a woman will permanently stop having a menstrual cycle.
Menopause officially begins 12 months after a womans last period. Most women begin menopause between the ages of 45 and 55, with an average age of 51 in the United States. But for some women, menopause comes early.
If youre between the ages of 35 and 45 and have missed your period for three months or more, you may be going through menopause earlier than normal. Read on to learn why this happens and what treatments are available.
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Abnormal Bleeding After Menopause
In some cases, bleeding continues after menopause. It is easy to mistake this type of bleeding for symptoms of perimenopause, which may mislead someone to think they have not reached full-menopause when they actually have.
Any spotting or bleeding after menopause is abnormal and should be checked out by a healthcare provider . Spotting or bleeding after menopause can be caused by a medical condition, such as uterine polyps . Uterine polyps are growths on the inside lining of the uterus , and become more common with age .
Why Am I Gaining Weight During Perimenopause
The shift in hormones slows down your metabolism. Its very common for women in perimenopause to gain weight once their estrogen levels start to decline. Maintaining a healthy diet and regular exercise can help prevent weight gain during the transition to menopause.
A note from Cleveland Clinic
Perimenopause is the transition to menopause. During perimenopause, you may start having menopause-like symptoms, such as hot flashes, mood swings or vaginal dryness. Most perimenopause symptoms are manageable. But if you need help managing symptoms, medications and other treatments are available. Perimenopause ends when youve had no period for a full year. At that point, you enter menopause.
Last reviewed by a Cleveland Clinic medical professional on 10/05/2021.
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Risk Factors For Early Menopause
Premature ovarian failure affects about 1 out of every 1000 women from ages 15 to 29 and about 1 out of every 100 women aged 30 to 39. It can be related to genetic factors, to illnesses like autoimmune diseases, thyroid disease, viral infection, hormonal disorders, and eating disorders. The risk of premature ovarian failure risk increases in women who have relatives with the condition.
Diagnosis Of Premature Or Early Menopause
Premature and early menopause is diagnosed using a number of tests including:
- medical history, family history and medical examination
- investigations to rule out other causes of amenorrhoea , such as pregnancy, extreme weight loss, other hormone disturbances and some diseases of the reproductive system
- investigations into other conditions associated with premature or early menopause, such as autoimmune diseases
- genetic tests to check for the presence of genetic conditions associated with premature or early menopause
- blood tests to check hormone levels.
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Vaginal Dryness And Atrophy
When your estrogen levels drop, your vaginal tissues start drying and become less elastic. Sex becomes uncomfortable you may be more prone to infections your vagina is frequently itchy and easily irritated, and, on the emotional side, you may feel older.
Your vagina is usually very elastic, able to easily stretch for sex and childbirth. But as estrogen levels go down, your vaginal walls get thinner and lose some of their elasticity. Your vagina becomes dryer and takes longer to become lubricated. Finally, it may atrophy becoming somewhat smaller in width and length.
If you experience a sudden drop in estrogen , these vaginal symptoms might appear more suddenly than if you go through a natural premature menopause. Either way, though, its a very unpleasant side effect of going through menopause and often very emotionally upsetting when youre in your 20s or 30s.
You may find it takes longer and longer to get sexually aroused. Sexual stimulation that you used to enjoy may become unpleasant. Intercourse can be very uncomfortable, even painful. In a worst case scenario, your vagina may even tear during intercourse.
All in all, sex may become less and less pleasurable making you feel even worse about being in premature menopause. I remember I began thinking that, at the not-so-ripe age of 38, my days of enjoying sex were over and was very glad when I learned that I was wrong.
How To Cope
What Are The Signs Of Early Menopause
There can be other signs of early menopause besides not bleeding for a year, says Faubion. A lot of these women have what is called premature ovarian insufficiency , she says. POI used to be called premature ovarian failure, but its not called failure anymore because a lot of these women will have spontaneous periods periodically, says Faubion. Theres about a 5 to 10 percent spontaneous pregnancy rate in that group of women in POI, she says.
In premature ovarian insufficiency a woman may have spotty periods or have a menstrual cycle every three months or so. If we really did the investigations, we would see that the anti-Müllerian hormone , which is an indicator of how many viable follicles a woman has, would be quite low, says Faubion.
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What Are The First Signs Of Menopause How Do You Know If You’re In Perimenopause
In my experience, and chatting to thousands of women on My Second Spring over the years, the following symptoms are the first signs that you might be in perimenopause:
- Increased feelings of anxiety and low confidence – even panic attacks out of the blue
- Increased feelings of irritation
- Intermittent hot flushes and night sweats – often if you’ve been out and consumed alcohol
- Vaginal dryness – painful sex and low libido
- Urinary leakage and increased urgency
- Fatigue and trouble sleeping – either problems dropping off or you wake during the night at 3am, 4am … Insomnia
Most of us find that these symptoms come and go and periods are still mainly present – adding to confusion as to what’s going on. Also, I find that no two women have the same cocktail of symptoms. Click on the links above to get more details of these symptoms and how to manage them. Many of us experience some of these symptoms but never put two and two together and realise it’s the menopause knocking on the door. I get a huge number of messages from second springers telling me that they thought they had a terminal disease or were going crazy or developing dementia. We need to chat about this a lot more. There’s no need to suffer in silence there are plenty of ways to treat these symptoms. Keep reading…!
Are There Other Health Issues That Affect Women In Premature Menopause
Like all menopausal women, women in premature menopause experience lowered estrogen levels as the ovaries stop most of their production of this hormone. Low levels of estrogen can lead to changes in women’s overall health and may increase their risk for certain medical conditions, such as osteoporosis. Other health risks associated with the loss of estrogen include increased risk for colon and ovarian cancer, periodontal disease, tooth loss, and cataract formation.
However, compared with women who go through natural menopause, women undergoing premature menopause spend a greater portion of their lives without the protective benefits of their own estrogen. This puts them at an even greater risk for the above mentioned menopause-related health problems.
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How Is Early Menopause Diagnosed
The time leading into menopause is called perimenopause. During this time, you may have irregular periods and other symptoms that come and go.
Youre generally considered to be in menopause if you go 12 months without menstrual bleeding, and you dont have another medical condition to explain your symptoms.
Tests arent usually needed to diagnose menopause. Most women can self-diagnose menopause based on their symptoms. But if you think youre experiencing early menopause, you may want to see your doctor to be sure.
Your doctor can order hormone tests to help determine whether your symptoms are due to perimenopause or another condition. These are the most common hormones to check:
- Anti-Mullerian hormone . The