Menopause And Your Hormones
Estrogen plays a key role in regulating the absorption and breakdown of collagen while also assisting ones bladder function .
Changes in estrogen levels during menopause can have an effect on the pelvic floor, explains Galbraith. This may mean that women are more susceptible to urine leaking post menopause due to the reduction in estrogen.
Therefore, adopting a strength training routine may aid in maintaining good pelvic floor health and decrease the risk of urinary incontinence. For example, performing exercises such as squats, glute bridges and kegels with intentional, controlled contractions can help reinforce stability and proper muscle engagement in the pelvic region.
Symptom wise, menopause is most commonly associated with hot flashes, night sweats, and chills, otherwise known as vasomotor symptoms.
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What Treatments Are There For Symptoms Of Perimenopause
- Bleeding problems: Before treatment is started, you should have a thorough check-up. If the abnormal bleeding is due to the hormonal changes of perimenopause, treatment can be started with estrogen and/or progesterone in the form of pills, shots, patches, or intrauterine device .
- Hot flashes: Taking estrogen as pills, patches, gels, or sprays is very helpful in relieving hot flashes. Women who have a uterus should also take medications that protect against precancerous changes in the lining of the uterus that can come from the long-term use of estrogen alone. For some women, herbal medicines or acupuncture may help a little, but there is not much medical evidence that these work for all women. Finally, some medicines that are typically used for other reasons can also relieve hot flashes. They may also help women who have problems with their sleep or mood. Lifestyle changes, such as avoiding caffeine and alcohol, keeping the environment cool, and wearing lighter clothing, may reduce symptoms. Be sure to talk to your doctor about whether hormone therapy is the right choice for you.
- Vaginal symptoms: Women often find relief for vaginal dryness and discomfort by using hormone medication . Vaginal moisturizers or lubricants can also help. Please be sure to talk to your doctor about any vaginal symptoms. These symptoms are some of the easiest to successfully treat and have the fewest side effects.
Q: How Long Will I Get Hot Flashes
A: On average, you may be looking at 10-15 years of living with hot flashes. Though they are sporadic, their unpredictability is very frustrating. Lets look at what you can expect:
- 40s: This is when most women start perimenopause. Some hot flashes and night sweats begin.
- 46-53: In the U.S., this is the average age for menopause, which is defined as 12 straight months with no period. Hot flashes tend to be most frequent in the two years after menopause.
- Late 50s: Most women continue to have hot flashes anywhere from 4-10 years after menopause. But most of these will decrease in frequency and severity.
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Is There Such A Thing As A ‘male Menopause’
The “male menopause” is an unhelpful term sometimes used in the media.
This label is misleading because it suggests the symptoms are the result of a sudden drop in testosterone in middle age, similar to what occurs in the female menopause. This is not true.
Although testosterone levels fall as men age, the decline is steady at less than 2% a year from around the age of 30 to 40, and this is unlikely to cause any problems in itself.
A testosterone deficiency that develops later in life, also known as late-onset hypogonadism, can sometimes be responsible for these symptoms, but in many cases the symptoms are nothing to do with hormones.
Other Drugs Used For Menopausal Symptoms
Despite its risks, hormone therapy appears to be the most effective treatment for hot flashes. There are, however, nonhormonal treatments for hot flashes and other menopausal symptoms.
The antidepressants known as selective serotonin-reuptake inhibitors are sometimes used for managing mood changes and hot flashes. A low-dose formulation of paroxetine is approved to treat moderate-to-severe hot flashes associated with menopause. Other SSRIs and similar antidepressant medicines are used “off-label” and may have some benefit too. They include fluoxetine , sertraline , venlafaxine , desvenlafaxine , paroxetine , and escitalopram .
Several small studies have suggested that gabapentin , a drug used for seizures and nerve pain, may relieve hot flashes. This drug is sometimes prescribed “off-label” for treating hot flash symptoms. However, in 2013 the FDA decided against approving gabapentin for this indication because the drug demonstrated only modest benefit. Gabapentin may cause:
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How To Handle Hot Flashes During Menopause
Hormone therapy is the most effective tool. If you cant take hormone therapy, dont despair. There are more treatments for vasomotor symptoms than ever before, including the many SSRIs and anti-anxiety meds that have been found to have the welcome bonus of reducing hot flashes, making them a good option if you are having emotional and mental health symptoms along with your physical ones.
That said, many lifestyle interventions will also help, especially in combination, including:
- Cognitive behavioral therapy
- As with sleep, yoga has been found to relieve hot flashes.
- If you are a smoker, one of the most important things you can do for your health is to stop smoking. Its linked with earlier perimenopause. But, once youre in perimenopause, stopping can also help minimize the severity of hot flashes during menopause and beyond.
- You may also want to start limiting alcohol. We all become more sensitive to its effects as we grow older, and the associated health risks rise. Research seems to show that once youre postmenopause, drinking can trigger hot flashes. Read more about the effects of alcohol during menopause here.
What Are The Stages Leading Up To Menopause
After puberty, there are three other phases of female fertility:
- Pre-menopause: Women have full ovarian function, regularly produce estrogen and ovulate.
- Perimenopause: The ovaries begin to fluctuate in their ovulation and production of estrogen, which can result in unpredictable menstrual cycles and symptoms.
- Menopause: When the ovaries have shut down. Someone would be in menopause after 12 months without menses.
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What Questions Should I Ask My Doctor
Discuss your perimenopause symptoms with your healthcare provider. It might help to keep a journal of your menstrual cycles including when they start and stop and the amount of bleeding.
Some questions you should ask are:
- Are these symptoms of perimenopause?
- What can I do to relieve my symptoms?
- How long do you think I will have these symptoms?
- Would hormone therapy be an option for me?
- Do I need to start taking medication or vitamins?
- Are there any tests that should be done?
- Can I still become pregnant?
How To Approach Strength Training During Menopause
The way we perceive strength training today has dramatically evolved over the past decade, especially around the subject of weight training for women.
Yes, men and women respond differently to strength training, but it doesnt mean one sex benefits from it more than the other. While lifting weights may carry the stereotype of being more beneficial for men, due to the link between strength training and boosting testosterone levels, its a habit thats extremely beneficial for women of all ages.
Throughout their lives, most women will experience menstruation, menopause, and potentially pregnancy. These big shifts will not only impact their sex hormones and reproductive system but practically their entire bodies.: mood, cognitive response, sleep, metabolism, you name it. By adding in another stressor, such as strength training, their bodies will experience more tissue damage and spikes in select hormones which will impact their systems in a variety of other ways.
Editors note: The content on BarBend is meant to be informative in nature, but it should not be taken as medical advice. The opinions and articles on this site are not intended for use as diagnosis, prevention, and/or treatment of health problems.
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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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We Can Help You Manage Your Cold Flashes
- Meet with a Menopause-certified Doctor to understand cold flash symptoms, and their impact on your overall health and wellness
- Partner with a Health Coach for actionable solutions to manage your cold flashes and the support you need to get you feeling better
- Black Cohosh – this dietary supplement may help relieve hot flashes, cold flashes, night sweats
- Vitality the nutrient-packed multi-vitamin supplement that that supports, mood, energy, stress response, immune health, joint pain, and inflammation
The information on the Gennev site is never meant to replace the care of a qualified medical professional. Hormonal shifts throughout menopause can prompt a lot of changes in your body, and simply assuming something is just menopause can leave you vulnerable to other possible causes. Always consult with your physician or schedule an appointment with one of Gennev’s telemedicine doctors before beginning any new treatment or therapy.
Can Perimenopause Be Treated
There isnt any treatment to stop perimenopause. Perimenopause is a natural part of life. The cure for perimenopause occurs when your periods stop and you enter menopause.
But your healthcare provider may recommend over-the-counter or prescription perimenopause treatment to help ease symptoms. Your provider may recommend:
- Antidepressants: These medications help with mood swings or depression.
- Birth control pills. These medications stabilize your hormone levels and typically relieve symptoms.
- Estrogen therapy: This treatment stabilizes estrogen levels. You may take estrogen therapy as a cream, gel, patch or swallowable pill.
- Gabapentin : This medicine is a seizure medication that also relieves hot flashes for some women.
- Vaginal creams: Your provider can tell you about prescription and over-the-counter options. Treatment can decrease pain related to sex and relieve vaginal dryness.
Your healthcare provider will discuss the risks and benefits of perimenopause treatment with you and recommend the best option based on your needs. Certain lifestyle changes like eating a healthy diet, light exercise and avoiding foods or activities that trigger hot flashes can also help.
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What Are The Hormonal Changes During Perimenopause
The hormonal changes you experience during perimenopause are mostly caused by declining estrogen levels. Your ovaries make estrogen, which plays a vital role in maintaining the reproductive system. Once you enter perimenopause, your estrogen levels start to decrease. As estrogen decreases, it throws off the balance with progesterone, another hormone produces by the ovaries. These two hormones together are responsible for ovulation and menstruation. Its common for hormone levels to fluctuate during perimenopause to go up and down like a rollercoaster.
When you reach menopause, your body makes so little estrogen that your ovaries no longer release eggs. At this point, you stop having your period.
Does Sexual Function Change During The Menopause
There are two primary sexual changes in the aging woman. Vaginal lubricating fluid is reduced in volume and there is loss of vaginal elasticity. This results in pain with sexual relations because of the feeling of dryness and tightness of the vagina. Women will complain of burning with sexual relations and vaginal irritation and soreness. This is less of a problem in the sexually active woman who is having vaginal intercourse on a regular weekly or more basis. If the frequency of intercourse is less than weekly, this dryness and atrophy can become a clinical problem. Decreased sexual desire is often described in menopause. It is difficult to determine if this is due to a hormonal cause or whether it is secondary to the fear of pain with sexual intercourse because of the vaginal dryness and loss of elasticity. The most common causes of loss of sexual desire are either anger at ones’ partner, or medications such as antihypertensives that tend to interfere with the vascular response. These factors must be looked for when determining if the decreased sexual desire is really due to the menopause.
For most menopausal women, if there is an available partner who is able and willing to having intercourse, sexual activity is usually maintained at a fairly stable level in the women’s post menopausal years.
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What Symptoms Am I Most Likely To Experience
Symptoms vary greatly from woman to woman. They may occur at different times and with different degrees of severity. The information below is meant only as a guide about what you may experience, and does not cover all possible symptoms.
Change in menstrual bleeding patterns: As women age, menstrual periods change. They may be more or less frequent, shorter or longer, and heavier or lighter. It is important to know that ovulation can still occur, and women in perimenopause can sometimes get pregnant. Women who do not wish to get pregnant should continue to use birth control until they have not had a menstrual period for 12 months.
Changes in a womans menstrual cycle are common and expected during perimenopause. However, worsening bleeding or irregular bleeding should be discussed with a health-care provider. Abnormal bleeding may be the result of other problems with the uterus, such as polyps, fibroids, hyperplasia , or even cancer.
Mood symptoms/sleep disturbances: During perimenopause, some women also have problems with sleeping, forgetfulness, and depression/anxiety. Decrease in sex drive is also quite common. While many of these symptoms can be a result of dropping estrogen levels, they may also be a sign of other medical conditions. If you experience any of these symptoms, please talk to your doctor to get the proper care.
Is There Such A Thing As Perimenopause
Perimenopause is time before and after menopause during which symptoms due to the loss of ovarian function begin and finally reach their maximum effect. The perimenopausal period begins on the average at about 47 1/2 years. That is the time at which many women will note some menstrual irregularity. Actually only 10% of women have an abrupt cessation of menses with no period of irregular menses preceding it. Thus, the perimenopause lasts approximately four years in duration before menses totally stop. Back to top
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What Are Bioidentical And Compounded Hormones
Partly in response to the WHI report, women turned to bioidentical hormones. These are hormones that are often touted as chemically identical to the ones the human body produces. Surprise! The hormones typically used in most traditional, FDA-approved HT are not.
However, there are no peer-reviewed studies that show that bioidentical and compounded hormones are any safer or more effective than HT. In fact, studies have shown that the amounts of hormones in them can be wildly unreliable, unlike FDA-approved hormones, which are regulated. When hormones doses are too high, they can cause health issues like blood clots and increased risk. When they are too low, they are a waste of money. More reasons to only use FDA-approved HT under the care of you doctor:
The FDA does not recognize the term bioidentical as a real thing. It is more of a marketing term to sell products than anything else.
The FDA has approved some products that happen to be chemically identical to human-made hormones, so if that is important to you, you can still find that type of hormones with the help of your NAMS-certified medical practitioner . Keep in mind that these products will not be labeled as bioidentical, because the scientific and medical community does not recognize it as a valid word or medical term.
- An estimated 2.5 million US women use cBHT
- Of the 9% of American women taking HT, a third of them are using cBHT
- Among women ages 40-44, cBHT use is equal to FDA-approved HT
Should I Consider Hormone Replacement Therapy For Menopause
Replacement of estrogens and progestins after the menopause is not always without some side effects. Progestins are recommended to take along with estrogens if a woman has an intact uterus. This helps to prevent any cancer causing effect on the endometrium by estrogen alone. If progestin is added then this risk is reduced to the baseline for women not on hormone replacement therapy. Unfortunately, hormone replacement therapy can lead to some irregular bleeding which in itself may be a sign of cancer. This then has to be worked up to make sure an endometrial cancer is not present. Between the inconvenience of the symptoms and the concern and expense over diagnostic workups, many women become discouraged with hormone replacement therapy and choose to discontinue it. If a woman is not having hot flashes, all the other benefits of hormone replacement are fairly indirect and take many years to show their benefit. It is often difficult to trade short term occurrence of symptoms for these long term benefits. Back to top
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