How Women Of Color Can Advocate For Their Health
We are on the steep part of the learning curve in appreciating how we have shortchanged women of color. We have all seen that it doesnt matter who you are, even if you are Serena Williams, you risk not being listened to, and not having your symptoms receive appropriate attention, says Santoro. She advises:
- Bring someone with you to your doctor appointments to have a second pair of ears or who can speak up if you are momentarily flustered. That extra person in the room can reiterate and reinforce what the patient is saying.;Its a pretty sorry state of affairs that a second person is needed to get medical professionals to listen to an adult Black woman, but if that is what it takes, then that is what needs to happen, says Santoro.
- Bring your doctor a list of your symptoms in order of importance to you. List any other symptoms beyond the obvious ones that you think may be related to your menopause transition. Santoro says, Sometimes there are oddball or nontraditional symptoms that women have that respond well to hormone therapy or other treatments, and its good to get them out in the open from the start.
More Meaning For Mothers Day
Who knew that a single question could provide so many insights? Now, while all this science is undeniably cool, Mothers Day is about much more than things like fertility and menopause. We celebrate Mothers Day by honoring the many individuals who nurture and care, whether or not we spent nine months chilling out in their uterus. We also understand this holiday can be difficult, perhaps if youre struggling to conceive or have lost your mom. So, to all the a dog moms, volunteers, mother-in-laws, teachers, new mothers, best friends, aunties, partners, caregivers, godmothers, and plant mamas out there: Happy Mothers Day from all of us at Modern Fertility. Were here to support you, no matter where you are on your fertility journey.
When Does Perimenopause Start
Before you experience menopause, youll go through a transitional period, known as perimenopause. This phase can last for months or years, and usually starts when youre in your mid-to-late 40s. On average, most women experience perimenopause for about four years before their periods stop completely.
Hormone Treatment And Therapy
Estrogen and progesterone therapy
Hormone therapy , or menopausal hormone therapy , consists of estrogens or a combination of estrogens and progesterone . This was formerly referred to as hormone replacement therapy . Hormone therapy controls the symptoms of menopause-related to declining estrogen levels , and HT is still the most effective way to treat these symptoms. But long-term studies of women receiving combined hormone therapy with both estrogen and progesterone were halted when it was discovered that these women had an increased risk for heart attack, stroke, and breast cancer when compared with women who did not receive HT. These risks were most pronounced in women over 60 taking hormone therapy. Later studies of women taking estrogen therapy alone showed that estrogen was associated with an increased risk for stroke, but not for heart attack or breast cancer. Estrogen therapy alone, however, is associated with an increased risk of developing endometrial cancer in postmenopausal women who have not had their uterus surgically removed.
Hormone therapy is available in oral , transdermal forms . Transdermal hormone products are already in their active form without the need for “first pass” metabolism in the liver to be converted to an active form. Since transdermal hormone products do not have effects on the liver, this route of administration has become the preferred form for most women.
Can Menopause Cause Depression
Your body goes through a lot of changes during menopause. There are extreme shifts in your hormone levels, you may not be sleeping well because of hot flashes and you may be experiencing mood swings. Anxiety and fear could also be at play during this time. All of these factors can lead to depression.
If you are experiencing any of the symptoms of depression, talk to your healthcare provider. During your conversation, your provider will tell you about different types of treatment and check to make sure there isnt another medical condition causing your depression. Thyroid problems can sometimes be the cause of depression.
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What Factors Effect How Early Or Late Women Hit Menopause
Genetics seem to play a major role in how early or late menopause starts. Family history is quite relevant, and is indeed the best predictor of age at menopause, Dr. Minkin says. If youre able, ask the women in your family when they went through menopause to get a sense of when to expect it in your own life.
Beyond your genetic background, the biggest risks associated with early menopause are smoking, cancer treatments, and hysterectomy which removes the uterus but leaves the ovaries intact, and can allow menstruation to continue.
A December 2017 study published in Human Reproduction also suggested that women who were underweight may go through menopause earlier than women of average weight, whereas a 2002 study published in International Journal of Obesity and Related Metabolic Disorders suggested that women with high BMIs more commonly go through menopause later than average.
If youre in the right age range and experiencing symptoms, you might be going through menopause. If it seems too early, or if symptoms are bothering you, its worth speaking with your doctor to see how they might be able to help.
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Results Will Help Bipoc Women Access Better Healthcare
These findings are important, says Dr. Santoro. I have practiced medicine in environments where the menopausal experience of Black women was simply not appreciated. Not knowing that a Black woman is likely to have longer and worse menopausal symptoms does her a disservice, because the clinician might tend to minimize the impact of her symptoms and might be less likely to offer her hormone therapy or other treatments. Having a better idea of how long symptoms will last is also helpful, and knowing more about differences in the timing of menopause may influence the decisions to do testing such a bone density screening and other aspects of menopause care.
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Understand Your Bodys Changes At Menopause
It is important to understand the changes your body is going through before, during and after menopause. There are many different sources of information available. Make sure you seek out reputable websites and brochures that provide up-to-date, non-biased information from organisations that specialise in womens health.
Some examples include:
When Do Menopause Symptoms Start
The symptoms usually associated with menopause are actually a byproduct of the perimenopausal stage, or the years leading up to menopause. This is when estrogen and progesterone levels begin to erratically fluctuate as ovarian reproductive functions come to a halt.
Perimenopause usually starts in a woman’s mid-40s, although some women can enter it as young as their early 30s or even as late as their 50s .
As such, a woman is considered to have reached menopause when she has been period-free for 12 consecutive months, and the average age for menopause in the United States is 51.
How Does Menopause Affect My Bone Health
The decline in estrogen production can affect the amount of calcium in your bones. This can cause significant decreases in bone density, leading to a condition known as osteoporosis. It can also make you more susceptible to hip, spine, and other bone fractures. Many women experience accelerated bone loss the first few years after their last menstrual period.
To keep your bones healthy:
- Eat foods with lots of calcium, such as dairy products or dark leafy greens.
- Take vitamin D supplements.
- Exercise regularly and include weight training in your exercise routine.
- Reduce alcohol consumption.
- Avoid smoking.
There are prescription medications you may want to discuss with your doctor to prevent bone loss as well.
Menopause Mystery: Why Do Female Killer Whales Experience The Change Of Life
For people who cannot take estrogen therapy, or choose not to, Stuenkel says some drugs in the antidepressant family, such as SSRIs and SNRIs, can help with hot flashes. Stuenkel says, “While they’re not perfect, they can take the edge off and help enough so that women can get a better night’s sleep.”
There are an abundance of nonhormonal, nondrug treatment options for managing symptoms, some of which have significantly more evidence backing them than others. In 2015, a North American Menopause Society panel found that cognitive behavioral therapy and hypnosis were significantly effective in treating hot flashes. The same panel also found that popular herbal remedies are “unlikely to help,” although some NPR listeners who wrote in said they got relief from some of those treatments.
For depressive and anxiety symptoms, women may want to seek out professional counseling or a psychiatrist.
When do I need to see a doctor?
You might not need to at all. Some people sail right through menopause with little trouble. But if you are experiencing symptoms that are interfering with your life, it’s worth making an appointment. Some of these symptoms could indicate other problems that need treatment, such as fibroids or even cancer.
Ways to cope with symptoms
For people approaching this stage of life or who are already going through it, here are four steps for making this transition more manageable.
1. Get educated
2. Monitor your health
3. Practice smart self-care
4. Cultivate community
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Vaginal Lubricants For Menopause Symptoms
In women for whom oral or vaginal estrogens are deemed inappropriate, such as breast cancer survivors, or women who do not wish to take oral or vaginal estrogen, there are varieties of over-the-counter vaginal lubricants. However, they are probably not as effective in relieving vaginal symptoms as replacing the estrogen deficiency with oral or local estrogen.
Antidepressants And Other Medications
Antidepressant medications: The class of drugs known as selective serotonin reuptake inhibitors and related medications has been shown to be effective in controlling the symptoms of hot flashes in up to 60% of women. Specifically, venlafaxine , a drug-related to the SSRIs, and the paroxetine , desvenlafaxine , citalopram , and escitalopram have all been shown to decrease the severity of hot flashes in some women. However, antidepressant medications may be associated with side effects, including or sexual dysfunction.
Other medications: Other prescription medications have been shown to provide some relief for hot flashes, although their specific purpose is not the treatment of hot flashes. All of these may have side effects, and their use should be discussed with and monitored by a doctor. Some of these medications that have been shown to help relieve hot flashes include the antiseizure drug gabapentin and clonidine , a drug used to treat high blood pressure.
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How Does Menopause Happen
Menopause is a natural occurrence.
The process of menopause begins when your body starts to produce less estrogen. Over time, your body will eventually cease making estrogen, and you will stop having your period because of this. Your ovaries, which produce the estrogen, no longer release the eggs through ovulation because they arent being produced by the hormones inside the ovaries. This whole process before the official ceasing of periods and production of estrogenis called perimenopause.
Once your body no longer releases the eggs and you stop having periods, you have reached menopause.
Once your body no longer releases the eggs and you stop having periods, you have reached menopause.
Nearly every woman will go through menopause naturally. The only way a woman will not naturally go through menopause is if her ovaries were removed. There are reasons why a womans ovaries have been removed, with the leading reason being a risk of ovarian cancer. Some women carry genes called BCRA1 and BCRA2, both of which increase womens risk for breast and ovarian cancer. Women with either one of those genes who remove their ovaries via surgery reduce their risk of getting ovarian cancer by up to 90 percent.
Woman And Their Doctors Should Discuss Age Of Menopause
The key takeaway here is that we need to be asking our patients about their menopausal history way earlier so that we can be proactive about investigating and modifying their cardiovascular risk factors to help them stay healthy over the next many decades, says Freaney. If women have experienced menopause before age 40 and their doctor doesnt ask about it, they should feel empowered to initiate the conversation, she adds.
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What Else Affects When A Woman Will Finally Stop Having Menstrual Periods
Researchers continue to explore a number of factors that may influence the timing of menopause.
The level of education a woman has completed is one thing that seems to correlate with menopause timing, says Faubion. Women who have more education tend to go through menopause later, she says.
A study published in January 2020 in JAMA Network Open found that pregnancy and breastfeeding may reduce the risk of early menopause.
How frequently a woman has sex has also been correlated with early menopause. A study published in January 2020 in Royal Society Open Science found that women who had sex at least once a week were less likely to go through menopause compared with women who had sex less than once a month.
Findings May Help Improve How Cardiac Risk Is Assessed In Women
These findings add to what we already know about early menopause and cardiovascular risk, says Laxmi Mehta, MD, professor in the division of cardiovascular medicine and director of Preventative Cardiology and Womens Cardiovascular Health at The Ohio State University Wexner Medical Center in Columbus. Dr. Mehta was not involved in this research.
Since the recent 2019 primary prevention guidelines were released and premature menopause was added as a risk enhancer for coronary heart disease its helped to get physicians to start asking the question, At what age did you go through menopause? says Mehta.
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Racial Differences In Early Menopause Have Not Been Highlighted Before
This aspect of the study shows a significant racial difference that hasnt been brought out in other research on premature menopause, according to Stephanie S. Faubion, MD, the director of the Center for Womens Health at the Mayo Clinic in Rochester, Minnesota, and the medical director of The North American Menopause Society . Dr Faubion was not involved in the research.
Black Women Are More Likely To Have Premature Menopause And The Potential Risks That Come With It Compared With White Women
While early-onset menopause was associated with future heart risks for all research subjects, a marked racial difference emerged. A total of 3522 Black women and 6514 white women were included in the analysis; early menopause occurred in 15.5 percent of Black women and 4.8 percent with white women.
The disparities between when Black women and white women go through premature menopause are striking, says Dr. Freaney. We need to further study social determinates of health, systemic, and structural racism and get a better understanding in order to address those factors to try to get to the root of these disparities, she adds.
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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.
General Recommendations For Ht
Current guidelines support the use of HT for the treatment of severe hot flashes that do not respond to non-hormonal therapies. General recommendations include:
- HT may be started in women who have recently entered menopause.
- HT should not be used in women who have started menopause many years ago.
- Women should not take HT if they have risks for stroke, heart disease, blood clots, and breast cancer.
- Currently, there is no consensus on how long HT should be used or at what age it should be discontinued. Treatment should be individualized for a woman’s specific health profile.
- HT should be used only for menopause symptom management, not for chronic disease prevention.
Before starting HT, your doctor should give you a comprehensive physical exam and take your medical history to evaluate your risks for:
- Heart disease
- Breast cancer
While taking HT, you should have regular mammograms and pelvic exams and Pap smears. Current guidelines recommend that if HT is needed, it should be initiated around the time of menopause. Studies indicate that the risk of serious side effects is lower for women who use HT while in their 50s. Women who start HT past the age of 60 appear to have a higher risk for side effects such as heart attack, stroke, blood clots, or breast cancer. HT should be used with care in this age group.
Women who should not take hormone therapy include those with the following conditions:
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