Ht Forms And Regimens
HT comes in several forms:
- Oral tablets or pills
- Vaginal ring
- Topical gel or spray
HT pills and skin patches are considered “systemic” therapy because the medication delivered affects the entire body. The risk for blood clots, heart attacks, and certain types of cancers is higher with hormone pills than with skin patches or other transdermal forms.
Vaginal forms of HT are called “local” therapy. Doctors generally prescribe vaginal applications of low-dose estrogen therapy to specifically treat menopausal symptoms such as vaginal dryness and pain during sex. This type of ET is available in a cream, tablet, or ring that is inserted into the vagina.
“Bioidentical” hormone therapy is promoted as a supposedly more natural and safer alternative to commercial prescription hormones. Bioidentical hormones are typically compounded in a pharmacy. Some compounding pharmacies claim that they can customize these formulations based on saliva tests that show a woman’s individual hormone levels.
The FDA and many professional medical associations warn patients that “bioidentical” is a marketing term that has no scientific validity. Formulations sold in these pharmacies have not undergone FDA regulatory scrutiny. Some of these compounds contain estriol, a weak form of estrogen, which has not been approved by the FDA for use in any drug. In addition, saliva tests do not give accurate or realistic results, as a woman’s hormone levels fluctuate throughout the day.
How Do I Decrease My Cancer Risk After Menopause
Late-onset menopause usually occurs because of a genetic predisposition. If your mother went through menopause late, chances are you may also. A study found that late menopause is not uncommon among obese women because fat tissue produces estrogen. If you are worried about your age and menopause exercise, eat a healthy diet, dont smoke, and maintain a healthy body weight which can have a plethora of health benefits. Regular mammograms and Pap smears are also important for women experiencing late-onset menopause. Remember, pap smears have changed to the HPV test in December 2017.
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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.
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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.
How Long Does The Menopause Last
Symptoms of the menopause can start months or even years before periods stop completely. They usually continue for around 4 years after your last period, though some womens symptoms continue for much longer.
The menopause usually happens between the ages of 45 and 55, but its very difficult to predict when it will take place in an individual.
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Mood And Memory Effects
Menopause-related cognitive impairment can be confused with the mild cognitive impairment that precedes dementia. Tentative evidence has found that forgetfulness affects about half of menopausal women and is probably caused by the effects of declining estrogen levels on the brain, or perhaps by reduced blood flow to the brain during hot flashes.
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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What Other Factors Influence When Perimenopause Starts Or When A Woman Reaches Menopause
New research published online on April 12 in Menopause, the journal of NAMS, looked at the various factors that may affect the age when natural menopause occurs.
They found that there are factors that do seem predictive of when a woman will approach menopause, such as higher estradiol and follicle-stimulating hormone levels, which weve known for a while,” says Streicher. Irregular menstrual bleeding and hot flashes were also indicators of earlier menopause, she adds.
One new finding uncovered in the research was around alcohol consumption. The authors observed that participants tended to increase their alcohol consumption when approaching menopause, making it a potential clue that the change was coming.
That makes sense, says Streicher. This can be a time of added stress for women, and we know that any stressful situation can cause someone to drink more, she says.
Although this study didnt find a strong association with smoking, other research has indicated that smoking is related to early onset of menopause, says Streicher.
What Herbs And Supplements Help Menopause Symptoms
Black cohosh is a commonly used herbal supplement that is believed to reduce hot flashes. However, small German studies that tested black cohosh only followed women over a short time period. The German agency that regulates herbs does not recommend using black cohosh for longer than 6 months. Side effects can include nausea, vomiting, dizziness, visual problems, slow heartbeat, and excessive sweating. Black cohosh is not regulated by the U.S. Food and Drug Administration , so women must be careful about the safety and purity of this supplement.
Plant estrogens such as soy protein are a popular remedy for hot flashes, although data on their effectiveness are limited. Phytoestrogens are natural plant estrogens , which are thought to have effects similar to estrogen therapy. The safety of soy in women who have a history of breast cancer has not been established, although clinical studies indicate soy is no more effective for treating symptoms than a placebo. Soy comes from soybeans and is also called miso or tempeh. The best food sources are raw or roasted soybeans, soy flour, soy milk, and tofu. Soy sauce and soy oil do not contain isoflavones.
Herbals: Inconclusive and conflicting studies indicate that other herbals, such as dong quai, red clover , chasteberry , yam cream, Chinese medicinal herbs, and evening primrose oil, should be avoided or taken with care under the supervision of a health care professional to avoid unwanted and dangerous side effects and interactions.
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Can Early Menopause Contribute To Other Conditions
Infertility is often the most obvious concern when you start menopause 10 or more years early. Yet, there are other health concerns.
A steady stream of estrogen to your tissues has many uses. Estrogen increases good HDL cholesterol and decreases bad LDL cholesterol. It also relaxes blood vessels and prevents bones from thinning.
Losing estrogen earlier than normal can increase your risk of:
- premature death
Discuss your concerns about these symptoms with your doctor. Because of these risks, women who enter menopause early are often prescribed hormone replacement therapy.
Sleep Problems And Mood Swings
Try these options to avoid sleep problems:
- Avoid large meals, smoking, coffee, or caffeine after noon.
- Avoid napping during the day.
- Avoid exercise or alcohol close to bedtime.
- Drink warm milk or warm caffeine-free tea before bed.
- Sleep in a dark, quiet, and cool room.
- Treat hot flashes to improve sleep.
Easing stress, eating right, and staying physically active can help with mood swings and sleeping problems. Your doctor may also prescribe medication to help with mood swings.
You should talk to your doctor about managing your symptoms and to rule out other conditions that may be causing your symptoms, like depression or asthma. Its also helpful to join a support group for women in menopause so you have a safe place to share your concerns and issues.
Your doctor may also prescribe menopausal hormone therapy to help treat your symptoms. MHT can ease:
- hot flashes
Studies show that women who take MHT are at an increased risk of heart attack, stroke, and blood clots. The risks are similar for women using contraceptive pills, patches, and rings. However, women taking MHT are older, and the risks increase with age.
Many women cant take MHT because of a previous illness such as cancer or because they take other medications.
Additional research found that the risk of getting breast cancer can increase with five or more years of continuous MHT use .
Women who have had their uterus removed will use estrogen-only therapy.
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Should I Continue Using Birth Control During The Transition To Menopause
Yes. You can still get pregnant during perimenopause, the transition to menopause, even if you miss your period for a month or a few months. During perimenopause you may still ovulate, or release an egg, on some months.
But it is impossible to know for sure when you will ovulate. If you dont want to get pregnant, you should continue to use birth control until one full year after your last period. Talk to your doctor about your birth control needs. Learn more about different .
You cant get pregnant after menopause, but anyone who has sex can get . If you are not in a monogamous relationship in which you and your partner have sex with each other and no one else, protect yourself by using a male condom or correctly every time you have vaginal, oral, or anal sex. After menopause you may be more likely to get an STI from sex without a condom. Vaginal dryness or irritation is more common after menopause and can cause small cuts or tears during sex, exposing you to STIs.
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.
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Why Does Menopause Happen
The reasons for menopause are not well understood. Currently, we think that menopause happens because the ovaries run out of eggs. This leads to changes in the hormones produced by the ovaries and the hormones from the brain that control the ovaries. Eventually, the ovaries stop producing eggs and menstrual periods stop permanently. After menopause, the ovaries continue to produce oestrogen at lower levels and also testosterone.
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 Long Do Menopause Symptoms Last
Menopause symptoms are reported to last for an average of 7.4 years with some women experiencing them for only a few months or for over a decade.
In general, women suffer from menopause symptoms up to a few years into postmenopause. However, this depends on the individual as some women report experiencing hot flashes well into their 70s and 80s.
Having said that, all postmenopausal women are at an increased risk of developing other serious health complications, such as osteoporosis and cardiovascular disease, and they should have their hormone levels monitored for a proper treatment plan.
Differences By Socioeconomic Status
A number of studies have observed that lower social class, as measured by the woman’s educational attainment or by her own or her husband’s occupation, is associated with an earlier age at natural menopause.,,,,,, However, results from a British birth cohort indicated that early life socioeconomic status was more strongly associated than adult status with age at natural menopause, although even the relation of early life SES was greatly attenuated when adjusted for childhood cognitive ability and having been breastfed. One study found that education was more strongly associated with age at natural menopause than occupation. Most studies that have examined the relation of marital status have found that single women undergo an earlier natural menopause, and this association cannot be explained by nulliparity.,,
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Hot Flashes And Night Sweats
One of the major symptoms of menopause, hot flashes can make your whole body uncomfortably warm for a minute or more. Your face flushes, you perspire, and it feels like your heart is racing. You may wake up hot and sweaty at night, even though your room is cool.
What to do: To reduce the discomfort of hot flashes, dress in layers during the day, and in light pajamas at night. Keep a cool bottle of water close at hand, and use an ice pack to cool your pillow at night.
How Do You Know You’re In Postmenopause
Your healthcare provider will be able to tell you if you’re in postmenopause based on your symptoms and how long it’s been since your last menstrual period. In some cases, your healthcare provider will take a blood sample and check your hormone levels to confirm you’ve gone through menopause. Remember, you’re not considered to be through menopause until it’s been over one year since youve had a period.
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I Got My First Period Early Does That Mean Ill Go Through Menopause Early
I have many patients tell me, I know Im going to go through menopause earlier because I started my period really early, says Streicher. The reason women think that is because they think menopause occurs when you run out of eggs. This isnt going to happen were born with millions of eggs and many of those are never used. When you go through menopause is really about the aging of eggs and what causes them to age more quickly, she says.
The average age of menarche in the United States has gotten younger for a variety of reasons, but that hasnt made women go through menopause earlier, she points out.
Is Hormone Replacement A Safe Option For Management Of Menopausal Problems
Several hormone therapies are FDA-approved for treatment of hot flashes and prevention of bone loss. The benefits and risks vary depending on the severity of your hot flashes and bone loss, and your health. These therapies may not be right for you. Talk to your doctor before trying any hormone therapies.
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What Happens After Menopause
After menopause you will no longer be able to get pregnant and you will no longer get a period. If you have any type of vaginal bleeding after menopause, you should see a doctor as soon as possible. Vaginal bleeding after menopause is not normal and can mean that you have a serious health problem.
You may experience any of the following after menopause:
- Low hormone levels. With menopause, your ovaries make very little of the hormones estrogen and progesterone. Because of changing hormone levels, you may develop , including osteoporosis, .
- Menopause symptoms instead of period problems. After menopause, most women get relief from or menopause . However, you may still experience symptoms such as hot flashes because of changing estrogen levels. One recent study found that hot flashes can continue for up to 14 years after menopause.,
- Vaginal dryness. Vaginal dryness may be more common post-menopause. Learn more about for vaginal dryness.
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