Menopause is the natural life change when a woman stops having menstrual cycles and is no longer fertile. The ovarian production of female hormones, estrogen and progesterone, declines over a period of 4-8 years. During this transition time, called the peri-menopause, the menstrual cycles can be irregular. Once a woman has not had a period for 12 months, she is considered post-menopausal. In the US, the average age that this happens is 51.
For most women, the transition to menopause is a smooth ride, with the occassional hot flash and unusual periods. However, not everyone is so lucky. Frequent hot flashes, insomnia, night sweats, vaginal dryness, memory problems, and irritability are the most common symptoms. Long-term side effects of menopause include urinary incontinence, painful intercourse, osteoporosis, thinning of the skin, and depression.
Management of menopause depends upon its physical and emotional effects and how significant they are in a woman’s everyday life. Many women navigate this natural process with simple lifestyle changes such as using vaginal moisturizers, drinking cold liquids, avoiding coffee and spicy foods, exercising regularly, and attending support groups. For women with more prominent symptoms, however, these simple steps may not be enough.
The most common treatment for menopausal symptoms is hormone replacement therapy. This is traditionally given as a combination of estrogen and progesterone (for women who have a uterus) or estrogen alone (for women who don’t have a uterus). These medications can be given in a variety of ways, including pills, patches, creams, and sprays. These are prescription medications that are made by a pharmaceutical company and dispensed from your local drug store or made in a local compounding pharmacy, often referred to as “bioidentical hormones”.
To treat the mood changes of menopause, a traditional antidepressant may be used. They can minimize emotional swings and help with memory loss.
Alternative therapies are prevalent as well. While the effectiveness of these methods may not have been proven, they may provide relief for individual patients. Acupuncture treatments are available. In addition, herbal supplements such as soy, red clover, and black cohosh have been used for the treatment of hot flashes. However, many studies do not support their effectiveness. Ultimately, the use of alternative therapies depends on the individual. Talk with your doctor about which treatments may be appropriate for you.