Referred to in hushed tones by your grandmother as “The Change,” menopause marks the time in a woman’s life when the body no longer makes the hormone estrogen, leading to the end of menstruation and fertility.
"Many women start noticing symptoms around age 50 and generally by 60 you’re considered post-menopausal,” said Peggy “Lisa” McCullum, a Certified Nurse-Midwife with Samaritan Obstetrics & Gynecology - Corvallis. “Unfortunately during the early phase women may have more severe symptoms but as you work through menopause the discomfort will often lessen."
Although menopause is typically diagnosed when a woman has not had a menstrual period in the previous 12 months, the hormone fluctuations and accompanying uncomfortable side effects leading up to menopause can last as long as 10 years. During this stage, known as perimenopause, women may notice inconvenient or uncomfortable symptoms like inconsistent periods, hot flashes and night sweats, brain fog, changes in mood, vaginal dryness and sleep disorders.
Dipping estrogen levels are generally held responsible for menopause symptoms but the exact relationship isn’t clear. McCullum notes that some women notice triggers for symptoms. For example, hot flashes may be more likely to occur after drinking alcohol or caffeine, eating spicy food, exposure to cigarette smoke and being stressed or anxious.
In fact, a study published in JAMA Internal Medicine found that women who were overweight, were current or former smokers, or were stressed, depressed or anxious were more likely to experience hot flashes for a longer period of time.
Some women find that their symptoms are mild and manageable without any intervention, while others may experience symptoms so severe that they require support from their medical provider. McCullum recommends starting with these steps if you’re looking for ways to ease symptoms.
Start with Lifestyle Changes
McCullum reports that eliminating alcohol and smoking are the biggest things that can help improve menopause symptoms. Exercise, a reduced carbohydrate diet and limiting caffeine can also help.
"Lifestyle changes are hard, but for some women it’s all they need to lessen their symptoms,” said McCullum. “Medication may be easier but many women get better results if they explore lifestyle factors first."
Manage Existing Symptoms
Be prepared for hot flashes and night sweats. McCullum recommends dressing in layers you can remove during the day. At night, keep your bedroom cool, use lighter bed linens and follow a bedtime routine including putting away electronic devices an hour before bed.
Brain fog isn’t just in your mind — according to a study published in the journal Menopause, women may produce lower levels of a form of estrogen called estradiol as they near menopause which can impact memory. Embrace technology to keep yourself organized and play brain games. McCullum notes that exercise and improving sleep may also help with brain fog.
For vaginal dryness, using an over the counter vaginal moisturizer or lubricant may be helpful. These products do not contain hormones.
Explore Medication & Supplements
For bothersome symptoms that persist, McCullum encourages women to talk to their provider about medication risks and benefits, and if it is the right choice for you.
Hormone replacement therapy is a common option that helps with several symptoms. It is given as a pill or patch that provides estrogen, and if you still have a uterus, progestin, to help ease hot flashes and vaginal dryness. If vaginal dryness is the main complaint, estrogen therapy alone may be helpful and can be applied through a cream, tablet or vaginal ring. For hot flashes, an antidepressant can help. When the issue of hot flashes is addressed, women also often notice an improvement in sleep problems related to night sweats.
There are many natural and herbal remedies available and McCullum notes that they can be effective, especially when symptoms are mild. Bioidentical hormones refer to hormones that are chemically identical to those that are made in the human body. These are available with prescription from your provider. Soy, black cohosh and Chinese herbs are available over-the-counter, however McCullum cautions that the supplement industry is not well regulated so be sure to discuss with your provider what is right for you. Always tell your provider about any herbal remedies you are taking, especially if you have a history of uterine or breast cancer.
No matter where you are in your journey through menopause, don’t let symptoms make you miserable.
"Menopause symptoms are a problem for anybody if they interfere with activities for daily living,” said McCullum. “We really want women to talk to their provider if menopause symptoms are a problem.
Visit our Well-Woman page to find a provider or learn more about gynecological services at Samaritan Health Services.