Menopause is a time to shape a new chapter of your life. Defined as a complete year without a menstrual period, the average age of this transition is 51. Women now are generally living and maintaining active lifestyles for decades beyond.
Physically, the symptoms of menopause can be uncomfortable, but they are manageable and treatable. Some women experience hot flashes, night sweats, and vaginal dryness as well as overall dry skin and eyes. Urinary urgency, sleeping problems, mood swings, anxiety and depression can also accompany menopause.
The management of menopause is not "one size fits all." Your healthcare provider can help chart the right course for you, starting with a detailed history and physical exam. Approaches to menopause include natural remedies, hormone therapy and other prescription medications.
A healthy diet and daily exercise can go a long way, and relaxation and stress-reduction techniques are a good first step in any treatment plan. Simple lifestyle changes can help, such as maintaining consistent sleep patterns, dressing in lighter clothing and avoiding caffeine and alcohol late in the day.
Supplements such as black cohosh, St. John's wort, vitamins B6 and E and others have been shown to help relieve menopausal symptoms. But studies on their efficacy are mixed and some risks are involved, such as the supplements’ interaction with prescription drugs. To be safe, you need to discuss these options with your healthcare provider.
Hormone Replacement Therapy (HRT)
A viable option for women who have no relief with lifestyle modifications and/or natural remedies, HRT replaces the estrogen the body stops making during menopause. In addition to relieving symptoms, systemic estrogen - absorbed throughout the body usually via pill or skin patch - also has proved to prevent bone loss. However, it comes with some cardiovascular and breast cancer risks that can depend on length of treatment and the age and overall health of the patient.
HRT is not an option for everyone. Generally, however, medical experts agree that it is acceptable for healthy women who are bothered by moderate to severe menopause symptoms.
Vaginal estrogen to relieve dryness carries substantially less risks as it is primarily absorbed locally through use of creams, tablets, suppositories and rings. Additionally, non-hormonal vaginal options include suppositories with hyaluronic acid, over-the-counter lubricants and vaginal moisturizers.
Antidepressants have been used for hot flashes and mood changes associated with menopause. Selective serotonin reuptake inhibitors (SSRIs) such as paroxetine, fluoxetine and venlafaxine are options. Also, blood pressure-lowering drugs such as clonidine and anti-seizure medications such as gabapentin have been used for the relief of hot flashes.
A personalized approach is the key to managing menopause. Consult with your healthcare provider about the many treatment options available to ensure that this time of transition is positive.
Anna Shoshilos, DO, is a board-certified obstetrician/gynecologist with Holy Name Medical Partners in Englewood. She has extensive expertise in the management and treatment of fibroids, pelvic pain, and menopause. To schedule an appointment with Dr. Shoshilos, call 201-871-4040 or visit HolyNameMedicalPartners.org. She is also booking telemedicine appointments at NorthJerseyTelemedicine.com.