Understanding and navigating menopause

Published: Thursday, October 10, 2024
Family Medicine

Women’s health: understanding menopause

I had a patient arrive for her appointment with concerns of hot flashes and mood swings. She was about to turn 50 and planning to celebrate her birthday in Hawaii next month. She was worried that her symptoms would negatively impact her trip. When I walked into the room, I encountered a middle-aged woman who was sweating profusely and rapidly fanning herself with a piece of paper. Her first statement to me was “I think I’m going through menopause.” I immediately sat down with her, and we started discussing the ins-and-outs of menopause.

What is menopause?

Menopause is sometimes thought of as a scary thing, but it is a natural process for a woman’s body. It is part of the aging process, just like hair going gray. The steps of menopause can besplit up into three stages:

  • Perimenopause is the transition into menopause. Women will start to notice irregular menstruation and fluctuating hormone levels and may experience symptoms like hot flashes and increased fatigue. 
  • Menopause occurs after perimenopause and is defined as the complete stopping of a period for 12 months. 
  • Post-menopause is the time after menopause when a woman has not had a period for over 12 months.

What are the sign and symptoms of menopause?

Symptoms of menopause typically begin during perimenopause and peak in the first couple of years of post-menopause. Keep in mind that symptoms can vary from person to person – some women will have mild symptoms, while others can experience multiple, severe symptoms. These symptoms include:

Vasomotor: Vasomotor symptoms, like hot flashes and heat intolerance, are the most common complaints for women during menopause.

Neuropsychiatric: These symptoms can affect the systems in our body regulated by our brain. They include impaired sleep, anxiety, irritability, mood swings, depression and vertigo.

Genitourinary syndrome of menopause (GSM): Women undergoing menopause may experience increased difficulty with sex. This is because changes in the hormones cause vaginal dryness, weakening of the pelvic muscles and decreased libido. Additionally, weakening of the urinary tract may occur. This can result in pain during urination, difficulty controlling your bladder and frequent urinary tract infections.

It’s important to talk to your doctor about these symptoms so you can begin treatment, find ways to manage them and enjoy a better quality of life during menopause.

Managing menopause

There are many ways to manage menopause symptoms. Treatment focuses on the specific issues each woman is experiencing. These options can include changes to diet and exercise to natural supplements or medications.

Vasomotor symptoms, like hot flashes and heat intolerances, can be addressed in different wayswithout the need for medications. Staying in a cool environment can help control hot flashes and prevent overheating or excessive sweating. Engaging in stress-relieving activities, like meditation, exercise and acupuncture, can also help. Some herbal supplements, like black cohosh or vitex, have been shown to offer some relief, as well. Your doctor may prescribe medications or treatments, like hormone replacement therapy (HRT) or certain antidepressants, to help manage hot flashes.

Genitourinary syndrome can be treated with or without medications. Women who have pain during sex should try using vaginal lubricants or dilators before intercourse. These products can help reduce friction and prevent injury. Vaginal moisturizers, like hyaluronic acid, can also be useful. Alternatively, vaginal hormone therapy consisting of estrogen can help restore natural lubrication in the vagina.

There are several ways to treat neuropsychiatric symptoms. Good options to start with include therapy, relaxation techniques, healthy sleep habits and exercise. In some cases, doctors might prescribe antidepressants or anti-anxiety medications to help with depression and anxiety.

What to do after menopause?

After menopause, hormone changes can increase a woman’s risk for certain conditions. For example, women are more likely to develop osteoporosis because their bone density decreases due to these hormonal changes. Taking calcium and vitamin D supplements can help keep bones strong and healthy. It is also a good idea to incorporate strength-bearing exercises into your physical fitness routine to prevent fractures and bone loss.

Menopausal and post-menopausal women should also discuss important screening tests with their doctor. These screenings may include mammograms to check for breast cancer, questionnaires for depression and bone density scans (DEXA) for bone problems. 

So, if you are suffering from the ups-and-downs of menopause, just know that you are not alone. A good place to get help is by speaking with your primary care physician or gynecologist.Remember the patient that I encountered who was experiencing menopausal symptoms? With changes made to her diet and a prescription for an antidepressant, she went on to feeling much better and had a wonderful trip to Hawaii. 

Here are some resources from the National Institutes of Health and NGPG to get you started on understanding the journey of menopause. You can also check out this article on health screenings for women aged 40 to 64. 

Reach out to your doctor if you have concerns regarding menopause. If you don’t have a primary care doctor or a gynecologist, or you’re looking for a new one, NGPG has many qualified providers. You can search for one and book an appointment online.