From Hot Flashes to Hormonal Harmony: Coping with Menopause

Menopause signifies the end of a woman’s menstrual cycle and natural reproductive years. After going 12 consecutive months without a period, 1.3 million women in the United states enter this significant life stage annually. Generally, women experience menopause between the ages of 40 and 55 and everyone’s journey to menopause is unique.

Falling levels of hormones trigger a whole series of things, not just changes to your period. Emotionally you are like Dr. Jekyll and Mr Hyde. You can't seem to remember where anything gis. 10 pounds have magically been added to the scale and hair starts showing up in places it is not meant to be. It may sound scary and terrifying but your body is just going through some changes as it prepares itself for the remainder of your life. 

Understanding some of the most common signs and symptoms can help ypu better navigate menopause and embrace the power, growth, and wisdom that it signifies.  

Perimenopause

You may have heard the term perimenopause. Perimenopause, or “around menopause” refers to the transitionary period to menopause. During perimenopause, your body’s estrogen levels fluctuate dramatically and begin to decline, leading to irregular periods, skipped periods, changes in menstrual flow, such as shorter, longer, heavier, or lighter periods. 

Most women start this transition in their 40’s but of course there are exceptions with some women starting in their 30’s. The average length of perimenopause is 3-4 years but can range from little as a month to as long as a decade. 

The biological clock doesn't stop ticking when you reach perimenopause. Pregnancy is not likely but still very much possible no matter how irregular periods become. So do not write off contraceptives just yet. 

Menopause

Perimenopause ends and menopause occurs when 12 consecutive months have passed since your last period. At this point, the ovaries are producing so little estrogen, there is no stimulus to release eggs which means natural pregnancy is no longer possible. Unlike perimenopause which is a transitionary period, menopause is a point in time in which periods stop altogether. After this point in time, you are considered postmenopausal, though you may continue to experience symptoms for several years afterward. 

Most women reach menopause between 40 and 55, with the average age in the U.S. being 51. The age at which menopause occurs can be influenced by external factors like family history, smoking, hysterectomy, treatment for cancers and more.

Symptoms

Symptoms associated with menopause occur during the perimenopause period and can last beyond menopause. Some of the symptoms can include:

• Hot flashes
• Night sweats
• Irregular or skipped periods
• Breast tenderness
• Vaginal dryness
• Chills
• Cognitive changes (forgetfulness, word finding difficulties, "brain fog", decreased concentration)
• Sleep disturbances
• Sexual discomfort
• Decreased sex drive
• Fatigue
• Weight gain
• Headaches
• Depression, anxiety, and/or irritability
• Dry skin
• Joint or muscle aches
• Hair thinning
• Frequent urination
• Urinary incontinence
• Urinary or vaginal infections
• Bone loss
• Cardiovascular disease

Some women have frequent symptoms, others have little to no symptoms at all. Some have consistent symptoms and others have waxing and waning symptoms. It is important to note that many of these symptoms are exhibited in other physical and mental health conditions so it is important to get an accurate diagnosis. 

Diagnosis

Most of the time your doctor will be able to ask you questions, evaluate you, and based on the clinical picture, diagnose you. In cases where the diagnosis is not as definitive, we diagnose menopause with blood tests that measure;

• Follicle-stimulating hormone (FSH)
• Leutenizing hormone (LH)
• Estradiol
• Thyroid, liver, and/or kidney function

At menopause, the ovaries become less responsive to FSH and LH hormones, so the body makes more of these hormones to compensate. Estradiol and other hormones decrease around menopause as well.

Treatment

Although perimenopause and menopause are unavoidable, there is good news! Thankfully, we have options as far as relieving uncomfortable, painful, or bothersome symptoms. If your symptoms are interfering with your daily life options include the following:

• Hormonal birth control pills: In the years before menopause, these pills can help regulate irregular, painful, or heavy periods, as well as reduce hot flashes, vaginal dryness, and mood swings.
• Hormone Therapy: Many perimenopause and menopause symptoms are the result of lower estrogen and progesterone levels. Hormone therapy helps alleviate some of these symptoms by providing additional estrogen and progesterone which come in a variety of forms, such as pills, patches, rings, vaginal creams, and injections.
• Other medications: In addition to hormonal treatments, there are over-the-counter supplements and prescription medications to treat various symptoms
  • Antidepressants: May help with mood changes and hot flashes.
  • Calcium and Vitamin D: Calcium and Vitamin D are essential for maintaining bone health, and as women age, their risk for osteoporosis increases.
  • Black cohosh: This herb is often used to help reduce hot flashes and night sweats.
  • Soy: Soy contains isoflavones that have weak estrogen-like effects, and may help reduce symptoms such as hot flashes.
  • Red clover: Red clover is another herb that contains isoflavones, and is sometimes used to help relieve menopausal symptoms.
  • Probiotics: Probiotics can help maintain a healthy gut microbiome and may have a positive impact on overall health and mood.
  • Omega-3 fatty acids: Omega-3 fatty acids are essential for overall health and can help with mood regulation and hot flashes.
  • Vitamin E: Vitamin E is a powerful antioxidant that can help reduce hot flashes and improve overall health during menopause.
• Lifestyle changes: Eating a nutritious, balanced diet, exercising regularly, limiting alcohol, getting a good night’s sleep, and practicing mindfulness techniques can all help.

At Elam Health and Wellness, Dr. Stephanie Opusunju is a skilled internist who is here to help you through all phases of life. If you have questions about perimenopause or menopause or are concerned about your symptoms, book an appointment today.