Menopause is the time in a woman’s life when her period stops. It usually occurs naturally, most often between the ages of 40-58. The average age is 51. Menopause happens because the woman’s ovaries stop producing the hormones estrogen and progesterone. A woman has reached menopause when she has not had a period for one year.
Changes and symptoms can start several years earlier. This transition phase is called perimenopause and may last for 4 to 8 years. Each woman’s experience of menopause is different. Many women report no physical changes during perimenopause except irregular menstrual periods that stop when menopause is reached. Other women experience many combinations of the following symptoms:
• A change in periods – shorter or longer, lighter or heavier, with more or less time in between
• Hot flashes and/or night sweats
• Trouble sleeping
• Vaginal dryness
• Mood swings
• Trouble focusing
• Less hair on head, more on face
How severe these body changes are varies from woman to woman, but for the most part these changes are perfectly natural and normal. Below are some simple suggestions you can do to try and relieve common menopausal symptoms.
Hot Flashes and Night Sweats
Hot flashes are the most common menopause-related discomfort. They involve a sudden wave of heat or warmth often accompanied by sweating, reddening of the skin, and rapid heartbeat. They usually last 1 to 5 minutes. Hot flashes frequently are followed by a cold chill. Night sweats are hot flashes at night that interfere with sleep. If hot flashes and/or night sweats are interfering with your daily activities, don’t hesitate to seek relief. There are some easy and practical steps you can try:
• Sleeping in a cool room
• Dressing in layers, which can be removed at the start of a hot flash
• Drinking cold water or juice when you feel a hot flash coming on
• Using sheets and clothing that let your skin “breathe”
• Not smoking
You can also try to keep a written record of what you were doing just before the hot flash started. This might reveal some triggers for your hot flashes which you could then try to avoid. Exercise can improve your quality of life and may help with hot flashes. It will also help reduce your risk of heart disease and osteoporosis. Another technique of deep breathing, known as relaxation breathing, may also help reduce hot flashes.
Deep breathing, relaxation breathing, and paced respiration all refer to a method used to reduce stress. It involves breathing in (inhaling) deeply and breathing out (exhaling) at an even pace. Do this for several minutes while in a comfortable position. Slowly breathe in through your nose. With a hand on your stomach right below your ribs, you should first feel your stomach push your hand out, and then your chest should fill. Slowly exhale through your mouth, first letting your lungs empty and then feeling your stomach sink back. You can do this almost anywhere and several times during the day, whenever you feel stressed. You can also try this if you feel a hot flash beginning or if you need to relax before falling asleep.
Because different things can cause sleep problems, the solutions vary. If night sweats are disrupting your sleep, treating them could help you sleep better. If you find yourself getting up to go to the bathroom, try limiting fluids shortly before bedtime unless you need a cool drink to handle a hot flash. If you aren’t sure what is keeping you from getting to sleep or causing you to wake during the night or early in the morning, there are still some things you can do to get a good night’s sleep:
• Be physically active most days of the week but not within 3 hours of bedtime.
• Go to bed and get up at the same time every day, even on weekends, and avoid naps, if possible, in the late afternoon and evening.
• Have a bedtime routine that you follow each night—read a book or magazine, take a bath, etc.
• Make sure your bedroom and bed are comfortable for sleeping, and only use the bedroom for sleeping and sexual activity.
• Don’t eat a large meal close to bedtime, and stay away from caffeine later in the day.
• After turning off the light, give yourself about 15 minutes to fall asleep. If you don’t go to sleep, get out of bed, and only go back when you feel sleepy.
• Try relaxation breathing.
The drop in estrogen around menopause leads to vaginal atrophy (the drying and thinning of vaginal tissues) in many women. It can cause a feeling of vaginal tightness during sex along with pain, burning, or soreness. Over-the-counter water-based vaginal lubricants and moisturizers are effective in relieving pain during intercourse. For women with more severe vaginal atrophy and related pain, speak to your primary care provider about treatment options.
What about hormones for symptoms of menopause?
Some symptoms may require medical treatment. Hormone Replacement Therapy (HRT) uses hormones to ease the symptoms of menopause or to prevent osteoporosis. This type of treatment comes in a variety of types and doses such as pills, creams, or skin patches. The FDA recommends that HRT be used at the lowest dose that relieves symptoms for the shortest time needed. If you are not able to take hormones, other management options may be available.
Talk to your primary care provider about how to best manage menopause. Make sure the doctor knows your medical history and your family’s medical history. This includes whether you are at risk for heart disease, osteoporosis, or breast cancer. Then work with them to find the best treatment option for you.
The Department of Obstetrics/Gynecology & Infertility is concerned with diagnosis and treatment of diseases, problems, or pathology affecting the female reproductive system. Additionally, the department deals with wellness of the female population. Our board certified physicians provide complete obstetrical and gynecology care. Professional infertility services include routine evaluation of infertile couples, diagnosis of infertility problems and treatment such as induction of ovulation and artificial insemination. Call 563-584-4435 to schedule an appointment.
National Institute on Aging
The North American Menopause Society