Coping with Menopause
Every woman undergoes menopause at some point in her life and coping with menopause can be difficult for most women.
The average age of menopause is 51 years of age but it can occur as young as 30 or at age 60. If you have menopausal symptoms prior to that, it is known as premature menopause. The exact definition of menopause is the cessation of menstrual periods for a consecutive 12 months.
Symptoms of Menopause
While some women can slip through menopause with no symptoms or subtle symptoms. Others will have debilitating symptoms requiring some form of medical treatment.
Common medical symptoms include the following:
• Hot flashes—a sensation of bodily warmth that comes out of nowhere and that can be associated with facial flushing or sweating. Hot flashes tend to come and go, lasting anywhere from 10 seconds to 30 minutes.
• Night sweats—this involves waking up at night, usually drenched in sweat. Night sweats may simply be hot flashes that come on while you are sleeping.
• Mood swings—this can involve increased irritability, depressive symptoms, or symptoms of anxiety.
• Vaginal dryness—this is the result of a lack of estrogen produced by the ovaries that thins the vaginal mucosa making it drier. It is usually associated with pain on intercourse.
• Urinary tract symptoms—this can include an increase in bladder infections or urinary incontinence that is in part due to the thinning of the mucosal lining of the urethra, which is the tube that exits the bladder and leads to the outside.
• Osteoporosis—the lack of estrogen accelerates bone loss to the point where the bones can become brittle and you have an increased risk of fractures should you fall. Fractures can also occur spontaneously and unrelated to a fall. This is especially in the case of vertebral fractures.
• Insomnia—this can occur even if you don’t have any hot flashes and is related to the hormonal changes associated with menopause.
Help Coping with Menopause
If menopausal symptoms become too difficult to manage, there are many things you can do to alleviate the symptoms so you feel better while going through this inevitable change.
Some things you can do include the following:
• Lifestyle Changes. This includes having a personal fan to cool you during hot flashes, sleeping in a cool room with nonbinding pajamas and few blankets, exercising regularly, stopping smoking, stress reduction, and keeping a cool rag by the bedside (or a cool glass of water), which are things you can do if you wake up with hot flashes or night sweats.
• Hormone Replacement Therapy. This involves taking hormones the ovaries no longer make, such as estrogen and progesterone. The lack of estrogen is what normally contributes to the majority of symptoms and can be taken alone or in combination with progesterone.
Taking unopposed estrogen is generally considered unsafe if you still have your uterus because it can cause you to have an increased risk of endometrial or uterine cancer. Progesterone thins the uterine lining, decreasing the chances of developing cancer of the uterus.
Taking hormone replacement therapy is not without risk. While it was a popular treatment in the 1990s, research from the Woman’s Health Initiative (WHI) indicated that women who took hormone replacement therapy suffered from an increased risk of cardiovascular disease.
• Selective Serotonin Reuptake Inhibitors. This is also known as SSRI therapy. While normally used for depression, these medications (Prozac, Paxil, Lexapro, and Celexa) can also be used for the mood swings and insomnia associated with menopause. They can also be used to decrease the risk of anxiety in menopause.
• Benzodiazepines. These are anti-anxiety medications can be used for short periods of time to decrease the anxiety that can be associated with menopause. Some common anti-anxiety medications include Xanax, Ativan, Valium, and Klonopin (clonazepam). As they can be addictive, they are used at the lowest possible effective dose and for a short period of time.
• Black cohosh. This is an herbal remedy that is believed to curb hot flashes and night sweats.
Who can’t take Hormone Replacement Therapy? Some women should not take estrogen replacement therapy.
These include women with the following conditions:
• A history of blood clots
• A history of stroke
• A history of breast cancer
• Previous or current uterine cancer
• Heart disease
• A history of liver disease.
Most of the time, menopause passes without significant debility. If, however, you have severe symptoms, talk to your doctor about trying hormone replacement therapy or other alternative therapies for this condition.