The North American Menopause Society (NAMS) estimates that 6,000 women daily and more than 2 million women each year enter menopause.² Menopause occurs in three stages: perimenopause, menopause, and post menopause. Perimenopause is when estrogen levels begin sporadically increasing and decreasing, leading to irregular menstruation and adverse symptoms, such as hot flashes. Perimenopause begins the transition to menopause and can last for 5 years or longer. Menopause is defined as the final cessation of menstrual periods and is confirmed after 12 consecutive months of amenorrhea. A woman is then considered to be postmenopausal. At this time, her ovaries produce very little estrogen and no progesterone, and ovulation has ceased. Typically, a woman experiences natural menopause between the ages of 45 and 54 years.

For clarification, this article uses the NAMS terminology: ET refers to unopposed estrogen therapy; EPT refers to combination estrogen and progestogen therapy; and the term progestogen refers to both progesterone and progestins. NAMS describes progesterone as being identical to the hormone produced by the ovaries, whereas progestins are synthesized compounds that act like progesterone. HT refers collectively to both ET and EPT.³

http://www.jaapa.com/a-new-verdict-for-hormone-therapy-ht-safe-for-younger-symptomatic-women/article/158743/

“It is a necessary evil you have to go through,” said Dr. Robert Ogdee, obstetrician/gynecologist of Abilene Regional Medical Center.

But women may feel some relief when they understand the transition their bodies are going through physically and emotionally.

“What is happening is the ovaries are not producing any estrogen, so the brain is trying to tell the ovaries to kick in and produce more estrogen because they are not popping out an egg anymore,” Ogdee explained. “It is the quitting of ovulation every month that is the reason they do not pop out an egg or have a cycle, which is the true cause of menopause.”

Most women experience what are called perimenopausal symptoms, while some may be asymptomatic.

About 70 to 80 percent of women experience hot flashes, night sweats, mood swings and irritability, Ogdee said.

“Symptoms that get worse because the estrogen levels are dropping are decreased lubrication to the vagina causing pain during intercourse, pain with urination and having to go to the bathroom more frequently,” Ogdee said.

But women need to understand that the symptoms are temporary.

“It is a phase; it is not a permanent condition,” said Dr. Marjorie Gass, designate executive director of The North American Menopause Society.

It may help to understand exactly what menopause really means.

“By definition, menopause is one year without a period,” said Whitney Mascorro, obstetrician/gynecologist of Women’s Health Professionals at Hendrick Hospital.

For some, menopause is a natural process, whereas others experience surgical menopause from having their ovaries removed or go through menopause as a result of chemotherapy.

Those who experience early menopause should take extra precautions.

“It may pose a risk to your health, so you should pay particular attention to keeping your bones strong and doing things to prevent cardiovascular disease like living a healthy lifestyle, not getting overweight or excessively thin and not smoking,” Gass said.

The good news is that the discomfort can be managed.

“The most effective way is with hormone replacement therapy, replacing the hormones that are being diminished at this period of time with estrogen and progesterone,” Mascorro said. “This can be in the form of a pill, patch, gel, cream or spray and ranges in strength.”

The intent is to keep these treatments short-lived. “The goal with symptom control is the smallest dose for the shortest time,” Mascorro said.

Other remedies may also be helpful in dealing with the effects of menopause.

“If you cannot take hormone replacement therapy, we will prescribe antidepressants,” Mascorro said. “There is also a certain blood pressure medication that helps 50 percent of the time.”

There are also prescriptions available that provide plant-based or equine-based estrogen.

Some women may turn to alternative sources of relief.

“Black cohosh, red clover and soy products are options,” Gass said. “Slow-paced respirations can be beneficial. One of the anti-seizure medications has been shown to have a beneficial effect on hot flashes.”

There are also some precautions women can take that do not involve medication.

“Some people have luck with exercising,” Gass said. “You can pay attention to triggers of hot flashes like alcohol and spicy foods. You should not wear clothing that fits snuggly around your neck because that is one of the areas that is most sensitive to the heat.”

Dressing in layers may also be helpful in dealing with hot flashes.

Some women feel better by trying to become more in tune to their bodies.

“You can monitor your follicle-stimulating hormone levels, luteinizing hormones and estradiol,” said Linda Roark, medical technologist at Any Lab Test Now. “There are quite a few tests you can have to determine if you are going through menopause.”

Caregivers also emphasize that women should try not to worry about the phase they’re going through.

“It helps to talk to friends, see what they are experiencing and maintain a sense of humor,” Gass said.

And women should not be afraid or shy about asking questions of their gynecologist.

“You have to become your own advocate,” Roark insisted.