Women2Women - Fall 2017 - 40

Health2Wellness

Stages: menopause
M

enopause is a normal stage of a woman's
reproductive cycle when menstrual cycles
stop completely. Natural menopause occurs
between ages 40 and 58, averaging around age
51. Because the average age of menopause is 51
years and the average age of death of women
is the US is 79 years of age, you will likely be
spending one third of your life in menopause.
Menopause happens when the ovaries stop
making estrogen and progesterone. Menopause
is not a disease that needs to be treated. In
fact, while most people think of negative
symptoms when referring to menopause, for
many women never having another menstrual
cycle can truly be a cause of celebration. Your
attitude about menopause as well as aging in
general can have a significant impact on your
experience of it. Studies have shown that
negative beliefs held prior to menopause are
predictive of more significant menopausal
problems. For instance, the more negative
your thoughts about hot flashes, the more
intense they will be.
The years leading to menopause are called
perimenopause. Beginning in your 30s to
40s, the amount of estrogen produced by the
ovaries begins to fluctuate and your menstrual
cycles start to change. Perimenopause is the
mirror image of puberty, but with all the
responsibilities and wisdom that middle age
can bring. Let's review some common issues
women may experience and some strategies
to deal with them.
Common symptoms of perimenopause and
menopause are hot flashes and night sweats,
otherwise known as "power surges." A hot
flush is a sudden feeling of heat that rushes
to the upper body and face that lasts a few
seconds to several minutes. Postmenopausal
hormone replacement therapy is the most
effective treatment of hot flushes and night
sweats and is relatively safe in many women.
The decision to proceed with hormonal
therapy is highly individual and should
be carefully discussed between the woman
and her health care provider while carefully
weighing her risks, benefits, and goals of
therapy. Other non-hormonal treatments
for hot flushes and night sweats include
mind-body approaches such as cognitive

40 Women2Women Fall 2017

Natural menopause occurs between ages 40 and 58,
averaging around age 51.
behavior therapy, hypnosis, acupuncture
and mindfulness-based stress reduction.
Paroxetine (Paxil), a selective serotonin
reuptake inhibitor (SSRI), is the only nonhormonal medication approved by the FDA
for treating hot flushes. However, other
related antidepressants have also shown to
be effective for treating hot flushes. Studies
have shown that weight loss helps lower the
intensity of hot flushes.
Phytoestrogens found in soy act like estrogen in the body and may be helpful in some
women. There is limited evidence for black
cohosh, evening primrose oil, ginseng, dong
quai, wild yam or red clover to support their
use for hot flushes and night sweats.
Hot flushes that occur at night are called
night sweats and may wake you up feeling
drenched. Night sweats can cause you to
feel tired, sluggish and irritable during the
day. Strategies to stay cool while you sleep
include dressing in light nightclothes, layered
bedding, or wicking materials. Also, keep the
room temperature cool or cool down with an
electric fan, sip cool water throughout the
night, keep a frozen cold pack under your
pillow and turn over the pillow often so that
your head is always resting on a cool surface,
or put a cold pack on your feet.

Up to 60 percent of menopausal women
experience insomnia. Strategies that can help
include establishing a regular, consistent sleep
schedule. Relax by reading a book, take a
warm bath, drink a cup of herbal tea. Keep
the bedroom dark, quiet and cool to support
sleep. Avoid caffeine, alcohol and exercise
late in the day.
Depression and anxiety are common during
menopause. Hormone fluctuations in perimenopause can create feelings of being out
of control. Relaxation and stress-reduction
techniques including deep-breathing exercises, massage, and enjoyable, self-nurturing
activities are helpful. When women actually
make themselves a priority for even as little as
15 minutes a day, dramatic changes can occur.
Discussing mood issues with your physician can
help you identify the causes and decide on the
most appropriate treatments. For depression
or anxiety, prescription medications may be
necessary to correct a chemical imbalance.
Antidepressant therapy is more effective when
combined with counseling or psychotherapy.
Menopause can also lead to genitourinary
syndrome. The lining of the vagina becomes
thinner, dryer and less elastic. Vaginal dryness
may cause pain during sex. Vaginal infections
may occur more often. The urethra can become



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