Understanding the Menopause Transition
If it has been twelve months or more since your last period, then congratulations: you are in menopause. If you have your ovaries surgically removed, you go through menopause immediately following surgery. For everyone else, menopause typically happens in your late 40’s or 50’s. At this point, you can no longer get pregnant, and your estrogen and progesterone levels have dropped significantly. Testosterone levels also decline during this stage of life. Perimenopause starts several years before menopause, during which time your hormones - and your mood - can fluctuate wildly. Many people also start to experience:- Hot flashes
- Difficulty sleeping
- Changes in sex drive
- Weight gain
- Mood swings
The Importance of Empowering Women Through Menopause
It’s hard to overstate the importance of removing the stigma from menopause while increasing the support people receive during perimenopause and menopause. Ultimately, silence has served as a harmful barrier to evidence-based care for the treatment of menopause symptoms and the prevention of menopause-related health problems. Thankfully, there is a growing movement of women and others with female reproductive organs* advocating for a new approach to menopause and aging in general. No longer is menopause a dirty word, and aging women are far less willing to suffer in silence. We are encouraging each other to get educated on how to stay strong and healthy, live vibrant and full lives, and make our voices heard even if no one seems particularly eager to hear them. It makes sense, right? If half the population goes through menopause, we should be talking about it - freely, openly and with pride! We should also feel empowered to ask for evidence-based care from our providers to help ease the symptoms that can torpedo our quality of life. By advocating for ourselves and others going through this transition, we can also help prevent the many diseases and health problems we are more susceptible to because of menopause.Supporting Women’s Health During Menopause
In the 1960s, hormone replacement therapy (HRT) was introduced as a way to reduce menopause symptoms caused by the loss of estrogen. Although it became wildly popular almost immediately, HRT was soon wrapped in controversy, due in part to a complex tangle of flawed research studies and misinterpretations of those studies. It’s also fair to say that fear-mongering, along with a societal belief that women shouldn’t need treatment for a “natural process” like menopause, made it almost impossible for accurate information about HRT’s safety to cut through the noise. Even now, with ample evidence suggesting that the benefits of HRT appear to far outweigh the risks for most people, many healthcare providers and the public continue to question whether HRT is an appropriate treatment for menopause. Fortunately, an increasing number of healthcare providers have been willing to let research guide their interventions, and the past few years have seen a surge in comprehensive menopause care, including HRT. Providers also have become more vocal about encouraging midlife patients to prioritize “strong over skinny,” emphasizing strength-training and protein intake over weight loss.Evidence-Based Treatment Options
Most FDA-approved treatments for symptoms focus on hot flashes. However, hot flashes are just one of many symptoms people experience during perimenopause and menopause. Mood swings, sleep problems, bone density loss, pain during intercourse and reduced sex drive are just a few of the numerous other symptoms people experience as a result of fluctuating hormones. Among the treatments for menopause symptoms include:- Estrogen Therapy: Effective for hot flashes, sleep problems and bone health. Available as a patch, as a pellet inserted under the skin, and as a vaginal cream. Although estrogen therapy isn’t appropriate for everyone, experts estimate just a fraction of women who would likely benefit from it are currently receiving HRT.
- Progesterone Therapy: Prescribed in addition to estrogen to reduce cancer risk in people who still have a uterus. Usually taken in capsule form.
- Testosterone Therapy: Although testosterone is not approved by the FDA as a treatment for menopause symptoms, many providers prescribe it for women experiencing low libido. It may also help reduce muscle loss associated with menopause. It is typically administered as either a topical cream or is added to the pellet in combination with estradiol.
- Antidepressants: For the mood fluctuations that women experience during perimenopause and menopause, anti-depressants continue to be the most commonly prescribed remedy, although some women report relief of symptoms from HRT alone. LynLake offers medication management for those who explore this pathway.