Hot flashes are one of the primary discomforts of menopause. The good news is you don’t have to peel off layers, toss and turn in bed, or suffer in silence, even if you’re wary of traditional hormonal therapy. Hormones work great if you’re the right candidate!
Here are the top 8 things to know to help you navigate menopause without breaking a sweat.
1. Menopause is defined as not having had a period for one year. The average age has held steady at 51 and a half years, though the transition known as pre-menopause varies in length and experience among women. I suggest asking your mom or aunts when they went into menopause; knowing family history can shed light on your own experience.
2. The two most common complaints are hot flashes (also called hot flushes), which often disrupt sleep, and vaginal atrophy, in which the walls of your vagina become thinner and dryer due to reduced estrogen. Painful intercourse can be a result of vaginal dryness.
3. Traditional hormonal therapy, using estrogen and sometimes progestin, is proven to relieve symptoms. But in 2002, when a Women’s Health Initiative (WHI) trial appeared to flag an increased risk of breast cancer, heart disease, stroke, and dangerous blood clots, women backed away without knowing the details. People are scared of hormonal treatment without fully understanding what these studies were looking for, the information they gathered, and the stages of post-menopause the patients were in.
By having an honest conversation with your doctor that includes your family history and personal medical history, I believe there’s more wiggle room. Your doctor can assess your individual health profile to weigh the risks and benefits of estrogen or combination therapy.
4. That said, to reduce unwanted health risks, companies are developing more targeted estrogen treatments. Two examples: a suppository gel for building back vaginal walls or a transdermal estrogen cream that’s applied on the arm. Those doses are small and targeted, as opposed to systemic and possibly excessive.
5. Options for non-hormonal treatments are growing in response to patient demand. Recently the FDA approved a “bioidentical hormone,” a synthetic hormone derived from plant estrogen that is chemically identical to the estrogen women produce. Bioidentical estriol is a milder form of estrogen that binds to the estrogen receptors in your body with lower risk of adverse effects.
6. Another approach to relief is protecting sleep from sweat-drenched disruptions with a selective serotonin reuptake inhibitor (SSRI) called paroxetine, also FDA-approved. By regulating serotonin levels in the brain, similar to an antidepressant, this SSRI can substantially reduce the number of nighttime awakenings.
7. If you can add it to your tea, don’t fully count on it. While flaxseed, ginseng, and St. John’s wort might seem medicinal, there’s no evidence from the American College of Obstetricians and Gynecologists that these remedies help or hurt.
8. Obesity complicates matters. Adipose tissue, or fat tissue, has estrogen that prolongs bleeding. However, excess fat can interfere with your body’s ability to regulate temperature. Getting regular exercise – even with a daily walk – eating well-rounded meals, and managing your stress can provide both overall health benefits and postmenopausal relief.
Dr. Adrienne Galang specializes in women’s health, including obstetrics and gynecology. To make an appointment, call 914-328-8444.