One of the most challenging times in a woman’s life can be the onset of menopause. It can sneak up in many different forms and many women can mistake symptoms as just lack of energy due to busy schedules, or varying levels of depression.
By definition, menopause is when a woman has gone one year without a menstrual cycle, according to obstetrician and gynecologist Leigh Redden, M.D., who practices at Womens Group of Franklin.
“What menopause really is, is the end of fertility for a woman,” she said. “The average age for women to go through menopause is 51, but many women begin to experience pre- and peri-menopause before then. Some even in their 30s.”
Kim Scott, M.D., obstetrician and gynecologist also with Womens Group of Franklin, said the biggest misconception with menopause is that it varies so widely from woman to woman and that no two cases are alike.
“There is no one size fits all when it comes to menopause,” Scott said. “What’s good for one woman isn’t necessarily good for another and what works for a woman might not work for another. Women often ask me what menopause is going to be like and I have to say, ‘I don’t know.’ In my opinion, it’s very individualized.”
She added that women need to be open-minded and accepting of it. “It’s a part of life and at some point you are going to go through it, so you might as well talk about it and be ready for it when it does come.”
Some of the classic symptoms, aside from lack of a menstrual cycle, are hot flashes, night sweats, depression, mood swings, lack of energy, decreased libido and weight gain particularly in the midsection. Redden says unfortunately, these symptoms can last for years.
But don’t give up hope, because there are now a number of treatments ranging from behavioral changes to medications and hormone replacement therapy.
Make Some Changes
“Let’s start with the behavioral changes,” Redden said. “If you are having hot flashes during the day, I recommend always layering your clothing so that you can take off a layer as your body temperature rises. Cold drinks can also help bring the body temperature down, so I advise women to keep cold water or other drinks handy. Staying away from hot and spicy foods can also help, because spicier foods can actually trigger a hot flash.”
Scott added that it’s important to go into menopause as healthy as you can by making sure you lead a healthy lifestyle full of exercise, healthy eating and no smoking.
“Women do more these days than we’ve ever done before,” Scott said. “We are busier, we work full time, we manage kids and you have all this extra stress, and now you have menopause to deal with at the same time. Managing the stress is so important. I encourage women to eat right, avoid processed foods and get enough sleep.”
If a woman is dealing with moderate depression, Redden says low-dose anti-depressants can not only help with your mood, but have also been shown to have an effect on reducing hot flashes without adding in many of the risks and side effects of higher doses of anti-depressants.
Hormone Replacement Therapy
These days, women don’t necessarily have to suffer through the night sweats and hot flashes. There’s help, but unfortunately nobody has found a miracle pill just yet.
“I see women who still want to look and feel like they did when they were 20, and that just isn’t going to happen,” Scott said. “So I try to empower women with knowledge so they can know what to expect and can feel empowered about what’s going to happen.”
One rather successful remedy that has gotten a bit of a bad rap is hormone replacement therapy. Scott and Redden both agree that only your gynecologist should prescribe hormones and that bioidentical hormone clinics are not the safest place to turn.
“Hormone clinics are all about money and they are not run by gynecologists,” Scott said. “Women have to be very careful because they can spend thousands of dollars, which doesn’t necessarily equate to better treatment.”
Redden says before anyone starts on hormone replacement therapy, your physician should go over your personal health and family history then weigh the risks against it. For a woman who has no risk factors precluding estrogen use or history of breast cancer, hormone therapy can be a great solution to many symptoms. Some women are even a candidate for replacing just estrogen or testosterone as studies have shown it was the combination of estrogen and progesterone that increased the risk of breast cancer.
There are different types of replacement hormones that can be customized to fit a woman’s particular situation and designed to minimize the risks associated with the replacement of hormones.
Redden says hormone replacement therapy initially got a bad reputation after a study was published in 1998 called the “Women’s Health Initiative”. Redden and Scott agree that this study was flawed and hence produced a lot of inaccurate information that scared many women away from using hormone therapy. Many primary care physicians still won’t recommend hormone replacement.
“Women have traditionally used hormones,” Scott said. “In fact, not too many years ago, it was strongly encouraged. Now, the pendulum has swung back to where hormone therapy is an option again. We always weigh the benefits and the risk and individualize each patient and decide what’s best.”
Kim Scott, M.D., and Leigh Redden, M.D., are both board-certified obstetricians and gynecologists with Womens Group of Franklin. They are credentialed physicians at Williamson Medical Center. Their office can be reached by calling (615) 778-0010.Share this Article