Often referred to as the change of life, menopause is a time of transition that women experience during midlife. With menopause comes several questions, such as When to expect it? How do I regulate my hormones? And is there anything I can do about those annoying hot flashes? Women's health specialist Annie Siewert, MD, walks us through what to expect.
Menopause is kind of reverse puberty and it's hormonal chaos. So it's very important for people to understand that there are things that we can do to help ease that a little bit. It's a natural process, but I think it's really important to know that we can make it not feel as bad. Starting the conversations with your providers can hopefully help direct you where you need to be.
How do I know I am going through menopause?
So, menopause itself is basically a day in a woman's life. It is, by definition, it is when a woman has not had a period in 12 months. So that is really just a day, but perimenopause, the transition, can be very variable, like can last greater than 10 years on the front or back side of the actual menopause definition date.
What are some normal changes that women may experience?
Well, it's all technically normal. It certainly doesn't feel normal sometimes when a woman is experiencing it, but classic symptoms would be hot flashes, night sweats, sometimes some sensation of anxiety or feeling overwhelmed, difficulty coping with situations that they normally could. Insomnia is a big one, especially because of night sweats. There is a musculoskeletal syndrome of menopause that occurs with achy joints and muscles and vaginal dryness is another one that plagues many women.
At what point should a woman go and see her doctor?
I think it is an important thing to discuss as women are entering into their mid-40s for sure, but when they should seek medical care is when these symptoms or however they're feeling is starting to impact their daily life. That is a problem, and we need to take care of that. An OB/GYN can handle and manage most symptoms that occur during the menopausal transition, but lots of family practice and internal medicine doctors are very seasoned in taking care of women in this age group.
At what point does hormone therapy help; when should that be started?
In my personal practice, I start hormone therapy and I offer it to patients who are good candidates whose symptoms are impacting their life and they want to feel better. If someone's having significant hot flashes or night sweats that's impacting their activities, I have women who are executives who are in meetings that are having horrible hot flashes that's impacting their approach to their careers. I have women who are working moms who can't sleep at night and that, of course, is making them tired and having difficulties with their family relationships. So I think especially those situations are when hormone therapy can be really beneficial.
Do I still need to see a gynecologist for annual exams after menopause?
All women should have an annual exam. It doesn't necessarily have to be an OB/GYN, but of course they can seek their OB/GYN for their breast and pelvic exams, but lots of family practice and internal medicine doctors will do the same well-woman exam. So every year a woman should see a physician.
Best advice or encouragement that you have for patients and women that are going through this?
I think it is really important for women to know that this is a time in their lives that is oftentimes swept under the rug, but can be very miserable for them. And I think it's really important for them to know that there's options, there's lots of things, even there's lots of options besides hormonal therapy if they're not good candidates. There's things that we can do to help. And I think it's really important to start those conversations. As soon as they start having symptoms or issues that they think they need to be dealt with.
