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Managing Menopause

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With life expectancies higher than ever, women today can expect to live more than one third of their lives after menopause, and treatment options are abundant. However, with all of these options comes confusion and conflicting studies about the pros and cons of the different treatments. Over 35 million U.S. women have gone through menopause, but 40 percent of women surveyed said they were not getting enough information about their health after menopause.

During menopause hormone levels fluctuate, causing a variety of symptoms including hot flashes, night sweats, dry vagina and mood swings. Symptoms can begin as early as in a woman's mid-thirties during what is known as perimenopause, a stage characterized by irregular menstrual cycles that can last for ten years. These symptoms may be more severe for women who have undergone surgery that resulted in early menopause.

Estrogen levels also decline and millions of women choose estrogen replacement therapy to ease their symptoms and for the health benefits associated with estrogen, although many of these benefits have been widely disputed. The main concern among women deciding whether to use estrogen is breast cancer. As of yet, there is no definitive word on the risks of breast cancer and estrogen. Many doctors though caution that media reports regarding estrogen and breast cancer have been highly exaggerated and that generally studies have not found any significant problems with the short-term use of estrogen. What does seem certain about estrogen though is that it does relieve symptoms like hot flashes and night sweats and it helps maintain bone health to guard against osteoporosis. Estrogen also may help with Alzheimer's disease and lowering cholesterol levels to minimize a woman's chances of cardiovascular disease, although the verdict is still out on estrogen's impact on heart disease. Estrogen has clearly been shown to increase the risk of uterine cancer, which is why some doctors combine it with progesterone. Doctors may also prescribe so-called designer estrogens that only act on the bones and heart, not on the breast and uterus, but they do not improve symptoms. Potent herbal and plant estrogens are also available.

Soy supplements are also gaining popularity and have been shown to reduce menopausal symptoms without the negative side effects, although soy might not work as quickly as estrogen. Japanese women who have taken soy for years appear to have fewer hot flashes and fewer complications from osteoporosis, heart disease and breast cancer. Soy is now available in pill form and although results have been promising, research about natural estrogen replacement is still in its infancy.

Different women have different symptoms so most experts advise women to consult their own physicians as to which treatment options are best for them based on their personal medical history. Communication is key. Studies have found that the majority of women and OB/GYNs are not completely comfortable discussing sexual problems that may arise during menopause and groups like the Red Hot Mamas stress that communication between a woman and her doctor is vital in helping women better understand the effects of menopause. In addition, doctors continue to recommend that all women get the right amount of nutrients, especially calcium and vitamin D, exercise regularly and stop smoking to offset the effects of menopause.

LINKS AND RESOURCES

The North American Menopause Society

Menopause Online

Minnie Pauz

Women's Health Interactive

Pfizer Women's Health