You Don’t Have To Suffer With Symptoms of Menopause

November 28, 2021

older woman fanning herself with an orange fan

Menopause and the time leading up to menopause can be unnerving and challenging, especially when hormonal changes lead to symptoms such as hot flashes and mood swings.

Jean Marino, a UH certified nurse practitioner who specializes in menopause, wants women to know there are many treatment options available to deal with symptoms. She also wants women to see the positive side of menopause.

“Menopause is normal. We should all be so fortunate as to get to menopause,” she says. “Remember to practice self-love and gratitude. Menopause doesn’t have to be anything to be scared about. This can be a really nice time of new beginnings, new freedoms.”

Don't Be Reluctant To Seek Treatment

Ms. Marino advises women to seek treatment for bothersome symptoms, whether you are menopausal or perimenopausal.

The average age of menopause onset is 51, but it can happen anytime between age 40 and 60. When it happens, women lose 90 percent of their estrogen.

“You have estrogen receptors everywhere. That drop off can really affect everything,” she says.

Hot flashes are the most common symptom, and can be severe and long-lasting for some women.
Mood changes can also be significant. Some women are particularly vulnerable. A history of depression increases risk of severe depression.
Other symptoms include brain fog, dry skin, weight gain, thinning head hair, difficulty sleeping, vaginal dryness, acne, joint pain, urinary tract infections and frequent urination.

Treatment Options

Menopause symptoms may be mild and not require treatment. But for bothersome symptoms, a number of prescription and non-prescription treatments are available.

Hormone therapy (estrogen) is the primary treatment for symptoms, as well as progestogen to protect the uterine lining.

Some women are concerned about health risks of hormone therapy. Women who start hormone therapy after age 60 and more than 10 years after menopause have a slightly elevated risk of heart disease, Ms. Marino says.

Ms. Marino follows guidance from the North American Menopause Society, which states that benefits of hormone therapy outweigh risks for women who start the therapy before age 60 and within 10 years of menopause.

The menopause society says:

Hormone therapy might slightly increase your risk of stroke or blood clots in the legs or lungs (especially if taken in pill form).
If started in women aged older than 65 years, HT might increase the risk of dementia.
If you have a uterus and take estrogen with progestogen, there is no increased risk of cancer of the uterus.
Hormone therapy (combined estrogen and progestogen) might slightly increase your risk of breast cancer if used for more than three to five years.
Using estrogen alone (for women without a uterus) does not increase breast cancer risk at seven years, but may increase risk if used for a longer time.
Non-hormonal options include several antidepressants or mood-disorder drugs. Cognitive behavior therapy also has been shown to be effective.

Genitourinary Syndrome of Menopause

Ms. Marino added that many postmenopausal women experience genitourinary syndrome of menopause (GSM), which can affect the vagina, vulva and lower urinary tract. It often is unrecognized and undertreated, she says.

Symptoms are vaginal dryness, itching, irritation, frequent urination, trouble with lubrication, arousal, orgasm, or pain with sexual play.

“Unfortunately, GSM affects at a minimum 50 percent of all postmenopausal women. Unlike hot flashes and night sweats that eventually should go away, this will never go away and just gets worse with time,” she says.

The good news, however, is there are a number of prescription and non-prescription remedies. Over-the-counter lubricants and moisturizers are an option for mild vaginal symptoms.

For more moderate symptoms or urinary symptoms; a prescription for vaginal estrogen, vaginal DHEA, or oral ospemiphene are safe and effective options without any increased risk of heart disease or cancer.