Menopause
Menopause is a natural and spontaneous process that happens in three phases: The first phase is perimenopause, then menopause, and finally postmenopause.
- Perimenopause is a transitional period leading up to menopause when women experience physical and emotional changes related to fluctuating estrogen levels. Estrogen is produced by the ovaries. Perimenopause usually lasts about seven years but can last as long as 14 years!
- Menopause is defined as the complete cessation of menstrual periods for the 12 months after a woman’s last period. The average age at which menopause occur in America is age 51 but it can happen during your 40s or late fifties.
- Postmenopause is the time after menopause.
What are the symptoms?
85% of women going through perimenopause and menopause will experience problematic symptoms including:
- vaginal dryness
- sexual discomfort
- hot flashes
- chills and night sweats
- sleep disturbances
- mood swings – irritability, anxiety, fatigue, depression
- brain fog – difficulty concentrating and thinking clearly, forgetfulness
- weight gain
- slowing metabolism
- urinary incontinence
- thinning hair and dry skin
After menopause, genitourinary symptoms dominate including vaginal atrophy and dryness, and lower urinary tract symptoms like urinary frequency, urgency and nocturia. These symptoms can significantly impair health, sexual function, and quality of life.
How is menopause diagnosed?
When you meet with Dr. Dwaita Patel, she will review your medical and menstrual history, listen to your concerns, discuss your symptoms, and order blood tests to evaluate your thyroid function and sex hormones to confirm menopause. Thyroid disorders are common in women and share some of the symptoms of menopause.
What are the available treatments for menopause symptoms?
Hormone Replacement Therapy (HRT) remains the most effective treatment for genitourinary symptoms including vaginal atrophy and dryness, painful intercourse and urinary incontinence, and vasomotor symptoms including night sweats, hot flashes, and flushing. HRT also prevents bone loss and fractures.
Prescribing HRT, however, is a complex balance of benefits and risks. Dr. Patel will discuss the benefit and risks with you so you can make an informed decision about whether to use HRT.
All HRT is individualized for each patient based on the most appropriate type, dose, duration, route of administration and formulation, the woman’s age, symptoms, breast cancer risk, and general health. The goal of HRT is to maximize the benefits and minimize the risks.
Other treatment options include vaginal lubricants and moisturizers, vaginal estrogens, and DHEA (dehydroepiandrosterone). The choice of therapy depends on the severity of symptoms.
Treatments for the mood swings of menopause may include relaxation and stress reduction, good nutrition and daily exercise, and potentially, an antidepressant. Often, menopause coincides with many midlife changes, including loss of a spouse through divorce or death, empty nesting, caring for elderly parents, aging, and more. Dr. Patel will listen to your concerns and may refer you for medication and psychotherapy.
City OB+GYN is in Midtown East/Murray Hill, Manhattan. You will always be treated in a safe space with dignity and respect. Contact us to schedule a consolation today.
