Treat Menopause Symptoms

Menopause is the natural biological transition that happens when your ovaries stop producing hormones. The resulting decrease in circulating hormone levels clearly has a negative impact on your quality of life during this time. With the right outlook, some practical steps, and a little bit of medical assistance, most women find that they can experience a great deal of relief.

Steps

Understanding the Changes that Cause Your Symptoms

1. Know the stages of menopause. By understanding the stages of menopause, you can better understand the symptoms, determine where you are in the process, and prepare for what is coming next. The four stages of menopause include pre-menopause, peri-menopause, menopause, and post-menopause.
   • Pre-menopause begins with your very first period, continues through your reproductive years, and ends with your last menstrual cycle.
   • Peri-menopause includes the years immediately before you begin menopause. For most women, peri-menopause usually begins in your 40s, and lasts for about four years, although many women experience peri-menopausal symptoms for as many as 10 years. During this time you may experience irregular periods, as well as some of the symptoms routinely associated with menopause.
   • Menopause is actually determined after your final period. Once you have gone for one year without a menstrual period, you have technically been through menopause. The average age for menopause is 51, but it can occur earlier or later, and still be considered normal.
   • Post-menopause begins after your last period, and lasts for the remaining years of your life. Menopausal symptoms can linger for one to two years in most women, but they eventually taper off.
   • The post-menopausal years are associated with increased risk for health problems related to lower levels of estrogen and progesterone. Two primary areas of focus include osteoporosis and heart disease. Your doctor will help monitor for changes related to these conditions.
2. Recognize the symptoms of menopause. The common symptoms that occur during menopause include hot flashes and night sweats, vaginal dryness, pain with intercourse, problems sleeping, headache, weight gain and slowed metabolism, mood changes, problems with memory, thinning hair, dry skin, decreased sex drive, urinary changes, and loss of breast fullness.
3. Make sense of your symptoms. Not everyone has problems during menopause, but some women experience severe symptoms. Hormones, like estrogen and progesterone, play a role in many parts of your body. As your ovaries lose their ability to make enough natural hormones, the receptor sites located all over your body begin to notice.
4. Know what can happen next. Estrogen and progesterone receptors are found all over the body. The symptoms experienced during menopause are directly related to the lack of the natural hormones binding to those receptors. The receptors are located in your brain, skin, heart, and your bones, to name a few. Realizing where the receptors are, helps to explain why you are having those unwanted symptoms during menopause.
   • The absence of these hormones increases your risk of developing serious health problems once menopause has past. Two of the more serious complications include an increase in your risk of osteoporosis which can result in bone fractures, and heart and blood vessel disease that can lead to cardiovascular conditions including Identify Female Heart Attack Symptoms and stroke.
   • Talk to your doctor about your medical conditions, and any additional steps and lifestyle changes you should take to keep yourself as healthy as possible.

Treating the Symptoms with Prescription Medications

1. Talk to your doctor about your symptoms. Let your doctor know the most troublesome symptoms you are experiencing, and ask about medications that can help you manage those symptoms during this difficult time. Many women do not find the symptoms severe enough to warrant taking medications. Yet sometimes the symptoms can be extreme, interfere with your ability to function at work and at home, and cause both physical and mental distress.
2. Take prescription menopausal hormone therapy. Menopausal hormone therapy is a new name for hormone replacement therapy. This type of treatment involves taking both estrogen and progesterone. If you no longer have a uterus (due to hysterectomy), then you would just take estrogen.
3. Choose a method of administration that suits your needs. Menopausal hormone therapy provides estrogen and progesterone, or just estrogen, to supplement those hormones as your body adjusts to the transition. Products that contain these hormones are available in a variety of forms to suit your needs. Some examples of available forms include tablets, capsules, vaginal gels, patches, and topically applied products.
   • Taking menopausal hormone therapy has been proven to help with many of the symptoms associated with menopause. They work by providing a balance of hormones throughout the body to counteract the symptoms that occur during menopause.
   • Transdermal preparations are considered safer and more effective for managing mood symptoms because they avoid the first pass through the liver, decreasing blood clots. They also don't affect libido as much as pills.
4. Avoid menopausal hormone therapy if you have certain conditions. Do not take menopausal hormone therapy if you have vaginal bleeding with an unclear cause, a history of breast cancer, a history of uterine or ovarian cancer, a history of thromboembolic problems including DVT, pulmonary embolism, stroke, or heart attack, liver problems, or if you have a genetic condition that increases your risk of blood clots. Your doctor will know if it is safe for you to proceed with menopausal hormone therapy.
5. Know the facts about the benefits and the risks. A major clinical study, called the Women’s Health Initiative, was started in 1991 and lasted for 15 years. The study focused on women that were prescribed hormonal medications, 50 to 79 years of age, and included nearly 162,000 women.
   • The study results have provided a better understanding of the risks and benefits associated with the use of hormonal drugs in this population of women. The focus of the study was on the use of prescribed medications. Most healthcare professionals consider the results of this study to help determine the best course of treatment for their patients.
   • Review the Women’s Health Initiative study results for yourself. Even though the study results are rather detailed, a summary is provided here for your review.
   • A slightly higher risk was identified for women taking hormonal medications in the following areas:
     • Breast cancer: Eight women in 10,000 may develop breast cancer who would not have gotten it if they had not been taking hormones.
     • Heart attack: Seven women in 10,000 women may have a heart attack who would not have had one if they had not been taking hormones.
     • Stroke: Eight women in 10,000 women may have a stroke who would have not have had strokes had they not been on the mediation
     • Blood clots: 18 women in 10,000 may experience blood clots in the lungs or legs who would not have experienced blood clots if they had not been taking hormones.
   • A slightly higher benefit was identified for women taking hormonal medications in the following areas:
     • Hip fracture: Five in 10,000 women may be less likely to fracture their hips due to taking the medication.
     • Colon cancer: Six in 10,000 women may be less likely to develop colon cancer due to taking the medication
     • General bone fractures: Statistics are not provided, but the study authors concluded that fewer bone fractures are expected in the medication group as compared to the group not taking the medication.
6. Consider other risk factors. Other lifestyle factors should be considered in making your decision about menopause hormone treatments. Some things that can add to the risks and warrant your consideration include smoking, a family history of breast cancer and heart disease, your weight, and your level of physical activity.

Using Natural Remedies

1. Change your diet to include natural soy products. Soy contains phytoestrogens, which are substances that can act like natural estrogen in your body. Natural sources of soy include tofu, tempeh, soymilk, and soy nuts.
   • Some products claim to reduce menopausal symptoms by using natural ingredients, like soy. Since the manufacture of these products is not regulated in any manner, natural products may not always be reliable or even safe.
2. Use natural herbs that contain phytoestrogens. Some herbs contain varying amounts of phytoestrogens. Some examples include black cohosh, wild yam, dong quai, and valerian root. Many of these herbs can be made into different forms of administration, like oral tablets or topical creams.
   • Use caution with natural or herbal sources of phytoestrogens. Many herbs claim to provide benefit with hot flashes. Talk to your doctor if you decide to use herbs to treat your symptoms. The safety and reliability of these products is unknown.
   • Plus, plant sources and herbs can cause problems by interacting with some prescribed medications.
3. Make changes in your lifestyle. Take charge of making lifestyle changes that can help your body to handle the transition easier.
   • Quit smoking. If you are a smoker, try to quit. Smoking can trigger hot flashes, weaken your bones, and irritate your bladder which may already be more sensitive. Smokers also tend to go through menopause two to three years earlier than non-smokers.
   • Eat a healthy diet. Limit alcohol and caffeine, and maintain a good balance of foods in your daily food choices. Eating a well-balanced diet can help to provide you with the energy you need and avoid gaining weight during this time as your metabolism begins to slow down. You may want to include some of the natural soy products in your diet.
   • Regular exercise can help to control your weight, improve your sleep, provide strength for your bones, and help with mood changes.
   • Include stress-reducing and relaxation activities to help you cope with the symptoms you experience. Meditation, mindfulness exercises, and yoga, are a few ways to help control your stress.
4. Beware of products claiming to be “bio-identical.” Unless your doctor prescribes you Estrogel or Prometrium, be careful of companies trying to sell you their product. Some companies are making false claims of benefit by taking “bio-identical hormone replacement therapy,” or BHRT. Another commonly used name for this group of products is “compounded bio-identical hormone replacement therapy,” or “compounded-BHRT.” There is no scientific evidence to support the claims being made about the use of these products.
   • Some of the advertising claims about BHRT drugs include statements like, “A natural and safer alternative to prescription drugs,” “…can slim you down by reducing hormone imbalances,” “Prevents Alzheimer’s disease and senility,” and “…can cure or prevent heart disease.” There is no clinical research or valid scientific evidence to support these advertising claims.
   • An additional advertising claim describes using a saliva sample that provides your exact hormone levels in order to make a compounded BHRT drug that is specific to your needs. Saliva samples are far from reliable measures of your own levels of hormones. Hormone levels that can be measured in your saliva change depending on what time of day the sample is taken, and are naturally different from one day to the next. Other unknown variables can also alter the saliva test results. This is not a useful or scientific method in determining the best treatment options for you.
5. Use compounded forms of medications if you have allergies. In rare cases, someone may be allergic to the filler ingredients used in a manufactured menopausal hormone therapy product. If you have this type of allergic reaction, then your doctor can write a prescription that identifies the exact ingredients safe for you to use. This prescription can be filled at a specialty compounding pharmacy.

Dealing with Specific Symptoms

1. Manage your hot flashes. Try dressing in layers so you can remove some items of clothing when you experience a hot flash. Wear clothing made of natural fibers like cotton. Keep sandals nearby, so you can remove your socks and shoes.
   • Consider adding a room-size fan, or even a smaller personal-size fan, to your work area or rooms where you spend most of your time. You may also try slow and controlled breathing when you feel a hot flash beginning.
2. Consider other types of medications that are sometimes helpful. If menopausal hormone therapy is not right for you, other medications have been shown to be helpful with handling the hot flashes associated with menopause.
   • Low-dose antidepressants called selective serotonin reuptake inhibitors can help to manage hot flashes, plus this type of agent also helps with mood swings associated with menopause.
   • Two of the more commonly prescribed antidepressants for hot flashes are venlafaxine and Paxil.
   • Gabapentin is a drug primarily used for seizures, but is also helpful in treating hot flashes, headaches, and some mood symptoms associated with menopause.
3. Treat vaginal dryness. Using a lubricant can help to reduce vaginal dryness, as well as help with some of the pain associated with intercourse. Vaginal lubricants are available over-the-counter can be water- or silicone-based. Water-based lubricants include products like Replens®, K-Y Jelly® and Astroglide®. Silicone-based lubricants include Eros®, Wet Platinum®, ID Millennium® and Gun Oil®. Vaginal estrogen is also available in several formulations and provides estrogen directly to the vaginal mucosa.
   • Remaining sexually active during this time can help to maintain the elasticity of the vaginal walls.
4. Do Kegel exercises. A varying degree of bladder incontinence is often experienced as the menopausal years approach. Kegel exercises can help build the pelvic floor muscles and assist with urinary incontinence.
   • The first step in doing Kegel exercises is to identify the muscles you are supposed to contract and relax. Try stopping the flow of your urine while you are urinating. If you can do this, then you have identified the muscles you need to strengthen. Do not continue to stop your stream of urine since this can cause unwanted problems.
   • Now that you know the basic move in a Kegel exercise, try to hold your muscle contractions for two or three seconds, then relax. Contracting, holding, then relaxing is one complete exercise move. 10 repetitions make up one set. Try to do five sets of 10 repetitions each day. You can do this while driving or even seated at your desk while working. Be sure your bladder is empty when you do the exercise.
   • If incontinence is problematic and you can't figure out the correct muscles to exercise there are physical therapists who specialize in working with women to target these muscles.
5. Improve your sleep. Increasing your physical activity can help to address any sleep problems you may experience, plus this can help to maintain a healthy weight. Avoid exercising immediately before bedtime.
   • Other steps that can help with sleep problems include avoiding large evening meals, caffeine after noon, and alcohol near bedtime. Try drinking something warm and caffeine-free, just before bed.
   • Keep your bedroom dark, quiet, cool, and use your bed just for sleep or sex. Avoid watching television or playing video games just before trying to sleep. Avoid napping during the day, and try to go to bed and get up at the same times every day.
   • Acupuncture has been shown to be effective for menopausal sleep issues.
   • Consider asking your doctor for a medication that can help. Short-term use of agents used for insomnia may help you get the sleep you need during this transition. Zolpidem and eszopiclone are controlled prescriptions and come with risks such as abnormal behavior and risk of dependence and abuse. Safer medications for sleep such 1mg of melatonin, 25mg of Trazodone, or 10mg of Doxepin may be suggested.
   • The treatment for insomnia that has the most evidence for long term effectiveness is CBT-I, cognitive behavioral therapy for insomnia. Low dose progesterone is also helpful for sleep in menopausal women.
6. Treat the mood changes. Estrogen exerts profound effects on mood, mental state and memory by acting on both "classical" monoamine and neuropeptide transmitter mechanisms in brain. Recognize that this is not the time to be taking on more than you can handle. Manage your daily responsibilities with a positive attitude. Try to avoid becoming overwhelmed and negative. Consider finding a support group that includes other women dealing with the same changes.
   • Some mood changes such as depression and anxiety (which are common during menopause) can't be treated with a positive attitude. Women with significant mood symptoms should see a doctor for medications and consider psychotherapy.
7. Consider your sexual health. Decreases in estrogen can cause vaginal tissue to change and sex to become painful. If this is the case, you may want to talk to your doctor about taking osphena, a non hormonal treatment for painful intercourse.
   • A decrease in libido can also occur from mood swings, a natural decrease in testosterone with age, or emotional strain in the relationship.
8. Pay attention to problems with memory and concentration. Many women feel they have trouble focusing and notice a change in their memory function as they go through menopause. While there is little biological evidence to support these types of changes, taking care of yourself in a well-rounded manner can help.
   • If you continue to have trouble, talk to your doctor about treatment options. In some cases, there may be an underlying cause for your problem, such as the beginnings of depression.
9. Talk to your doctor about other symptoms. Some women experience additional problems such as frequent headaches, urinary problems, and dry skin. While menopausal hormone therapy can help to address many symptoms, there may be other options that can help with individual problems.
10. Take steps to combat osteoporosis. Due to the rapid loss of bone in the first few years after menopause, your doctor may recommend adding calcium supplements to your daily regimen; however, a recent finding by the US Preventive Services Task Force recommends against taking large doses of calcium during your menopausal and post-menopausal years. This topic is somewhat controversial.
    • Talk to your doctor to determine how much calcium and vitamin D your body needs. Lab tests can be done to measure your bone density and current calcium stores in your body. This is the best guide to determining your need for calcium and vitamin D supplements.
    • Natural sources of calcium and vitamin D are a part of any healthy diet. Sources include low-fat and nonfat milk and yogurt, hard cheeses, collard greens, tofu, calcium-fortified orange juice and breakfast cereals, sardines, and canned salmon with bones. The best natural source of vitamin D is natural sunlight.
    • If you doctor determines that you are at risk for osteoporosis, treatment options beyond calcium supplements are available that can help.

Knowing When to Seek Medical Attention

1. Watch for episodes of spotting or bleeding. Vaginal bleeding during menopause is not normal. If you experience any episodes of vaginal bleeding, call your doctor as soon as possible.
2. Contact your doctor if you develop bloating or nausea. These are not common side effects of the medication or normal symptoms of menopause. If you feel bloated, or have bouts of unexplained nausea, let your doctor know as soon as possible.
3. Seek medical attention if you notice changes in your breasts. Breast tenderness or swelling warrants medical attention. Any changes you may notice in your breasts can indicate a more serious condition, and you should notify your doctor as soon as possible.
4. Pay attention to headaches and mood changes. Even though these symptoms are sometimes experienced as you transition through menopause, they may also be warning signs of something more serious. Let your doctor know if you experience headaches beyond what is normal for you, or mood changes that are out of character.

Tips

• If you decide to take menopausal hormone therapy, take the lowest dose of medication that works for you, and consider stopping the medication once your doctor feels you can safely do so.
• Ask your doctor about medical advances that might be important to you during your menopausal and post-menopausal years.
• Be positive. Today's women spend a third of their lives postmenopausal. Consider menopause as a step forward in life and make it a change for the better.
• Get support. Friends, family, and other women going through the same changes can offer advice and reassurance to help you get through this transition. It really is a time of change.
• Do your homework. Preventive care recommendations and guidelines are changing all the time. Keep up with topics that are relevant to you, regarding the changes that are happening to your body.

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• Treat Menopause Naturally Without Estrogen Drugs
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