Difference between revisions of "Treat Menopause Symptoms"
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== Steps == | == Steps == | ||
===Understanding the Changes that Cause Your Symptoms=== | ===Understanding the Changes that Cause Your Symptoms=== | ||
| − | #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.<ref>https://www.urmc.rochester.edu/ob-gyn/gynecology/menopause/stages.aspx</ref> | + | #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.<ref name="rf1">https://www.urmc.rochester.edu/ob-gyn/gynecology/menopause/stages.aspx</ref> |
| − | #*Pre-menopause begins with your very first period, continues through your reproductive years, and ends with your last menstrual cycle.<ref | + | #*Pre-menopause begins with your very first period, continues through your reproductive years, and ends with your last menstrual cycle.<ref name="rf1" /> |
| − | #*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.<ref | + | #*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.<ref name="rf1" /> |
| − | #*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.<ref | + | #*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.<ref name="rf1" /> |
| − | #*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.<ref | + | #*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.<ref name="rf1" /> |
| − | #*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.<ref | + | #*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.<ref name="rf1" /> |
| − | #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.<ref>http://www.mayoclinic.org/diseases-conditions/menopause/basics/symptoms/con-20019726</ref><ref>http://www.menopause.org/for-women/expert-answers-to-frequently-asked-questions-about-menopause/menopause-faqs-understanding-the-symptoms</ref> | + | #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.<ref name="rf2">http://www.mayoclinic.org/diseases-conditions/menopause/basics/symptoms/con-20019726</ref><ref name="rf3">http://www.menopause.org/for-women/expert-answers-to-frequently-asked-questions-about-menopause/menopause-faqs-understanding-the-symptoms</ref> |
| − | #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.<ref>http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3389841/</ref> | + | #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.<ref name="rf4">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3389841/</ref> |
| − | #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.<ref | + | #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.<ref name="rf4" /> |
| − | #*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|heart attack]] and [[Know if You Are Having a Stroke|stroke]].<ref | + | #*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|heart attack]] and [[Know if You Are Having a Stroke|stroke]].<ref name="rf4" /> |
| − | #*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.<ref | + | #*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.<ref name="rf4" /> |
===Treating the Symptoms with Prescription Medications=== | ===Treating the Symptoms with Prescription Medications=== | ||
| − | #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.<ref>http://www.womenshealth.gov/menopause/symptom-relief-treatment/menopausal-hormone-therapy.html</ref> | + | #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.<ref name="rf5">http://www.womenshealth.gov/menopause/symptom-relief-treatment/menopausal-hormone-therapy.html</ref> |
| − | #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.<ref | + | #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.<ref name="rf5" /> |
| − | #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.<ref | + | #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.<ref name="rf5" /> |
| − | #*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.<ref>http://www.drugs.com/pro/premphase-prempro.html</ref> | + | #*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.<ref name="rf6">http://www.drugs.com/pro/premphase-prempro.html</ref> |
#*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. | #*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. | ||
| − | #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.<ref | + | #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.<ref name="rf6" /> |
| − | #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.<ref>https://www.nhlbi.nih.gov/whi/factsht.htm</ref> | + | #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.<ref name="rf7">https://www.nhlbi.nih.gov/whi/factsht.htm</ref> |
#*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. | #*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 [http://my.clevelandclinic.org/health/diseases_conditions/hic-what-is-perimenopause-menopause-postmenopause/hic_The_Womens_Health_Initiative Women’s Health Initiative] study results for yourself. Even though the study results are rather detailed, a summary is provided here for your review. | #*Review the [http://my.clevelandclinic.org/health/diseases_conditions/hic-what-is-perimenopause-menopause-postmenopause/hic_The_Womens_Health_Initiative Women’s Health Initiative] study results for yourself. Even though the study results are rather detailed, a summary is provided here for your review. | ||
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#**Colon cancer: Six in 10,000 women may be less likely to develop colon cancer 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. | #**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. | ||
| − | #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.<ref>http://my.clevelandclinic.org/health/diseases_conditions/hic-what-is-perimenopause-menopause-postmenopause/hic_The_Womens_Health_Initiative</ref><ref> https://www.nhlbi.nih.gov/whi/factsht.htm</ref> | + | #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.<ref name="rf8">http://my.clevelandclinic.org/health/diseases_conditions/hic-what-is-perimenopause-menopause-postmenopause/hic_The_Womens_Health_Initiative</ref><ref name="rf9"> https://www.nhlbi.nih.gov/whi/factsht.htm</ref> |
===Using Natural Remedies=== | ===Using Natural Remedies=== | ||
| − | #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.<ref>http://www.womenshealth.gov/menopause/symptom-relief-treatment/natural-alternative-treatments-lifestyle-changes.html</ref> | + | #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.<ref name="rf10">http://www.womenshealth.gov/menopause/symptom-relief-treatment/natural-alternative-treatments-lifestyle-changes.html</ref> |
| − | #*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.<ref | + | #*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.<ref name="rf10" /> |
| − | #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.<ref | + | #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.<ref name="rf10" /> |
#*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. | #*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.<ref | + | #*Plus, plant sources and herbs can cause problems by interacting with some prescribed medications.<ref name="rf10" /> |
| − | #Make changes in your lifestyle. Take charge of making lifestyle changes that can help your body to handle the transition easier.<ref | + | #Make changes in your lifestyle. Take charge of making lifestyle changes that can help your body to handle the transition easier.<ref name="rf10" /> |
| − | #*[[Quit Smoking|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.<ref | + | #*[[Quit Smoking|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.<ref name="rf10" /> 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.<ref | + | #*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.<ref name="rf10" /> |
| − | #*Regular exercise can help to control your weight, improve your sleep, provide strength for your bones, and help with mood changes.<ref | + | #*Regular exercise can help to control your weight, improve your sleep, provide strength for your bones, and help with mood changes.<ref name="rf10" /> |
| − | #*Include [[Reduce Stress|stress-reducing]] and [[Relax|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.<ref | + | #*Include [[Reduce Stress|stress-reducing]] and [[Relax|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.<ref name="rf10" /> |
| − | #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.<ref>http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm049311.htm</ref> | + | #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.<ref name="rf11">http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm049311.htm</ref> |
| − | #*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.<ref | + | #*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.<ref name="rf11" /> |
| − | #*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.<ref | + | #*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.<ref name="rf11" /> |
| − | #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.<ref | + | #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.<ref name="rf11" /> |
===Dealing with Specific Symptoms=== | ===Dealing with Specific Symptoms=== | ||
#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. | #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.<ref>http://www.womenshealth.gov/menopause/symptom-relief-treatment/index.html</ref> | + | #*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.<ref name="rf12">http://www.womenshealth.gov/menopause/symptom-relief-treatment/index.html</ref> |
| − | #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.<ref | + | #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.<ref name="rf2" /> |
| − | #*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. <ref | + | #*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. <ref name="rf2" /> |
#*Two of the more commonly prescribed antidepressants for hot flashes are venlafaxine and Paxil. | #*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.<ref | + | #*Gabapentin is a drug primarily used for seizures, but is also helpful in treating hot flashes, headaches, and some mood symptoms associated with menopause.<ref name="rf2" /> |
| − | #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.<ref | + | #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.<ref name="rf12" /> 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. <ref>http://www.menopause.org/for-women/sexual-health-menopause-online/effective-treatments-for-sexual-problems/yoga-kegel-exercises-pelvic-floor-physical-therapy</ref> | + | #*Remaining sexually active during this time can help to maintain the elasticity of the vaginal walls. <ref name="rf13">http://www.menopause.org/for-women/sexual-health-menopause-online/effective-treatments-for-sexual-problems/yoga-kegel-exercises-pelvic-floor-physical-therapy</ref> |
| − | #[[Do Kegel Exercises|Do Kegel exercises]]. A varying degree of bladder incontinence is often experienced as the menopausal years approach. <ref | + | #[[Do Kegel Exercises|Do Kegel exercises]]. A varying degree of bladder incontinence is often experienced as the menopausal years approach. <ref name="rf13" /> 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.<ref | + | #*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.<ref name="rf13" /> |
| − | #*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.<ref | + | #*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.<ref name="rf13" /> |
#*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. | #*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. | ||
| − | #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.<ref | + | #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.<ref name="rf12" /> |
| − | #*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.<ref | + | #*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.<ref name="rf12" /> |
| − | #*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.<ref | + | #*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.<ref name="rf12" /> |
| − | #*Acupuncture has been shown to be effective for menopausal sleep issues.<ref>http://www.ncbi.nlm.nih.gov/pubmed/24398406</ref> | + | #*Acupuncture has been shown to be effective for menopausal sleep issues.<ref name="rf14">http://www.ncbi.nlm.nih.gov/pubmed/24398406</ref> |
#*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. | #*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. | #*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. | ||
| − | #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.<ref>http://www.ncbi.nlm.nih.gov/pubmed/8818400</ref> 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.<ref | + | #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.<ref name="rf15">http://www.ncbi.nlm.nih.gov/pubmed/8818400</ref> 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.<ref name="rf12" /> |
#*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. | #*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. | ||
#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. | #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. | #*A decrease in libido can also occur from mood swings, a natural decrease in testosterone with age, or emotional strain in the relationship. | ||
| − | #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.<ref | + | #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.<ref name="rf12" /> |
| − | #*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.<ref | + | #*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.<ref name="rf12" /> |
| − | #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.<ref> ref>http://www.womenshealth.gov/menopause/symptom-relief-treatment/index.html</ref> | + | #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.<ref name="rf16"> ref>http://www.womenshealth.gov/menopause/symptom-relief-treatment/index.html</ref> |
| − | #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.<ref>http://healthland.time.com/2012/06/12/vitamin-d-and-calcium-not-recommended-for-postmenopausal-women-says-u-s-panel/</ref> | + | #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.<ref name="rf17">http://healthland.time.com/2012/06/12/vitamin-d-and-calcium-not-recommended-for-postmenopausal-women-says-u-s-panel/</ref> |
| − | #*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.<ref | + | #*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.<ref name="rf17" /> |
| − | #*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.<ref>http://www.hsph.harvard.edu/nutritionsource/calcium-sources/</ref> | + | #*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.<ref name="rf18">http://www.hsph.harvard.edu/nutritionsource/calcium-sources/</ref> |
| − | #*If you doctor determines that you are at risk for osteoporosis, treatment options beyond calcium supplements are available that can help.<ref | + | #*If you doctor determines that you are at risk for osteoporosis, treatment options beyond calcium supplements are available that can help.<ref name="rf17" /> |
===Knowing When to Seek Medical Attention=== | ===Knowing When to Seek Medical Attention=== | ||
| − | #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.<ref | + | #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.<ref name="rf2" /> |
| − | #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.<ref | + | #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.<ref name="rf5" /> |
| − | #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.<ref | + | #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.<ref name="rf5" /> |
| − | #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.<ref | + | #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.<ref name="rf5" /> |
== Tips == | == Tips == | ||
