Relieving Menopause Symptoms
While menopause is a natural process, the symptoms can be debilitating. And, contrary to conventional medical wisdom, there is a wide range of options to help you feel like yourself. Read on to learn more.
Relieving the Symptoms of Menopause
Toward the end of my second year in medical school, we had a lecture from a jovial OB/gyn to talk with us about managing menopause. “It’s malpractice,” he said, “if you don’t prescribe hormone replacement therapy (HRT) to your patients. I believe in it so strongly that I truly believe you’re committing malpractice if you don’t give hormones to your postmenopausal patients.” Three months later, in May of 2003, the Journal of the American Medical Association published an article on the risk of stroke in patients taking hormones in the Women’s Health Initiative Study (WHI). Not only did hormones increase the risk of stroke, the research showed, they also seemed to increase the risk of heart attacks, blood clots, and breast cancer. Over the next six months, more than 90% of women taking HRT stopped it for good, and I never heard another word about menopause treatments, let alone menopause itself, during the rest of my medical training.
For many physicians and clinicians, the story ends there. Hormones are dangerous, they say, you can’t take them. Or if you do, you have to stop within 2 years or within 5 years. Almost 20 years after that 2003 article, essentially nothing has replaced HRT as an effective way of managing menopausal symptoms for women.
Before I proceed, let me take a step back and talk about menopause, since it’s so rarely talked about anywhere else. Even the terminology can be confusing, so I’ll start at the very beginning.
Menopause is frequently defined as having had no menstrual periods for over one year. Perimenopause, in my mind, is the time between when a woman’s hormones start to change, often in her late thirties, until that time of no menstrual periods at all. The phrases “through menopause” or “done with menopause” are really combinations of the two concepts, reflecting the idea that hormones change, cycles change, and menstrual periods eventually stop. In all my communications with clients, I use the terms menopause (the absence of periods), perimenopause (periods that continue, but are different than they once were), and post menopause (the years after menstrual periods have stopped) to distinguish the different stages.
To be honest, I’ve always wanted to be the kind of physician who didn’t believe in HRT. I want to be the kind of physician who believes that menopause is not a disease, that it’s natural, that it doesn’t need to be medicated. I want to believe that women have been going through menopause since the beginning of time and doing it elegantly on their own and so nothing special has to happen in the postmenopausal years.
But . . . that’s not what I’ve observed. Many, many, many of my patients have endured postmenopausal symptoms that include but are not limited to the following:
Hot flashes
Night sweats
Fatigue
Depression
Anxiety
Heart palpitations
Insomnia
Panic attacks
Weight gain
Memory loss
Slow brain function
Joint aches
Hair loss
Low libido
And most of those patients have been told some version of “I’m sorry, there’s nothing that can be done” before they came to see me.
But that’s not true at all.
Because of that Women’s Health Initiative article, many physicians believe there’s nothing that can be done. While that may have been true in late 2003, it’s certainly not true now. There is actually a whole range of options that can help with these symptoms, starting with noninvasive approaches, such as meditation and deep breathing, and going all the way up to HRT, which these days can be done in highly effective and highly safe ways.
When I see a patient with symptoms of menopause, I start by assessing what their symptoms are and what they’ve previously tried. The most common debilitating symptoms are hot flashes and night sweats, but all the symptoms listed above—and more—are common. And, for better or for worse, the most common remedy that women have tried is “none.”
Hot flashes, for example, are generally a combination of low estrogen plus stress, so any treatment that produces estrogen or lowers stress is likely to be helpful. To help produce estrogen, we can try dietary changes, herbs and supplements, acupuncture, exercise, adjusting existing medications, or trying new medications. Strategies to reduce stress include meditation, deep breathing, yoga, psychotherapy, journal writing, exercise, and other lifestyle changes. I’ve seen all of those and more be helpful to manage symptoms. I’ve also seen HRT be helpful for hundreds of women; in some cases, it’s been life-changing.
HRT is a subject in and of itself, so I will be posting a separate blog post entitled “FAQs about HRT” in the coming weeks. The short version is that these medications can be used safely and effectively and should always be considered as an option for people suffering from symptoms of menopause.
In summary, though menopause is not a disease that in and of itself needs to be treated, it can be accompanied by symptoms that dramatically affect women’s lives. No one, in the 21st century, tells men that erectile dysfunction is a natural process that happens as they age, that they’ll get used to it, that they no longer need that physiological function, or that men weren’t meant to use that part of their anatomy at their age. The same needs to be true for women’s health. At Cormendi Health, we understand that none of the symptoms associated with menopause are irreversible and that highly effective treatments are available for every woman who wants them.
If you’ve been experiencing hot flashes, night sweats, or other symptoms of menopause, know that Cormendi Health is able to help. Click here to schedule an appointment with Dr. Stracks or Dr. Wynn to discuss the best options for you.
