Menopause

Many women “sail through” menopause with few symptoms, but hot flashes of variable severity may require treatment with estrogen. Some women (those who have had breast cancer) should not take estrogen or substances that behave like estrogen in the body (certain herbs or “natural hormones” can have the same effect as prescription estrogen on the breast). For other women, estrogen can dramatically improve the quality of their lives. Current guidelines suggest that estrogen should be given in the lowest dose and for the shortest time possible to control symptoms.

If menopause occurs after the age of thirty-five, it is said to be normal. Some women experience failure of the ovaries to produce estrogen at a much younger age. This is called premature ovarian failure. In some people, this is linked with other hormonal, autoimmune or genetic disorders and in some it may be hereditary. Simple blood tests can distinguish premature ovarian failure from other causes of periods stopping at a young age. (see above).

Many women experience a time when periods still occur, but hot flashes may have started and periods may become different or more irregular. This is called the “perimenopause” and simply reflects the fact that the ovaries often lose their function gradually.

It is also important to understand that some symptoms are related directly to loss of estrogen, including hot flashes, poor sleep as a result of night sweats, vaginal dryness, difficult intercourse and dryness and irritation of the urinary outflow tract (urethra). These symptoms can be expected to be improved with estrogen. Other symptoms, such as fatigue, dry skin, poor memory, moodiness or depression, decreased libido, hair loss, etc, occur as part of aging in some women, are not caused by lack of estrogen and will not be cured by replacement.

Since most women spend a third of their lives in menopause, it is important to understand the changes that occur in the body and what we can do to stay fit and healthy.

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