By Nelson Fong, MD, Lakeside Doctors Gynecology and Obstetrics
Menopause is a natural stage in a woman’s life that marks the end of her reproductive years, clinically diagnosed when you haven’t had a period for 12 consecutive months It typically occurs around age 51, but the transition period, called perimenopause, can last up to four years before that. While every woman’s menopause journey is unique, it’s common for periods to first become closer together and then gradually start spacing out before stopping altogether.
Feeling Like a Broken Thermostat? Tackling Hot Flashes, Night Sweats and More
Common symptoms of menopause include hot flashes, night sweats and vaginal dryness. Hot flashes, one of the most well-known symptoms, feel like a sudden, intense heat that starts in the core and radiates outward through the head and hands. Some women say it’s like opening an oven door, but it’s important to know that feeling hot all the time isn’t the same as experiencing a true hot flash. Hot flashes last a few minutes but can really impact daily activities.
Night sweats are similar but happen during sleep, causing sudden, excessive sweating that can wake you up, disrupt your sleep and leave you exhausted. These night episodes, along with other symptoms, can really affect your overall well-being.
The root cause of these symptoms is your body’s thermostat, located in your brain. Normally, it operates within a stable range, like your home’s thermostat keeping the temperature consistent. But during menopause, with estrogen levels dropping, that range shrinks, making your body overreact to temperature changes. This leads to hot flashes and night sweats as your body tries to cool off.
Vaginal dryness is another symptom caused by lower estrogen levels, which lead to thinning, drying and inflammation of the vaginal tissue. This can cause irritation, burning and pain during intercourse, which can negatively affect your relationships and sexual activity.
Beyond these noticeable symptoms, menopause can also impact your health in less obvious ways. Bone density loss accelerates significantly during menopause, increasing your risk of fractures later in life. Cholesterol changes, such as higher LDL (bad cholesterol) and lower HDL (good cholesterol), along with increased abdominal fat, can raise your risk of heart disease.
Hormone Replacement Therapy (HRT): Is it Right for You?
For women seeking relief from menopausal symptoms, hormone replacement therapy (HRT) can be an effective treatment by replacing the estrogen and progesterone that your body is no longer producing. HRT can alleviate symptoms like hot flashes, night sweats and vaginal dryness, as well as help protect against osteoporosis and bone fractures.
You can take HRT in different forms — pills, creams, or patches — and in varying doses. For women who experience vaginal dryness, localized estrogen treatments like creams, tablets or rings may be beneficial. Non-hormonal treatments are also available for managing symptoms like hot flashes and night sweats.
Deciding whether HRT is right for you is a personal choice. While it can greatly improve your quality of life, HRT isn’t without risks. These risks depend on the type of HRT, the dose, how long you take it and your individual health risks. Estrogen has been linked to slight increase in the risk of blood clots and stroke, while combined estrogen and progesterone therapy has been shown to slightly increase the risk of breast cancer. However, this increase is about 1% above the average risk, so it’s important to weigh the benefits of improved quality of life and make an informed decision with your healthcare provider.
Aging on Your Own Terms
Menopause is a natural part of aging, but it doesn’t have to mean your quality of life is on the decline. Middle age, often seen as starting around age 45, is a time when many people start thinking the best years are behind them and they are beginning a state of inevitable decline. I want to change that perspective. Yes, aging is part of life, but how you age and maintain your quality of life during the second half of your life is within your control. For some, HRT is part of that decision, while others prefer different options.
Whether you choose HRT or other treatments, the goal is to help you feel your best as you navigate this new chapter in life. Your health and well-being should be your priority, so make the decisions that are right for you!