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Successfully Mastering the Menopause Transition Elizabeth Rash PhD ARNP FNP-C

Published on: January 30, 2013 | Category: Medical Health Topics

Menopause and the menopause transition (also known as peri-menopause) are defined by a woman’s bleeding patterns. As a woman approaches menopause, her menstrual bleeding may become more frequent and heavier. Later she may have less frequent or missed periods. Menopause occurs when a woman has had no periods for one full year. The time after that is known as post-menopause.

Unfortunately, there are no good tests to determine where a woman is in the menopause transition. Sometimes a hormone known as FSH is measured but this hormone level can fluctuate, making it an often-inaccurate marker for menopause.

A woman may experience a variety of bothersome symptoms: hot flashes, insomnia, moodiness, anxiety, weight changes, bladder problems or vaginal dryness that can lead to itching, painful sexual relations or even increased vaginal infections. Every woman is unique. Some may have more and others fewer of these symptoms. There’s no way to predict how you will experience the menopause transition but biology (your genetics), your lifestyle (diet and smoking) and your culture can influence the experience.

The hormone estrogen decreases in menopause and may increase risks for cardiac disease and bone loss (osteoporosis). Prevention through exercise, proper nutrition, weight management, blood pressure, cholesterol and blood sugar control are the best strategies to combat these risks.

There has been an evolution, or perhaps more of a revolution, in how we think about hormone therapy (HT). Years ago HT was considered safe and preventive for healthy aging. In 2004, the Woman’s Health Initiative study announced alarming early results that associated HT with increases in breast cancers, strokes and heart disease. Many women and their health care providers concerned by these results stopped or avoided HT. Since that time, the study results have been further analyzed. New recommendations advise making HT decisions based on a woman’s personal risk factors and age and to use the lowest effective doses for short durations.

Patches are thought to be somewhat safer than pills and vaginal therapies are most appropriate for vaginal specific symptoms. FDA approved HT is preferred over compounded therapies since the latter may lack safety testing and standardization.

Regardless, there is a number of HT and non-hormone related therapies that can ease a woman through the menopause transition. It is important to discuss your symptoms with your health care provider to see what options are best for you.

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