Menopause

In the United States, the average age for menopause is 51, according to the American College of Obstetricians and Gynecologists. What many women do not realize, however, is that the process of reaching this milestone begins long before their 50s.

Menopause, itself, marks the end of ovarian function. A woman is considered to be in menopause if she has had no periods for 12 months.

Perimenopause is defined as “around the time of menopause,” which refers to the menopausal transition phase. Perimenopause is a timely process in which women begin skipping periods or find that their once-regular menstrual cycles have become elongated and erratic.

Perimenopause represents a time when the body is undergoing significant hormonal changes as estrogen and progesterone levels drop off. It can be marked by a host of physical and emotional changes that are unique to each woman. Some women experience mood swings, depression, or insomnia, while others undergo a change in libido marked by vaginal dryness or pain with intercourse.

One symptom, however, is shared by many midlife women: hot flashes. An estimated 40 percent of women in their 40s experience hot flashes, which is a sudden rush of heat to the neck, face, and other parts of the body that can last from 30 seconds to five minutes. While hot flashes can be uncomfortable, they often abate over time.

At this stage in a woman’s life, it is vital to consult a physician about health changes to make sure that an irregular menstrual cycle or other symptoms are signs of perimenopause, not more serious problems, such as cancer or low thyroid function.

During the perimenopausal years, women should begin or continue good health practices with regular exercise and a healthy diet. Not only can these practices help minimize the discomfort caused by hormonal changes, but they can set the stage for prevention of cardiac disease, the leading cause of death in women.
In recent years, findings from the Women’s Health Initiative have raised important questions about the connections between hormone replacement therapy (HRT) and heart disease, breast cancer and blood clots; therefore, the use of this therapy should be carefully reviewed with a physician.

Many women are opting to use “bio-identical” hormones as a “natural” alternative to HRT. Bio-identical hormones can be purchased over-the-counter without a prescription. However these products can, in fact, carry the same side effects as medically prescribed products and have not passed the rigorous testing required by the FDA.

To maintain bone health women should increase calcium intake, and by the time they reach menopause they should be taking 1,500 milligrams daily in the form of foods and supplements, along with Vitamin D. Calcium is found in foods such as broccoli, kale, spinach, bok choy, tofu, salmon and low-fat milk. Cigarettes, alcohol and caffeine are known to hinder calcium absorption.

As you approach age 50 and begin to notice a change in your cycles, try keeping track of them on a calendar. Write down the symptoms that are concerning you. Try to address your top three concerns at the start of your doctor visit to ensure that your questions get answered and your visit is more productive.

Dr. Anat Sapan is an OB/Gyn, and a member of the Solano Regional Medical Group.

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