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Women's Healths


Home Treatment - When to Call a Health Professional

For most women, menopause occurs between the ages of 45 and 55, when the production of female hormones (estrogen and progesterone) begins to decline. These hormonal changes will cause irregular menstrual periods before periods stop altogether. You may also experience hot flashes, vaginal dryness, and mood changes. Every woman is unique and will experience menopause differently.

Osteoporosis is also directly linked to the decrease in estrogen that comes with menopause. See Osteoporosis.

Women can expect to live 1/3 of their lives after menopause, so it is important to manage any problems related to menopause.

Irregular periods may mean that a woman's menstrual flows are lighter or heavier than usual; that the intervals between periods are shorter or longer; or that there is spotting between periods. Some women have regular periods until their periods stop suddenly, and others have irregular periods for a long time until menopause.

Although you are less fertile during the years before the onset of menopause, you may continue to release eggs (ovulate), so you could become pregnant. If you do not wish to become pregnant, continue to use birth control until your doctor confirms that you have reached menopause or until you have not had a menstrual period for 12 months.

Hot flashes are sudden periods of intense heat, sweating, and flushing. A hot flash usually begins in the chest and spreads out to the neck, face, and arms. Seventy-five to 80 percent of women going through menopause will have hot flashes. Hot flashes may occur as frequently as once an hour and last as long as 3 to 4 minutes. If they occur at night, they may disrupt your sleep patterns. Disrupted sleep can lead to insomnia, fatigue, irritability, or inability to concentrate.

Hot flashes usually stop within 1 or 2 years but may persist for several years.

Vaginal dryness , the loss of lubrication and moisture in the vagina, may lead to soreness during and after sexual intercourse. These vaginal changes may also increase your risk for vaginal infections and urinary incontinence. See Vaginitis on See Vaginitis and Urinary Incontinence on See Urinary Incontinence.

Mood changes are caused by the hormonal and physical changes of menopause. Symptoms such as nervousness, lack of energy, insomnia, moodiness, or depression are common.

Many women think that menopause means emotional upset and the loss of sexuality. On the other hand, many women look forward to the freedom that menopause brings, particularly freedom from menstrual cycle discomfort and the need for birth control. Understanding what is happening to you and using home care techniques to relieve any discomfort will help you through menopause.

Home Treatment

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  • Irregular periods

    Keep a written record of your periods in case you need to discuss them with a health professional.

  • Hot flashes

    Hot flashes usually improve after 1 to 2 years. In the meantime:

    • Keep your home and workplace cool.

    • Wear layers of loose clothing that can be easily removed.

    • Drink lots of water and juices. Drink cold beverages rather than hot ones.

    • Eat smaller, more frequent meals to avoid the heat generated by digesting large amounts of food.

    • Try the relaxation tips on See Relaxation Skills.

  • Vaginal dryness

    Use a water-soluble vaginal lubricant, such as Astroglide or Replens, to ease discomfort during sexual intercourse. Vegetable oil will also work. Do not use Vaseline or other petroleum-based products.

  • Mood changes

    The best thing you can do for yourself is realize that you are not alone. Discuss your symptoms with other women. Give yourself, and ask others for, abundant amounts of love, caring, and understanding. Try to develop a relaxed attitude about menopause. Tension and anxiety may make your symptoms worse.

Hormone therapy may improve hot flashes, vaginal dryness, and mood changes. If these symptoms are very bothersome, talk to your doctor about hormone therapy. See Hormone Therapy.

When to Call a Health Professional

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  • If your menstrual periods are unusually heavy, irregular, or prolonged ( 1 to 2 times longer than normal).

  • If bleeding occurs between periods when your periods have been regular.

  • If bleeding recurs after periods have stopped for 6 months.

  • If your symptoms are interfering with your life and Home Treatment does not help (see Home Treatment).

  • If you are considering hormone therapy.

  • If you have unexplained bleeding (different from what your health professional told you to expect) while you are taking hormones.

    Hormone Therapy

    During and after menopause, a woman's body produces much less of the hormone estrogen. Hormone therapy is often prescribed to treat symptoms of menopause and to reduce a woman's risk for osteoporosis. It also may reduce the risk of heart disease. There are 2 types of hormone therapy:

    • Estrogen replacement therapy (ERT). ERT is estrogen alone. Because ERT may increase the risk of cancer in the lining of the uterus (endometrial cancer), it is usually prescribed only for women who have had a hysterectomy.

    • Hormone replacement therapy (HRT). HRT combines estrogen with progestin, another female hormone. Progestin reduces the effect of estrogen on the uterine lining and protects against cancer of the uterus.

    Hormone therapy reduces the discomfort of menopausal symptoms such as hot flashes and

    vaginal dryness. However, hormone therapy can have unpleasant side effects, including bloating, cramping, nausea, breast tenderness, and irregular vaginal bleeding.

    Hormone pills are taken every day. Some forms of hormone therapy are available as skin patches. There is very little risk in taking hormone therapy for 1 year or less to manage symptoms of menopause. However, hormone therapy is not recommended for women who have had breast cancer, trouble with blood clots, liver disease, or undiagnosed uterine bleeding.

    The sooner hormone therapy is started and the longer it is used, the more protection it gives against osteoporosis (and possibly heart disease). Evaluate your risk for osteoporosis (See Osteoporosis) and heart disease and talk to your doctor before deciding whether hormone therapy is a good idea for you.

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