The why, when and what of menopause


Menopause marks the end of the transitional phase women go through as their bodies pass out of the childbearing stage of life. Even though all women experience “the change of life,” as it is often called, there is still a lot of confusion surrounding the stages of menopause and how to make the transition more comfortable. Put simply, menopause is the point 12 months after a woman’s final menstrual period. The transition leading up to that point is referred to as perimenopause.

Perimenopause:

Perimenopause generally begins between the ages of 45 and 55 and usually lasts about seven years, although it can last up to 14 years in some women. During this phase, a woman may experience a variety of changes, both physical and emotional. Emotional changes can range from feeling depressed about getting older to being happy about no longer having to worry about the possibility of becoming pregnant. Health professionals generally counsel women to focus on the positive aspects of the change and how it is the beginning of a new stage of life, one without the pain and inconvenience of menstruation. Think about it—no more cramps, no more having to stock up on sanitary products such as pads and tampons, and no more worrying about unexpected periods. Some women go through the perimenopausal years without experiencing any significant symptoms, but most women will notice some symptoms as their bodies’ production of the hormones estrogen and progesterone change. You may find that mild symptoms are manageable with lifestyle adjustments (such as dressing in layers so they can adapt to changes in body temperature), while others may require the help of your healthcare team.

Common symptoms:

The symptoms can vary greatly from woman to woman, but among the most common symptoms a woman may experience are:

  • Changes to period
  • Hot flashes
  • Loss of bladder control
  • Sleep difficulties
  • Vaginal dryness
  • Changes in libido
  • Mood disturbances
  • Memory problems
  • Weight gain
  • Night Sweats

Because changes to hormone levels can be triggering these symptoms, it is impossible to predict which women will get which symptoms, how severe they will be, or how often they will occur.

Treatments:

For vaginal dryness

  • Non-medicated vaginal moisturizers and lubricants: daily use, a few days per week, or specifically during intercourse
  • Prescription vaginal estrogen tablets or cream

For hot flashes and night sweats

  • Hormone replacement therapies: estrogen and progesterone
  • Other prescription medications: antidepressants, clonidine, gabapentin, pregabalin

Although hot flashes and vaginal dryness are the most common concerns, there are many treatments, prescription and non-prescription, available to help treat other menopausal symptoms you may be experiencing. Speak with your healthcare team, including your pharmacist, to help you choose what types of therapies may be right for you.

Herbal remedies:

Among the natural, non hormonal products used to treat menopausal symptoms are black cohosh, red clover, and evening primrose oil, which may reduce hot flashes in some women. Another option is ginseng, which may help with moods, a sense of well-being, and sleep disturbances.

In Canada there are regulations in place to ensure that natural health products are safe, effective for their intended use, and of high quality. However, more studies are necessary to demonstrate a high level of effectiveness, and just because a product is natural does not mean that is it without harm. Some herbal medications can interact with other medications or can cause harmful side effects for some people. Check with your pharmacist before starting any new natural remedy and inform your doctor as well. Your healthcare team can help you find the right products that will be safe for you to try.

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