MENOPAUSE & MID-LIFE SERVICES

It's inevitable that you'd reach this stage sooner or later---so welcome! Mid-life is one of those stages that we all reach and hopefully will learn to embrace.

The period of time before a woman reaches menopause is called the perimenopause and can last anywhere from 2 to 10+ years. During this time it is quite common for a woman to experience any or all of the following:

  • Disrupted sleep
  • Not feeling rested in the morning
  • Feelings of warmth and/or hot flashes during the day and/or night
  • Night sweats
  • Vaginal dryness

We do know that the following things can influence the presence of the above vasomotor symptoms:

  • Alcohol - and sometimes it takes only one glass of beer or wine
  • Consumption of caffeine
  • Emotional issues/stress
  • Lack of steady state physical activity --- in particular aerobic exercise

WHAT ARE MY OPTIONS?

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LIFESTYLE CHOICES

Remember that our nutritional and activity needs change as we get older! Pay attention to these things as they can help you feel vital and energetic throughout life.

  • EXERCISE, EXERCISE and EXERCISE!!!! Walking 10,000 steps every day will keep you filled with vitality, maintain a healthy weight and most importantly maintain the density of your bones!
  • DIET: Increase whole grains, fruits and vegetables while you decrease sweets, high-fat foods, caffeine and alcohol Once you're post menopausal your need for calcium increases and it is recommended that you take 1500 mg daily either through your diet and/or calcium supplementation
  • HERBAL PRODUCTS: Providing you have no risk of blood clotting problems (previous history of stroke, or blood clots in your legs, lungs, etc. Although many women report symptom relief when using over the counter products such as
    • Black Cohash, Soy, Vitamin E, Dong Quai, etc.
    • Remifemin or Estroven

Studies do not really demonstrate that these are universally effective---but each woman is different

For some women, a simple change in lifestyle may be all that's needed to prevent menopausal symptoms. But a thorough examination and discussion about menopause with the caring clinicians at the Wellness Center can help you choose the best option(s) for you!


HORMONE REPLACEMENT THERAPY: IS IT RIGHT FOR YOU?

As with most things the decision to use hormone replacement therapy is one that should not be made lightly. A few years ago, the Women's Health Initiative (WHI) published results, which resulted in the sudden stoppage of hormones by women all around the United States. As is often the case people were led to believe that there was a huge number of negative outcomes for women who used hormones simply because of the way the results were reported.

Upon closer inspection the actual increases in certain conditions were relatively small  (i.e. less than 20 per 10,000 women). The long and short of this study was the recommendation that women use hormone replacement therapy only if needed and for the shortest amount of time. For further information please refer to the links on this website. It should be noted that quality of life issues were not evaluated during the WHI ---which can be a major issue for women as we progress through this phase of our lives.


HORMONE REPLACEMENT THERAPY & THE WOMEN'S HEALTH INITIATIVE RESULTS


  Increased Risk Decreased Risk
Osteoporis   X
Colon Cancer   X
Breast Cancer
NOTE: HRT has not been proved to cause breast cancer; may result in its appearance/detection sooner		 X  
Stroke X  
Heart Disease X  

"The choice to use hormone replacement therapy is always a personal decision for each woman and should occur after a thorough exam and discussion of her personal risk factors with her medical provider."

 

SOME KEY POINTS YOU NEED TO KNOW

As with any medication there can certainly be risks, which are influenced by one's personal and family health history. One of the great things that came out of the WHI is that providers now prescribe much lower doses of hormone replacement therapy than had been done for decades and that decreases the risks of adverse effects.

Prior to starting hormone replacement therapy we recommend the following:

  • Monitoring and actually charting the frequency of the symptoms that you may be experiencing over the course of a few months
  • Reflect on how these symptoms are affecting the quality of your life
  • Schedule an appointment with your medical provider so that a thorough review of your medical history & physical exam can be completed
  • Schedule a discussion appointment with a medical provider who understands your concerns and can discuss your personal risks
  • Choose to become an informed consumer of health care---do lots of research on your own

Benefits of HT/ET may:

  • Relieve hot flashes and other perimenopausal symptoms
  • Relieve vaginal dryness associated with menopause
  • Improve a woman's feeling of well-being during perimenopause & menopause
  • Reduce the risk of osteoporosis
  • Reduce the risk of colon cancer

Side effects of HT/ET can include:

  • Breast tenderness
  • Nausea
  • Water retention and/or bloating
  • Symptoms of PMS
  • Headaches
  • Acne
  • Minor side effects usually require no treatment and may resolve in three months

If side effects persist, return to your medical provider who may change your dose or the combination of hormones.

  • Women who have a uterus must use a combination of estrogen and progestin which is typically called Hormone Therapy
  • Women who do not have a uterus do not need progrestin-typically referred to as ET or Estrogen Therapy
  • Hormone Replacement Therapy comes in the following forms:
    • pill/capsule
    • cream that is applied on the skin
    • vaginal cream or vaginal ring
    • patch
    • topical spray that is rubbed onto the skin
  • Bio-identical hormone replacement therapy is
    • frequently perceived as "natural"
    • available in a capsule or cream form
    • compounded from plant sources versus urine of horses
    • NO SAFER to use than chemically manufactured hormones; they carry the same risks
  • Bio-identical hormone therapy can be compounded/mixed to provide an individualized medication dose
  • Blood or saliva tests are NOT needed for a provider to prescribe hormone replacement therapy. Some women desire this to be done and some providers request these tests to be completed prior to prescribing. This is an individualized decision that each woman and/or provider makes. The Wellness Center does provide both blood and saliva hormone testing for those women who are interested.

Michele with patient

It may be difficult to decide if the benefits of taking HT/ET are worth the risks. Every woman is different and has different risks. To limit the risks involved with hormone replacement therapy, the Wellness Center will provide you with a thorough examination and prescribes the lowest dose of hormones to alleviate your menopausal symptoms. Your initial visit will include a health history, physical examination, laboratory tests, and counseling.

To make your decision, be sure to discuss your personal risks with your medical provider who will prescribe the lowest doses for the shortest period of time needed to relieve your symptoms.

If you choose hormone therapy, be sure to return for regular checkups to make sure the treatment is working well for you. Return sooner or call your provider if you have problems. Your health and wellness is important to us.

Order a copy of the 6th Edition of The Menopause Guidebook published by the North American Menopause Society.

If you'd like to make an appointment for an exam and/or to discuss perimenopause or menopausal issues at the Wellness Center simply call (920) 746-9444.

SAVE YOURSELF SOME TIME BY DOWNLOADING AND COMPLETING PATIENT FORMS PRIOR TO COMING IN FOR YOUR APPOINTMENT