Once a woman has experienced the absence of her period for twelve straight months, the functioning of her ovaries has decreased enough to cause the cessation of menstruation. This is called menopause, and all women, usually beyond their fifties and sometimes earlier in life, will experience it.
The cessation of menstruation requires no treatment whatsoever. The symptoms of menopause, however, can be severe and may include hot flashes, vaginal dryness, sleep disturbances, mood swings, and loss of bone density. These symptoms can – and in my opinion should – be treated, especially when one takes into account that these years can be the most fulfilling years in a woman’s life – years that signify the beginning of a new and most mature era in her journey and development.
There are many forms of treatment, including hormone replacement therapy, low-dose antidepressants, drugs such as Gabapentin that can reduce hot flashes, bisphosphonates, SERMs, and other medications as well as specially designed physical therapy to prevent or reduce the loss of bone density, and vaginal estrogen and other supplements for the relief of vaginal dryness.
The most effective of these treatments is hormone replacement therapy, including “bioidentical hormones,” often mentioned by my patients, which can replace the hormones that the body stops producing once the ovaries reduce their function. Hormone replacement therapy can treat virtually all the symptoms of menopause. It can also, however, increase the risk of certain serious conditions for some women. The most thorough way to determine if the benefits outweigh the risks is to talk to your gynecologist.
Before we prescribe any treatment for menopausal patients, we discuss their current symptoms and establish how significantly these symptoms affect their quality of life. We look carefully into family history and medical history, and we discuss the risk factors involved both if therapy is started and if it is avoided. The options that provide the greatest benefit and least amount of risk are chosen on an individual basis.
Gynecologists are aware of various aspects involved in the management of hormone replacement therapy. Your gynecologist may also confer with your other physicians to ensure that everyone is aware of, and agrees with, the approved treatment.
If you are experiencing menopause, or if you believe you are transitioning into menopause, please make an appointment and share your concerns with your gynecologist. After all, you deserve to enjoy your mature years as deeply and completely as possible.