I have seen and treated hundreds of women over the years. A common and unfortunate statement that I have heard is that, “I was never told what was going to happen to my body.” One woman told me that this is an issue that has underpinned her entire adult life as a woman – from puberty, to pregnancy, and through menopause. Once she hit menopause, her primary care provider put her on antidepressants and told her that this is just her ‘new normal’ and that she just has to learn to ‘get used to it.’ But, there are other options.
Menopause is typically understood by most women as when she will stop having menstrual cycles and she can no longer become pregnant. It tends to occur around the late 40s or early 50s for most women. Inside the body, that the ovaries stop producing estradiol, or estrogen, and ovulation ceases and which leads to a loss of progesterone.
Estradiol is the primary female sex hormone responsible for many female characteristics. The important effects of estradiol, that don’t often get discussed, give rise to proper function and health of the brain, the eyes, the cardiovascular system, the immune system, the bones, and even the gut. Most cells in the body have receptors for estrogen. When women stop producing estradiol, the rates of diseases such as cardiovascular disease, alzheimer’s disease, and osteoporosis can rise.
No Man’s Land
There is a period of time that occurs before menopause, called perimenopause. It can begin months or years prior to menopause, but typically the latter. There are some providers who refer to perimenopause as No Man’s Land. No man will ever understand what it’s like. Nobody can say exactly how long it will last. It can be a challenge for healthcare providers since the treatment, and response to treatment, varies with each woman. But, it is most difficult for the woman experiencing it.
Typically, a couple years before menopause, a woman will start to have irregular menstrual cycles. The trend is that a woman may miss a period, maybe spot for a few days, then have a long painful cycle. Then a few months back to normal, then irregular, then more irregular.
What Can Happen
For some women, it’s just a couple months of hot flashes and night sweats and they either accept the changes that their body will come to find once they’re through menopause or they will start bioidentical hormone replacement therapy (BHRT).
For many women, the hardest part can be the insomnia. Lack of sleep can feed in to the mood swings and irritability and some women will get depressed. It can get bad enough for some women that their mood can affect their relationships with their significant other, or even their children. Many women can gain weight, they can also have food cravings, that get worse in the evening, and when they go after the high-carbohydrate foods that they crave, they notice that the hot flashes get worse. Changes in the body, combined with lack of sleep and mood swings, will often cause a woman to lose interest in sex, which can also affect a relationship.
And After Menopause
Once a woman has made it through menopause, and some of the waxing and waning symptoms have subsided, she will no longer produce estradiol and this can cause a myriad of problems. She may complain of brain fog and memory issues; vision problems and dry eyes; loss of elasticity in the skin; loss of vaginal elasticity, vaginal dryness, vaginal itching, pain with sex, pain without sex, urinary tract infections, frequent urination, painful urination, incontinence. Bone density can start to decrease, cardiovascular disease can accelerate, and the risk for Alzheimer’s disease can increase.
But There’s Help
Bioidentical hormone replacement therapy is a safe and and effective option for both managing the symptoms of menopause and for prevention of postmenopausal osteoporosis. If you are a woman in your late 40s or early 50s, are having irregular cycles or absence of cycles, and having any of the symptoms of above, then you should have a conversation with your primary care provider, OB/GYN, or see a provider who is an expert in bioidentical hormone replacement therapy (BHRT).
A wise woman once told me that if she could speak her voice to the world she would let all women know that “they have options.” Women “don’t have to suffer through the things that are just supposed to happen.”
WE CAN HELP