All About Menopause, Perimenopause, and Hormones: A Candid Consult

Dr. Craig Henderson of Ocean OB/GYN shares his knowledge about the causes and complexities of menopause, how hormones play a role, and what symptom control options are available to women.

What exactly is menopause? What symptoms are normal, and when should I expect to experience them?

The definition of “menopause” is when a woman hasn’t had a period for a full year (hence, “pause” in menstruation). Menopause is caused by the natural, long-term decrease in production of estrogen, progesterone, and testosterone hormones in the body. Women entering menopause can experience a number of different symptoms, including those listed below. Not all women will experience all of these, as every woman is different.

Anxiety
Depression
Mood swings
Forgetfulness
Hair loss
Hot flashes
Night sweats
Difficulty sleeping
Fatigue
Low libido/sexual drive
Pain with intercourse
Joint pain
Vaginal dryness
Weight gain

In the U.S., the average age of women entering menopause is 51.5. However, there’s also something called perimenopause, which mimics the same symptoms of menopause, but can happen to women much younger – around age 40.

What is perimenopause?

Women in their 40s may sometimes believe they are experiencing menopause, but it’s possible they may actually be experiencing perimenopause.

Perimenopause is caused by the decreased production of estrogen by the ovaries. In reaction to this decreased production, the pituitary gland stimulates the ovaries to increase estrogen production. Because the ovaries can’t maintain this production, the constant fluctuation of estrogen (up and down, up and down) can cause unpleasant symptoms that mimic those of menopause, such as hot flashes and night sweats.

Why do I get hot flashes, and is there anything I can do to prevent them?

Hot flashes are caused by sudden estrogen level drops, as well as sustained low levels of estrogen. A hot flash feels exactly as it sounds – a sudden wave of warmth that is experienced for approximately 60-90 seconds. While difficult to prevent all together, it’s important to note that certain things can actually make hot flashes worse. I warn patients to avoid red wine and caffeine, for example, as these can make hot flashes more uncomfortable.

Will having a hysterectomy cause menopause?

A hysterectomy is the removal of the uterus, which will not cause menopause, as your ovaries are still in place and should be creating appropriate levels of estrogen. However, removing your uterus will cause you to no longer have your period.

If the ovaries are removed at the same time as your hysterectomy, you would experience menopause, as you would no longer have these organs helping you to maintain your estrogen levels.

How can my OBGYN help me address vaginal dryness resulting from menopause?

Vaginal dryness can be uncomfortable, as well as play a role in making intimacy painful. The good news is that your OB/GYN can help you with treating dryness by prescribing a local application of estrogen through the vagina – either by a cream, tablet, or suppository. Vaginal dryness can also be helped when taking systemic hormones, such as those taken through bio-identical hormone therapy. You should feel comfortable speaking about this issue with your provider, as there are multiple approaches to addressing this common problem, and you shouldn’t need to suffer in silence.

Will menopause increase my risk for other health problems?

Menopause does increase the risk for osteoporosis, which is why it’s so important to incorporate a calcium supplement into your everyday routine. Yet, on the flip side, there are ways that the treatment of menopause can actually help your long-term health. For example, women who undergo hormone replacement therapy to address their menopause symptoms have seen benefits from their increased estrogen levels.

For example, estrogen can increase high-density lipid proteins that give you a better good cholesterol ratio (good HDLs), decreasing the risk for heart disease. It can also help with decreased hair loss, improving skin problems, and provide joint lubrication to slow arthritis. One recent study even showed that women on hormone replacement therapy have a lower incidence and slower progression of Alzheimer’s Disease.

What does hormone replacement therapy look like?

Perhaps the most popular approach to hormone replacement therapy today is known as bio-identical hormone therapy. Bio-identical hormones are derived from plant sources and can be dispensed as a capsule, cream, lozenge, or pellet insertion. These therapies are made at a compounding pharmacy by a pharmacist that actually makes up the prescription so that the dosage can be adjusted to fit an individual woman’s symptoms and needs, making this an incredibly customized treatment for patients.

If your menopause symptoms are impacting your lifestyle, don’t hesitate to contact your Axia OB/GYN provider to discuss treatment options.