Have a question for our experts? This line is open until Friday, November 19th. Jenny will then answer a few questions and we’ll post her answers right here and on the forums.
Q: What are the symptoms of menopause? How do I know if I’m in premeno-meno- or perimeno- and what do those terms mean?
A: The technical definition for menopause is the absence of a menstrual cycle for 12 consecutive months. Surgical menopause occurs after a hysterectomy when the uterus and ovaries are removed. Most people use the term “menopausal” to describe the symptoms that occur around the age of menopause, which on average happens around age 51. Common menopausal symptoms are hot flashes, night sweats, mood swings, insomnia, decreased sex drive and vaginal dryness. Premenopause is the time before these symptoms start when hormone production is adequate. Perimenopause is on average a 5 year transition phase when a woman begins to have symptoms of menopause due to declining hormone production but is still having a menstrual cycle, although likely irregular. Most treatment can be initiated based on a thorough history of symptoms; however in some cases hormone blood testing might be appropriate to diagnose menopause.
Q: Why do I get hot flashes and what are they?
A: The most common menopausal symptom is hot flashes. A hot flash occurs from the changes in dilation and constriction in blood vessels caused by fluctuating estrogen levels. During a hot flash, a woman experiences a sudden warm sensation in her chest, neck and head and may even have a visible flushing of skin (hot flush). Hot flashes may also be accompanied by sweating, dizziness and heart palpitations.
Q: What is hormone replacement therapy? Is it safe?
A: Hormone replacement therapy (or HRT) is a treatment option to help relieve menopausal symptoms by replacing hormones your body once produced with a medication. HRT comes in a number of different delivery methods, including a pill, patch, topical gel, cream and spray, vaginal ring and injectable forms. Women who have had a hysterectomy (uterus surgically removed) usually only take estrogen for symptom relief. Women who still have an intact uterus must use estrogen plus progesterone to protect the lining of the uterus from thickening that could lead to precancer or cancer.
A study called the Women’s Health Initiative (WHI) investigated the risks and benefits of hormone replacement therapy. Risks of HRT include a slight increased risk of breast cancer, heart attack, blood clot and stroke in women who use both estrogen and progesterone (no increased risk of breast cancer or heart attack were found in the estrogen-only group). Benefits of HRT include a reduction in osteoporotic fractures and the incidence of colon cancer, in addition to the relief of menopausal symptoms and improvement in quality of life. If someone elects to use HRT, it is recommended to use the lowest effective dose for the shortest period of time to minimize risks. You and your health care provider can decide based on your individual health history if HRT is right for you, or if you should consider alternative treatment options to relieve menopausal symptoms.