Transitioning from a reproductive to post-reproductive life is a unique experience for every woman. It can be challenging, but it's an opportunity for you to explore new aspects of yourself and your relationships with others. During this time of change and adaptation, symptoms may include hot flashes, vaginal dryness, heavy bleeding during your periods, anxiety, and depression. Women who have had children may lose their libidos or sexual desire altogether due to the estrogen levels dropping dramatically after 40 years old. Postpartum depression (PPD) affects 10% or more women after childbirth, which can change their moods drastically while they go through menopause symptoms during this period.
Signs and symptoms of menopause
Menopause is a natural process for most women in their 40s and 50s. You may experience changes in your periods, sex drive, energy levels, and mood. While these symptoms are typical, they can be distressing if they bother you. For some women, the signs of menopause can make life more complicated than it needs to be. But don't worry - there are things you can do to help yourself through this time.
What causes menopause?
Menopause is caused by an imbalance in the hormones estrogen and progesterone produced by your ovaries (the tiny organs that make eggs). As you approach menopause, these levels drop off, causing your menstrual cycle to become irregular or stop altogether.
The seven stages of menopause
Menopause can last for seven years or more and generally occurs between the ages of 45 and 55. Menopause is the permanent cessation of menstruation, which means that a woman's ovaries no longer produce eggs, her uterus stops building up the lining in preparation for pregnancy, and estrogen levels decrease.
Menopausal hormone therapy
While menopausal hormone therapy (MHT) is one of the most effective treatments for menopausal symptoms, it can also have some side effects.
The use of estrogen and progesterone to treat menopausal symptoms has been an option for many years. The American College of Obstetricians and Gynecologists says that hormone therapy should be considered for short-term relief of hot flashes, night sweats, and vaginal dryness; however, there's not enough evidence to support long-term use.
Hormone therapy may be particularly beneficial if you want to maintain your bone density while avoiding other health risks associated with never using hormones or switching back to them later in life.
Estrogen and progesterone treatment for hot flashes and night sweats
Hormone therapy (HT) is a treatment for hot flashes and night sweats. Your doctor may recommend HT if your symptoms are severe, disruptive to your life, or causing you to worry about the future.
HT isn't a cure for menopause—it can only ease symptoms until they go away on their own. HT also has side effects: it might cause some women's breasts to become tender or make them tired, depressed, or anxious.
HT isn't suitable for everyone: talk with your doctor about whether this type of treatment would be helpful for you. If so, he'll help you decide which type is best—estrogen alone or estrogen plus progesterone (or progestin).
Vaginal estrogen for vaginal dryness, pain with intercourse, or decreased sexual desire
Vaginal estrogen is a hormone replacement therapy (HRT) for menopause symptoms. Vaginal rings and creams are available in the United States. They contain the same type of hormone in birth control pills but at a higher dose.
The rings are made of soft plastic and about 2 inches around, or about the size of a quarter. You can insert them into your vagina to get estrogen directly into your bloodstream without going through any digestive system first. They slowly release estrogen over 3 weeks, so you have to replace it every 3 weeks by squeezing out some on your finger and applying it to the inside edge of the ring before reinserting it into your vagina. It's meant to stay there continuously until removal time comes around again!
The creams work similarly: they can be applied directly onto affected areas like labia majora (the outer lips), labia minora (the inner lips), clitoris, periurethral area (near urethra), anal mucosa (tissue lining anus), perianal skin folds/folds between anus and rectum), vaginal walls/lining inside the vagina). If you're having trouble getting enough lubrication from sex during intercourse because of vaginal dryness due to low levels of estrogen production during menopause, then try this method!
Tibolone (Livial) for hot flashes and vaginal dryness
Tibolone is a synthetic steroid with estrogen and progestin properties, making it an option for women experiencing menopausal symptoms such as hot flashes and dryness. Tibolone isn't approved by the U.S. Food and Drug Administration (FDA) for treating menopausal symptoms, but it's been used in Europe to treat these issues since 2002 with favorable results. However, tibolone hasn't been studied extensively in clinical trials to verify its safety and effectiveness when used for this purpose.
Low-dose antidepressants for hot flashes
Selective serotonin reuptake inhibitors (SSRIs):
Paroxetine hydrochloride (Paxil)
Serotonin-norepinephrine reuptake inhibitors (SNRIs):
Venlafaxine HCL - Effexor or Effexor XR, generic name desvenlafaxine extended-release tablets. Brand names: Empliciti, formerly Brintellix and Brilinta - Teva Pharmaceutical Industries Ltd. It is also available in generic form made by several manufacturers, including Sun Pharmaceuticals Ltd., Torrent Pharmaceuticals Limited, Apotex Inc., and Lupin Pharmaceuticals Ltd. See also V Citrix F XR, which contains venlafaxine extended-release tablets plus ferrous sulfate tablets.
Gabapentin (Neurontin) or clonidine (Catapres) for hot flashes
Gabapentin (Neurontin) and clonidine (Catapres) are sometimes used for hot flashes, but they aren't recommended as first-line treatments.
Gabapentin is an anticonvulsant that can reduce the frequency of hot flashes in some women. It's usually taken three times a day for 12 weeks at a time, then stopped for two weeks before starting a new cycle. Side effects include dizziness, sleepiness, nausea, and constipation.
Intrauterine device (IUD) using the hormone progesterone that releases levonorgestrel (Skyla or Mirena) for heavy menstrual bleeding and anemia
IUDs are small, T-shaped devices inserted into the uterus by a health care provider. They are a non-hormonal form of birth control and can be used to treat heavy menstrual bleeding. IUDs release levonorgestrel (Skyla or Mirena) for heavy menstrual bleeding and anemia. The intrauterine device (IUD) is a small, T-shaped device inserted into the uterus by a healthcare provider. It releases levonorgestrel for heavy menstrual bleeding and anemia.
Types of vaginal estrogen
There are two types of vaginal estrogen:
You apply a cream to the inside of your vagina (the introitus) twice a day. It's absorbed into the body and works for about three hours.
A thin film tablet that you insert in the vagina before sexual activity, where it is absorbed into your bloodstream within 15 minutes.
The menopausal transition can last seven years or more.
Menopause is a natural process that occurs as women age. It's not a disease nor a sign of aging or weakness. Menopause is not a sign of infertility either—you can still have children after menopause! Menopause lasts an average of seven years, but some people experience symptoms for much longer.
Please read on if you're experiencing uncomfortable symptoms during this period and want additional information about them (and what they might mean)!
Menopause is a normal part of aging and can affect women of all races, ethnicities, and cultures. However, there are ways to manage the symptoms associated with menopause. If you experience any of these symptoms, talk to your doctor about treatment options that are right for you.