Menopause and Women’s Midlife Transitions
Today women can expect to live one third of their lives after menopause. Postmenopausal women make up the fastest growing segment of the population with the average woman now living into her mid-80ʼs. Menopause marks the end of a woman’s menstrual cycle and child-bearing years. While it’s a natural transition for women into healthy aging, a wide range of symptoms may affect both physical and emotional health. At Riverwood Healthcare Center, we offer personalized care for women’s midlife transitions.
Our Trusted Team for Menopause
At Riverwood’s specialty clinic in Aitkin, women have access to a team of three highly skilled OB/GYN physicians and surgeons with the Minnesota Center for Obstetrics & Gynecology at Riverwood Healthcare Center in Aitkin and Cuyuna Regional Medical Center in Crosby. All three doctors are National Certified Menopause Practitioners of the North American Menopause Society. They provide evidence-based information and treatment options in a comprehensive manner with one-stop convenience.
Common Menopause Symptoms
The spectrum of concerns, questions and bothersome symptoms associated with perimenopause/menopause are extremely varied. Common consults with our team of gynecologists are for:
- Bleeding concerns
- Pelvic pain/pressure
- Vulvar itching/pain
- Vaginal dryness
- Sleep disturbances
- Hot flashes
- Urinary or Bowel Incontinence
- Libido/arousal/orgasm concerns
- Painful intercourse
- Weight gain
- Mood changes
- Vulvar abnormalities
Frequently Asked Questions
There are some steps you can take to prevent or reduce hot flashes. Some triggers at avoid include stress, caffeine, alcohol, spicy foods, smoking, and heat. Turn the temperature down, especially at night. Exercise helps! Maintain a healthy body weight and use relaxation techniques like mindfulness, yoga and acupuncture. Hot flashes are a nuisance but not harmful to your health.
Our three OBGYN physicians have expertise in sexual medicine and can evaluate symptoms such as low desire, low arousal, vulvar skin problems and painful sex.
Antidepressants and cognitive behavioral therapy are first line treatments for depression. Estrogen itself is not FDA-approved, but it definitely has an antidepressant effect in perimenopausal patients. If you don’t want to take medication or do therapy, exercise is the answer supported by the most data. Healthy eating can help too. Avoid snacking on junk food; aim for regular nutritious meals.
See your doctor if you notice any of the following irregular bleeding: 1) a change in your monthly cycle; 2) have very heavy bleeding; 3) have bleeding that lasts longer than normal; 4) bleed more often than every three weeks; or 5) bleed after sex or between periods. An evaluation may include a pregnancy test, thyroid test, a pelvic ultrasound, pelvic exam and/or endometrial biopsy.
HT is most often prescribed in the form of pills, injections, vaginal rings or patches placed on the skin. Estrogen creams and tablets used in the vagina can help treat dryness but do not work well with other symptoms.
There is an increased risk of breast cancer in women who use combined (estrogen and progestin) HT. The increased risk appears to be small, but increases depending on how long a woman takes HT. HT also modestly increases the risk of a heart attack, stroke and blood clots.
While menopause does not cause sleeping problems, symptoms of menopause certainly do! Hot flashes occur more often at night and result in disrupted sleep/problems getting back to sleep. Anxiety is another menopausal symptom that widely affects women at midlife who are often juggling a lot of responsibilities between raising children and caring for aging parents.
What can be done for sleep problems? Treating hot flashes for some women is all that is needed. If mood swings, depression or anxiety are part of the woman’s history, vitamin B or magnesium helps some as do other prescription medications. Nonprescription and prescription remedies exist but are not part of a good long-term care plan. If you increasingly rely on medicines such as Tylenol Pm or Rozarem to get a good night’s sleep, you should see your healthcare provider.
The decrease in estrogen may thin the lining of the urinary tract and weaken supporting tissues. This can cause women to urinate more often. Also, the bladder may become more prone to infection. When the tissues get weak, some women may leak when they sneeze cough or laugh. This is known as stress incontinence. Some women get this problem even before perimenopause because their tissues have been stretched by childbirth. If you notice a loss of bladder control, tell your doctor. It often can be treated.
Hormone Therapy can slow or stop bone loss. For women who cannot take estrogen, there are other medications that may help. Calcitonin is one that slows bone loss. A group of medicines called biophosphonates have been shown to increase bone density and reduce fractures.
To prevent osteoporosis, you should focus on building and keeping as much bone as you can before menopause. You can do that by getting plenty of calcium and exercise.
Before menopause, you need about 1,000 mg of calcium per day. After menopause, you need, 500 mg per day. Milk fortified with vitamin D is a good source as well as yogurt, cheese, ice cream, seafood and vegetables. Vitamin D helps the body absorb calcium. A woman should take the recommended daily amount of vitamin D, which is 400-800 international units.
Regular weight-bearing exercise is best to strengthen bones and slow bone loss. Brisk walking is good. So is aerobic dancing, stair stepping, tennis and running. Lifting weights also improves bone strength.