Brain fog, weight gain, anxiety, depression — the signs of menopause may not seem like a reason to go to the doctor. “Too often, women don’t talk to their healthcare provider about how they are feeling and suffer needlessly. There are things you can do to lessen the symptoms of menopause. But first, you need to know what to expect,” said Ngozi Osuagwu, MD, FACOG, NCMP, medical director of the Women’s Health Center at OhioHealth Doctors Hospital. Dr, Osuagwu, author of recently released book, Sincerely, Your Gynecologist, sat down with us to help us better understand menopause.
What is menopause?
Sometime between the ages of 40 and 58, a woman’s body will begin to change. This natural transition of aging for every woman actually starts in the phase called perimenopause. A woman begins to lose ovarian follicular activity, and her hormone levels will vary greatly. As a result, her menstrual cycles will become irregular and lighter. The most common symptoms start at this stage.
Menopause occurs after a woman has missed her period for 12 months. When a woman enters menopause, her estrogen levels even out, and most symptoms will not be as frequent or uncomfortable, but they can last for up to seven years.
The common signs and symptoms of menopause
Some of the more common symptoms are:
- Physical exhaustion
- Sleep issues
- Brain fog
- Depression/anxiety/mood changes
- Hot flashes/night sweats
- Weight gain
“This is a time of transition for many women. Their parents are getting older, and their kids are leaving home, so mood changes may already be happening,” Dr. Osuagwu remarked.
She also stressed that “75% of women experience hot flashes. Brain fog is real. Many women feel both during menopause. So, don’t think you are imagining any of it.”
Other medical concerns during menopause
Because of decreased estrogen, menopausal women are at an increased risk for chronic diseases like heart disease, diabetes, high cholesterol and osteoporosis. “Our chances of getting heart disease increase to equal or surpass men’s after menopause, so it’s important to be vigilant about our heart health,” Dr. Osuagwu mentioned.
Some women may also develop genitourinary syndrome of menopause (GSM), symptoms caused by decreased estrogen. GSM can result in frequent urination, burning during urination, urinary tract infections, vaginal dryness and general vaginal discomfort. Many women who have GSM will experience pain or discomfort during intercourse.
“While hot flashes may get better after menopause, GSM will get worse. It’s important to talk to your healthcare provider if you are experiencing any of the symptoms,” Dr. Osuagwu stressed.
Treatments for menopause
“There is no one-size-fits-all for menopause treatment,” Dr. Osuagwu said. “Every woman will experience menopause differently, so treatment will vary. Treatment should happen when your symptoms become so bothersome that they affect your daily activities.”
The most effective way to treat hot flashes is with estrogen therapy. Taking hormones may also help with other symptoms of menopause. If you cannot take hormones, there are other non-hormonal therapies. Low-dose paroxetine is the only Food and Drug Administration (FDA)-approved non-hormonal option for treating hot flashes. Cognitive behavioral therapy may be helpful for sleep issues and mood changes. Antidepressants and antianxiety medications are also helpful for symptoms.
According to Dr. Osuagwu, lifestyle changes can also be effective in treating menopausal symptoms. These include:
- Regular exercise and healthy eating to maintain weight
- A regular sleep schedule for sleep issues and relieving brain fog
- Deep breathing exercises for anxiety
She also encourages women to practice all four types of exercise: aerobic, strength training, flexibility and balance.
When to talk to your doctor
“Healthcare providers cannot read your mind, but they do want to help you. The symptoms of menopause are just a part of getting older. Don’t be embarrassed to tell them what you are experiencing,” said Dr. Osuagwu. She suggests starting the conversation as soon as you start having symptoms so you can track your progression together.
It is important to talk with your healthcare provider about your menstrual cycle. While irregular bleeding is part of menopause, they will be able to tell you if it is normal or abnormal. If your cycle is lasting longer than eight days or coming more often than 21 days, you should speak with your healthcare provider. Abnormal uterine bleeding may be an indicator of endocervical cancer. It is also important for you to be screened for chronic diseases at this age.
Menopause is a natural part of aging that every woman goes through. It doesn’t have to be a negative experience or something that you feel like you have to hide. The signs and symptoms of menopause are important to recognize and can be managed, so don’t be afraid to talk to your healthcare provider. To find a doctor, visit our website.
