Katherine Caljkusic, University of Toronto, for NP-UN, Toronto.
What is menopause?
Menopause happens in all women, usually around the age of 50. The medical definition of menopause is the absence of a period for a full 12 months. While no monthly menstruation may be great news, many women can experience bothersome symptoms. During menopause, hormone levels are changing, resulting in common menopausal symptoms that women often complain about. These include: hot flashes, night sweats, vaginal dryness, pain with intercourse, anxiety and other physical and emotional changes.
Hot flashes and night sweats! How do you stop them?
Hot flashes, or night sweats are flashes of warmth, in which a woman may begin to feel very hot. Some describe it as warmth starting in the chest and moving up towards the head, leaving the face red, and sweaty. Hot flashes are typically used to described episodes which occur throughout the day, while night sweats occur during the night. They differ in intensity, frequency and length amongst women. For some ladies, night sweats may disrupt sleep, and cause insomnia, while for others hot flashes may occur often during the day, for minutes at a time. In any case, menopausal hot flashes may negatively impact a woman’s’ quality of life.
Some women may experience hot flashes for a couple of years after menopause starts, while for others they may last a lifetime. One tip to help deal with hot flashes is to keep the bedroom cool, especially at night. Also, restricting spicy foods, caffeine and alcohol may help, as these foods can trigger episodes. Aerobic exercise is recommended as it has been shown to decrease hot flashes, and wearing multiple layers of clothes can also be beneficial, as removing a layer once a hot flash episode begins may decrease the duration of the episode. Stopping smoking and weight loss are other factors which can promote reduction of hot flashes. Some natural over-the-counter products which have shown benefit for reducing hot flashes include black cohosh, and evening primrose oil. Ask your pharmacist if those products are right for you!
Vaginal dryness, it’s causing me pain!
Due to the decrease in estrogen when menopause begins, vaginal dryness occurs, which can lead to pain. Pain can occur even when sitting, urinating, exercising and most commonly with intercourse. Vaginal discharge may change as well, with the discharge becoming more watery, and irritating. Some tips to help with dryness include using vaginal moisturizers 2-3 times per week to help to draw moisture into the vagina and vaginal lubricants should be used prior to intercourse. Ask your pharmacist which over-the-counter products are best for you.
What if those non-pharmacological methods don’t help?
Some women require prescription medication to help manage their menopausal symptoms, as they may be more severe and bothersome. Estrogen is first line therapy for hot flashes and vaginal dryness. It can be given as an oral pill, a patch, cream or a vaginal tablet. Birth control pills are also an option, as they have both estrogen and progesterone. Other prescription medications which have shown effectiveness for hot flashes are anti-depressants, which may be an option for women experiencing problems with mood and anxiety due to beginning menopause. Therefore, it is best to have a discussion with your doctor about which option is best for you.
Menopause is a time of change for ladies, and it is important to embrace this change, however it is also best to seek advice and get your questions answered from your doctor and pharmacist so that they can help this transition be a smooth one.