Finding Solutions for Your Concerns
Your Body, Your Journey
The female body is in a constant state of change that is natural and complex. Hormones play a role in this change, from puberty to pregnancy to “child-bearing years” to perimenopause to menopause. While labels are placed on each of these stages, each change is an individualized journey for the body. For some patients, the journey is smooth, but for many women the path is less so. Each stage can have its challenges…heavy periods, anxiety, weight changes and shifts, hot flashes, fatigue, vaginal dryness, incontinence, to name a few. These concerns and complaints are common and can be incredibly frustrating as well as impact daily quality of life in many patients. There is some good news, however – there are easy, safe, and accessible treatment options that can improve life as well as have added lifelong health benefits.
Menopause
Menopause is the time during which a person naturally stops having menstrual periods as a result from a natural drop in estrogen levels from the ovary as a person ages. The average age of menopause is 51 and marks the end of reproductive years whereas perimenopause typically begins in the 30s or 40s and is characterized commonly by changes in a menstrual cycle.
Hallmark symptoms include the infamous hot flashes during which someone experiences a rush of heat to the upper body and face. These episodes can be debilitating and may occur at any time of day or night (night sweats). Sleep disruptions, whether related to hot flashes or not, are also common during which it may be difficult to fall or stay asleep.
Additionally, a drop in estrogen may also impact the skin of the vulva and vagina leading to dryness and irritation. These skin changes may cause pain at rest or with activity as well as lead to an increased risk of urinary tract infections.
Other non-specific gynecologic clinical features include changes in mood including a risk of new-onset depression and exacerbated mood lability. Relatedly, many patients experience perceived cognitive changes such as forgetfulness and trouble with word recall similar to a “brain fog.” Common complaints otherwise include joint aches and pain, breast pain and tenderness, and menstrual migraines.
Perimenopause, Menopause or Other Health Issues?
Unfortunately irregular bleeding and common symptoms of menopause may also represent other problems that need to be evaluated and treated. This is why it is important to seek out recommendations from a healthcare provider. Symptoms and concerns vary for each individual and can change with age. Your primary care physician can help navigate these stages. Your body systems are all interconnected, and it is important to address your body as a whole being, and not just one system at a time.
We recommend a wholistic approach to evaluating “all of you” to determine if there is any other contributing factor to your symptoms. For instance, fatigue can be a symptom of so many different things. Are you anemic? Is it your thyroid? Do you have sleep apnea? Are you anxious or depressed? Is your joint inflammation a manifestation of a rheumatologic condition? Is there any evidence of a more concerning development, such as cancer? These symptoms are distressing, frustrating, and influence day-to-day quality of life. It is important to address your concerns as well as think about long-term health benefits and effects.
Hormone Replacement Therapy
The goal of any treatment plan is to restore you to feeling “normal,” but sometimes the treatment process is to determine what your “new normal” is. Hormone replacement therapy is a safe and effective tool for many symptoms of the menopausal transition, but it is not the only answer. Many women are concerned about weight gain and a shift of weight “to the middle.” There are no shortcuts to improvement in health.
Cardiovascular exercise can ease stress and improve sleep. Weight training improves not only strength but may also improve confidence in the body and prevent falls. Nutrition gives the body the building blocks to age well. Sleep is essential. Hormone therapy may also not address the whole person. Hot flashes can contribute to sleep disturbance, which may lead to fatigue, depression, and anxiety. While it is important not to dismiss or be disingenuous to menopause, there are also many other causes of these symptoms and may overlap menopausal concerns.
Partnering with Your Healthcare Provider
Working with your healthcare team is the first step in improving day-to-day symptoms and setting one’s health up for long-term success. You are not alone. Your primary care provider and gynecologic specialists are two great resources of evidence-based information and safe reliable treatments to help make this transitional time of life easier and hopefully even more enriched.
What can you expect from your primary care physician? You can expect a comprehensive evaluation of your symptoms to include a discussion of your concerns, a physical evaluation to detect any other findings, and appropriate labs to discern the cause of your symptoms. Together, you will put together a plan that is evidence-based and appropriate for your needs.
Whether you choose to see an OB/GYN or your Primary Care Physician, addressing concerns is your first step to improving your health and outcomes. Your medical provider wants to ensure you are getting the best care possible and they are here to listen and work with you to achieve your optimal health.
