Most common questions women ask about menopause

This year, thousands of Canadian women will be experiencing physical changes in their lives as they approach menopause. Menopause can affect how a woman feels both physically and emotionally and every woman’s experience is completely individual. As such, it is important for all women to be aware of how menopause will affect their bodies, and the options they have to better manage their experience with these changes.

The following are the most commonly-asked questions by women entering menopause. Dr. Shawna Johnston, obstetrician and gynecologist, provides answers.

When does a woman officially experience menopause?
When a woman’s periods stop and start, she may begin to notice some signs of menopause, which occurs in stages. “Peri-” or “pre-” menopause is when a woman is experiencing changes in her body but she still has her period. This transitional period starts at about age 35. This stage can take place for up to a decade and women may experience changes including mood swings, hot flashes and sleep disturbances. Remember, because all women are different, the changes to their bodies may vary. The age at which these changes begin, and their duration, may al be different. When a woman goes one full year without a period, she has experienced menopause. After this, women are in their postmenopausal stage. When a woman hits the postmenopausal stage, she may feel more energetic and emotionally stable but the lower estrogen levels may contribute to changes in a woman’s health.

What can I do to control the physical and emotional changes associated with menopause?
Physical and emotional changes vary from woman to woman depending on their personal experience with menopause. One way of managing these symptoms is with hormone therapy (HT). HT is the treatment that replaces the hormones which ovaries stop making at menopause. The hormones given at and after menopause are estrogen and progestin. Many women are hesitant to take HT but they may not have all the facts. It is important to speak with your physician to determine if HT is right for you, as many factors must be taken into consideration, including lifestyle, family medical history, current symptoms and treatment options. Some women may decide to manage their symptoms without HT – lifestyle changes may be enough. Depending on the severity of the symptoms of menopause and their impact on a woman’s quality of life, she may conclude, with her physician, that the benefits of HT are right for her and her individual situation. When a decision has been made between a woman and her physician to take HT, women should take the lowest effective dose for the shortest period of time to manage menopausal symptoms.

Is there any information supporting hormone therapy?
Several studies have been conducted to determine the benefits of HT, notably, the Woman’s Health Initiative (WHI) study. This study is the largest clinically controlled trial regarding HT. A total of 16,608 healthy post-menopausal women between the ages of 50 and 79 participated in the estrogen plus progestin arm of the study. The purpose of the study was to identify if combined hormone therapy was successful in preventing heart disease and osteoporosis in women past menopause. Another purpose was to identify if the benefits of hormone therapy are greater than any potential risks. This study was not, however, designed to assess benefits of relief of distressing symptoms of menopause, as some of the individuals who started on HT in this study were healthy, menopausal women and did not suffer from any symptoms. Among the participants studied in the WHI study, there was no benefit for the prevention of heart disease or stroke. However, findings did not take into consideration all age groups therefore conclusions are not necessarily relevant for women approaching or entering menopause. Key findings among a sub-set of women studied – those who have had a hysterectomy, so only took estrogen, rather than the combination of estrogen and progestin required by women with an intact uterus – showed that hormone therapy is protective for a woman’s bones, prevents fractures due to osteoporosis and does not increase the risk of breast cancer. For more information about menopause and hormone therapy, visit www.sogc.org. – News Canada