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Understanding Menopause

Menopause is the natural change in ovarian function. One of the most obvious symptoms of the menopause is hot flashes. Women may also experience issues like irregular bleeding, changes in libido, questions about bone and heart health, and more. Below is a list of topics to answer your biggest questions.

Bone Health: Menopause is recognized for a number of changes in health, including More bone loss. Research shows that some women experience a more rapid thinning of bones when the body stops making estrogen. The risk to your bones does not really increase until you are IN menopause.

Entering menopause is marked by the periods stopping. Some women begin getting (or getting worse) hot flashes. Others have symptoms of menopause during the transition into menopause. We can do a blood test to prove if you are in menopause, or not. Your FSH level (follicle-stimulating hormone) goes UP in menopause. Sometimes we test for low estrogen too. The FSH is a more reliable test than an estrogen level. Women with risk factors are considered at higher chance of getting thin bones. Risk factors include:

  • Thin bones today
  • Mother or sister with thin bones that broke
  • Low body mass index (being skinny)
  • Lack  of exercise
  • Smokers and heavy drinkers of alcohol
  • Being Caucasian or Asian
  • Reaching menopause before age 45

Estrogens & Progestins: Once the decision is made to treat your hot flashes with estrogen, the question is which one? Estrogens may differ in how you take them, but your body does not really know the difference in terms of treating the hot flashes. All women with a uterus should take some form of progesterone with the estrogen to prevent the growth of abnormal cells inside the uterus. Daily progesterone should result in the least amount of bleeding.

Hormone Replacement: Menopause is the natural change in ovarian function. One of the most obvious symptoms of the menopause is hot flashes. Hormone replacement therapy (HRT) in menopause can treat hot flashes AND keep bones healthy and strong. HRT is probably best at doing BOTH of those things in an inexpensive, effective, tolerable fashion.

One common symptom of menopause that is often talked about is hot flashes. They are often reduced or prevented by using estrogen and tapering the dose over time. The speed of the taper is based on symptoms: if a lower level of estrogen does NOT cause hot flashes, then we keep going down. A typical interval is 3-6 months. If you begin experiencing hot flashes we can slow the taper, until the number and severity of hot flashes is OK, then go down in dose.