Menopause: Your questions answered
September is National Menopause Awareness Month.
So, the Daily Herald took this opportunity to chat with Missy Lavender, founder and executive director of the Women's Health Foundation, a Chicago-based nonprofit dedicated to women's and girls' pelvic health and wellness, and Dr. Corrado Altomare, vice president of U.S. Medical Affairs at Shionogi Inc., a pharmaceutical company focused on advancing women's health based in Florham Park, New Jersey.
The pair answered some common questions women have about menopause and perimenopause.
First, Lavender answered a couple questions about her group and its purpose:
Q. You've just finished a campaign to raise awareness about sex after menopause. Why did you pick this topic to focus on?
Lavender. With women spending one-third of their life after menopause and the topic of sex being important at every age, we wanted women who were postmenopausal to understand that if they were experiencing symptoms of painful sex, 1) they were not alone and 2) there were a number of options available to help them.
Many women suffer in silence with vaginal dryness or signs of vaginal atrophy, yet are reluctant, perhaps embarrassed, to bring it up to their doctors.
The other reason we embraced this campaign is that, surprisingly, research shows health care providers are also not talking to women about their sex lives after menopause, so it is a double whammy. Whether this is because they are embarrassed as well, or have inadequate resources to offer women, is unclear. What we stand for at Women's Health Foundation is women advocating for a healthy, vibrant life … (it) seemed like an important opportunity.
Q. Tell me more about your group, the Women's Health Foundation. Why did you start it and what are your goals?
Lavender. Women's Health Foundation's mission is simple: We want to improve the pelvic health of women and girls through driving innovative, community-based research, designing wellness programs and fostering dialogue, both digitally and through community events on topics "below the belt."
We are the only national nonprofit focused on pelvic health, and we hope that someday all women and girls realize the ins and the outs of this critical area of their lives; how things should work and what they should do; and who they should consult if things start to go in a direction they don't like.
We are continually hearing from women and girls in our programs things like, "Why didn't I learn this earlier or when I was younger?" or "I think every woman should have this information," and we agree. That is our goal - and our unofficial motto is that we are "Changing the World, One Pelvic Floor at a Time."
Dr. Altomare answered the following medical questions concerning menopause and perimenopause:
Q. What can women do to improve their sex life after menopause?
Altomare. If women are having issues after menopause such as pain with intercourse, the best course of action is talk with their health care provider. I am aware that many, if not most, women feel unable to talk openly to their doctors about some issues with their sex life that concern them.
To those who feel this way, I encourage you to take a deep breath and ask the questions on your mind. You may be amazed at the results. You may learn that what you're concerned about is completely normal and quite common.
Or, you may find there is a name for your condition and it can be treated. Either way, you can only gain from starting the dialogue. At Shionogi, many of our programs for women and health care professionals are designed to get this important conversation going.
Q. Women begin to go through perimenopause and menopause at widely varying ages. Why is that? And what symptoms should women recognize as possible signals they are starting to enter this stage of life?
Altomare. The North American Menopause Society (NAMS) has terrific online resources that can be easily accessed by visiting http://www.menopause.org/for-women.
Here is their definition of perimenopause: A span of time typically lasting six years or more that begins with the onset of menstrual cycle changes and other menopause-related symptoms and extends through menopause (the last menstrual period) to one year after menopause.
Perimenopause is experienced only with spontaneous (natural) menopause, not induced menopause. It is also called the menopause transition.
Q. How does a woman who no longer has a period (due to hysterectomy, for example) know when she is in menopause?
Altomare. Menopause is "official" when the ovaries stop functioning. When a woman has a total hysterectomy - one that includes the removal of her ovaries - menopause will start immediately after her procedure (provided that she was not already menopausal), no matter how old she is when the hysterectomy takes place. Common symptoms of menopause, such as vaginal dryness, hot flashes and mood swings, may come on suddenly.
Q. How long does perimenopause usually last? And when is a woman in menopause?
Altomare. The average length of perimenopause is four years, but for some women perimenopause may last only a few months or continue for 10 years. Perimenopause ends when a woman has gone 12 months without having her period. According to NAMS, there is no simple test to predict or confirm menopause, but research continues.
Q. Is it normal for symptoms to ebb and then return during perimenopause?
Altomare. The most common symptoms women in their 40s notice are changes in periods and the onset of hot flashes. These may come and go over a period of time that is individual for every woman, but averages four years.
Q. Friends have complained of "foggy brain syndrome" in perimenopause. How common is that, and will their memory get better once they've gone through menopause?
Altomare. Most people are familiar with the common symptoms of menopause such as hot flashes and vagina dryness, a symptom of vulvar vaginal atrophy (VVA). This is what causes painful sex. But many may not associate cognitive symptoms such as memory issues, confusion and decreased alertness with menopause.
Some researchers now believe hormonal changes associated with menopause can contribute to these problems. It is not uncommon for these symptoms to improve over time. Research shows that the intellectual edge lost during the period leading up to a woman's last menstrual cycle rebounds in the later phases of menopause.
Eating a well-balanced diet, regular exercise, smoking cessation, stress management and plenty of sleep will help.
Q. Are there other ways to deal with menopause other than hormone therapy? Any natural treatments for the hormonal swings associated with menopause?
Altomare. Many women can't or don't want to take estrogen or hormones. If they are experiencing moderate to severe symptoms of menopause, such as painful intercourse or hot flashes, there are other available non-estrogen treatment options. As always, the best course of action for them is to speak with their health care providers who will be able to make the most appropriate recommendations.
Q. Weight gain is a common complaint during perimenopause and menopause. What can women do about that?
Altomare. Most people, men and women, gain weight as they age, although it is important to note that this is not inevitable. There are simple steps women can take during and after menopause to minimize the extra pounds, such as eating a healthy diet and stepping up their daily exercise. Discuss any weight gain with your health care provider and make a plan together.
Q. Also, what can be done about the dreaded hot flashes during menopause?
Altomare. Some women going through menopause barely notice hot flashes. For others, hot flashes are highly disruptive. Avoiding the common triggers of hot flashes, such as stress, caffeine, alcohol, spicy foods and hot temperatures, may help. Regular exercise may also help, as may a cool bedroom at night. Women experiencing hot flashes that they find disruptive to their lifestyle should talk with their health care professional.
• For more information about the Women's Health Foundation, visit http://womenshealthfoundation.org.