Women's Health - Menopause -

Managing menopause

Since we're always learning more about menopause treatment options and hormone therapy, it can be confusing to figure out how to treat or manage menopausal symptoms. It is important for you to have a doctor that you trust, so you can have an open talk about your concerns and your treatment options, and make informed decisions about your health. If you feel that you have talked openly with your doctor and still don't feel satisfied, you should think about getting a second opinion.

Talk to your doctor about how to best manage menopause. Talk about your symptoms and whether they bother you. Make sure the doctor knows your medical history and your family medical history, including whether you are at risk for heart disease, osteoporosis , and breast cancer . Remember that your decision is never final—you can and should review it with your doctor during a checkup. Your needs may change, and so might what we know about menopause.

Hormone therapy

The use of hormone therapy has been debated a great deal since the Women's Health Initiative (WHI) Hormone Study findings were released in 2002, which showed that long-term use of hormone therapy poses serious risks and may increase the risk of heart attack and stroke.

During perimenopause, some doctors suggest birth control pills to help with very heavy, frequent, or unpredictable menstrual periods. These pills might also help with symptoms like hot flashes, as well as prevent pregnancy. As you get closer to menopause, you might be bothered more by symptoms like hot flashes, night sweats, or vaginal dryness. Your doctor might then suggest taking estrogen, as well as progesterone, if you still have a uterus. Taking these hormones will probably help with menopause symptoms and prevent the bone loss that can happen at menopause. However, there is a chance your symptoms will come back when you stop hormone therapy.

Currently, hormone therapy is recommended for postmenopausal women who have moderate to severe hot flashes or night sweats. Instead of hormone pills, topical hormones like vaginal creams are recommended for women who have problems with vaginal dryness. Women should talk about these issues with their doctors, who also may prescribe hormones to prevent osteoporosis if other kinds of medicines cannot be taken. Postmenopausal women should not take hormone therapy as they grow older to prevent problems like heart disease.

Hormone therapy can help with menopause by:

  • Reducing hot flashes
  • Treating vaginal dryness
  • Slowing bone loss
  • Decreasing mood swings and depression
  • Improving sleep
For some women, hormone therapy may increase their chance of getting:

  • Blood clots
  • Heart attacks
  • Strokes
  • Breast cancer
  • Gall bladder disease
Women who should NOT take hormone therapy for menopause are those who . . .

  • Think they are pregnant
  • Have problems with vaginal bleeding
  • Have had certain kinds of cancers (such as breast and uterine cancer)
  • Have had a stroke or heart attack
  • Have had blood clots
  • Have liver disease
  • Hormone therapy can also cause these side effects:
  • Bleeding
  • Bloating
  • Breast tenderness or enlargement
  • Headaches
  • Mood changes
  • Nausea

Natural treatments/alternative therapies

Tell your doctor if you decide to take herbal, natural, or plant-based products to help your symptoms, as they may have side effects or make another drug not work as well. Some of the most common ones are:

  • Soy. This contains phytoestrogens (estrogen-like substances from a plant). Some research has shown that soy food products can help with mild hot flashes. Other research suggests that women who have been diagnosed with estrogen-dependent breast cancer should be cautious with their soy intake. Eating large amounts of soy products could be harmful for women with this type of breast cancer.
  • Other sources of phytoestrogens. The active ingredients in most dietary supplements for menopause are phytoestrogens — chemicals found in plants that may act like the estrogen produced naturally in the body. These include herbs, such as black cohosh, wild yam, dong quai, and valerian root.
  • Bioidentical hormone therapy. Bioidentical hormones are custom-mixed formulas containing various hormones that are chemically identical to those naturally made by your body. These over-the-counter products are marketed as being tailored to a woman's individual hormone needs. There are two main types of Bioidentical hormones: those that are FDA-approved and commercially available with a prescription, and those that are mixed on an individual basis for women in compounding pharmacies, which are NOT FDA-approved.

Healthy living

  • Don't smoke.
  • Eat a variety of foods low in saturated fat, trans fat, and cholesterol. Include grains, especially whole grains and a variety of dark green leafy vegetables, deeply colored fruit, and dry beans and peas in your eating plan.
  • Maintain a healthy weight and be physically active for at least 30 minutes a day.
  • Engage in regular physical activity and reduce sedentary activities to promote health, psychological well-being, and a healthy body weight.
  • Achieve physical fitness by including cardiovascular conditioning, stretching exercises for flexibility, and resistance exercises or calisthenics for muscle strength and endurance.