What are the Symptoms and Treatments for Menopause?

Menopause Symptoms and Treatment Options

When I interviewed some of the Plano, Frisco and Dallas, Texas area physicians at Women’s Specialist of Plano for a women’s health feature on the topic of menopause, I assumed they would tell me the obvious: that menopause is simply a phase all women go through that causes unwanted symptoms and an end to all menstrual periods.

I was right, they did. But I also learned a lot more during my discussion with Drs. Murray Fox, Daryl Greebon, Jules Monier and Dennis Eisenberg —all skilled and experienced gynecologists with WSOP—that really made me think differently about the “change of life” and hormone replacement therapy (HRT).

Menopause symptoms and treatments are different for every woman and there is a range of options for each specific case.  As a 37-year old female, I thought I still had a long time until I had to deal with the side effects of menopause. I distinctly remember my mom going through it at age 50 when she had a serious hot flash during the middle of my engagement party.

The truth—is that what I saw in her, were symptoms she had been dealing with for several years.

What Is Menopause?

Every woman is born with a certain number of eggs. These eggs are stored in the ovaries and it is in the ovaries that the hormones estrogen and progesterone are produced, which regulate ovulation and menstruation. Menopause occurs when the ovaries no longer produce an egg every month and menstruation stops. Natural menopause is a normal condition that occurs in all women between the ages of 40-58. Natural, meaning that menopause occurs without the side effects of any medical treatment such as a hysterectomy or chemotherapy. All women will experience some of the same symptoms from menopause as they age, but all will experience one common characteristic: their reproductive period will come to an end.

While the end to a menstrual cycle is a welcomed part of menopause, there are a number of unwelcome symptoms associated with this change. They include: irregular periods, missed periods, fatigue, mood swings and irritability, insomnia, depression, headaches, muscle aches and pains, bone loss (osteoporosis), incontinence and changes in sex drive (libido) as well as a decrease in vaginal lubrication.  In additions, many women will experience hot flashes and night sweats. Fortunately, many of the symptoms associated with menopause are temporary and will eventually disappear once menopause ends.

Help for Menopause

For women who choose to discuss menopause symptoms and treatments with their physicians, it is reassuring to know that there are many natural and home remedy steps one can take to help decrease and prevent some of the symptoms such as exercise, yoga, eating a healthy diet and getting plenty of rest.  Many women learn how to cool a hot flash by learning what triggers them. This helps them limit when hot flashes will occur and control them when they start.

For women that need additional help during menopause, there are medications that can be taken to help minimize the symptoms such as antidepressants, bone loss medications, Clonidine (a high blood pressure medication that helps ease hot flashes), vaginal estrogen creams and Progestin pills which help with irregular periods before menopause occurs.

Hormone Replacement Therapy (HRT):  Is It Right For You?

The onset of menopausal symptoms occur when the body stops producing estrogens. There are three types of estrogen produced in the human body and all three of these occur in balanced proportions, and although they are closely related, each has its own special function:

• Estradiol is the primary estrogen hormone and in nature it comprises 80% of the estrogen a woman’s body makes.
• Estrone is the least prevalent of the normal estrogens in women.  It increases significantly during pregnancy, but is a bit weaker than estradiol in its effect.
• Estriol is the third natural estrogen, and is also less potent in estrogen effect than estradiol.

Menopause symptoms and treatments will vary for each woman. For many women, hormone replacement therapy is used in the post-menopausal patient to minimize symptoms caused by the lack of a predictable estrogen-progesterone production. While hormone replacement is not for everyone, it has made a difference in millions of women’s lives. Patients are generally divided into two groups: those with a uterus and those without.  Patients without a uterus are usually treated with estrogen alone (estrogen replacement therapy – ERT); while those with a uterus are treated with estrogen and progesterone (hormone replacement therapy – HRT).

Likewise, hormone medications are also divided into groups: natural (made from soy, yam or other roots), bio-identical (compounded by a pharmacy) and synthetic (manufactured by pharmaceutical companies). In a woman who still has her uterus, ANY form of estrogen can stimulate the uterine lining and cause bleeding issues and the risk of endometrial cancer. The key in preventing this problem when estrogen replacement therapy is needed is to use progesterone with it in an adequate amount to protect the endometrium. For women who do not have a uterus, the endometrium is gone, and there is no need for progesterone, which can make estrogen therapy easier whether it is a cream, pill, or patch.

HRT and ERT:  Pill or Cream?

Is it better to take a pill, or use topical therapy?  This too has been debated for years.  Not all people respond equally well to the same product, so one woman may find it easier in her routine of life to take a pill.  Another may not react well with the pill, or may have trouble remembering to take a pill regularly and may be a better candidate for the patch, vaginal ring or for estrogen cream.  Each method works the same and it is important for a woman to find the best match for her and for her current lifestyle.

Hormone Replacement Therapy and Breast Cancer

The link between estrogen and breast cancer has been a highly discussed topic over the last decade.  According to Dr. Murray Fox, “Much of the data that has been reported in the media regarding the link between estrogen and breast cancer has been vastly misrepresented.  The media touts that 30% or 40% of women develop breast cancer while taking estrogen.  Those numbers are distorted. In recent tests that included several groups of 10,000 women, out of those who had no hormone treatment, 28 developed breast cancer; those with hormone treatment resulted in 36 women who developed breast cancer.  In a similar group of women who took estrogen alone, without any progesterone (because they had had hysterectomies), there were 7 fewer cases of breast cancer, suggesting that it is not primarily estrogen that causes the problem, but is the combination of estrogen and progesterone.”

Dr. Daryl Greebon agrees, “It is important for women to understand that estrogen poses greater risks for other medical issues than cancer. The primary risk of estrogen is blood clots (phlebitis); this can include blood clots in the leg, pulmonary embolus, or stroke. These risks exist with any estrogen replacement therapy whether oral or topical, and whether compounded or not.”

Dr. Jules Monier and the other physicians at the Women’s Specialist in Plano, Texas recommend their patients who are on estrogen replacement therapy use the lowest dose of estrogen possible for the shortest time possible, preferably no more than 5 years.  “However, quality of life is an important consideration, and as with all medical treatments one must weigh the benefits and the risks. For women who have incapacitating symptoms it may be worth the risks to have a better life style, this is an individual choice, “ says Dr. Monier.

Menopause symptoms and treatments and the best solution to handle the “change of life” can be a complex issue for many women. Each woman should discuss the options that are available with their doctor. The choice of using HRT or ERT should be made based on a balance of risks and benefits.  While there are risks to consider, for those women who suffer severely from menopausal symptoms, hormone replacement therapy and estrogen replacement therapy can make a major difference in their life.

To learn more about menopause symptoms and treatment options, or to discuss if you are a candidate for hormone replacement therapy (HRT), please contact the physicians at the Plano, Frisco and Dallas, Texas area office of Women’s Specialists of Plano.