Many people associate menopause with experiencing symptoms such as hot flashes and night sweats. In fact, these symptoms are most severe in the years leading up to the official onset of menopause. This transition period, also called perimenopause, usually begins sometime in your 30s or 40s and can last for several years.
Even if you have hot flashes and irregular periods, you’re not officially in menopause until you haven’t had a period for at least 12 months. In the United States, the median age at which a woman begins menopause is 51.
“To be menopausal, you must be at least 40 years old,” explains OB-GYN Katie Lessman, MD. “If you don’t have a period before then, your doctor will want to look for another cause.”
Will Menopause Test Kits Tell Me If I’m Menopausal?
Menopause is a clinical diagnosis that your doctor will make based on several factors. A menopause test kit only measures the level of follicle-stimulating hormone in your blood or saliva. Women in their mid-40s have elevated FSH levels. However, this number doesn’t tell you when your period will stop or how long other symptoms will last.
What symptoms can occur during menopause?
As you enter menopause, your ovaries stop ovulating and your estrogen levels fluctuate. These fluctuations in hormone levels are responsible for the symptoms that many women experience at this time.
The signs and symptoms of menopause can vary greatly from person to person. “Typically, one-third of women go into menopause with only mild symptoms or no symptoms at all,” says Dr. lessman “Another third will have troublesome symptoms for a few years. The last third will have symptoms that improve but never go away.”
Common symptoms of menopause are:
- Hot flashes and night sweats: Hot flashes and night sweats, collectively known as vasomotor symptoms, are usually one of the first signs a woman is approaching menopause. As the ovaries begin to work less predictably, estrogen levels rise and fall. The estrogen spikes make the temperature sensor in the brain extra sensitive, causing hot flashes and night sweats
- Sleep disorders: Many women notice changes in the quality of their sleep. Night sweats can wake you up and make it difficult to fall asleep. Even if you don’t suffer from night sweats, the quality of your sleep may not be the same as it was before
- mood swings: The drop in hormone levels makes people more prone to anxiety and depression, just like they do after childbirth
- vaginal dryness: Once your estrogen levels have been low for a while, vaginal dryness and pain during sex become more common
The good news is that many of these symptoms improve or stop altogether once you’ve officially entered menopause. So if you suffer from anxiety and depression, your mood should return to normal. Hot flashes and night sweats are also likely to improve if they don’t stop completely once you hit menopause.
Treatment of menopausal symptoms
Hot flashes and night sweats
“Hormone replacement therapy is the most effective treatment for hot flashes and night sweats. We can expect a 70% to 90% improvement in vasomotor symptoms with estrogen,” says Dr. lessman
Do I have to stop HRT after five years? What if I still have hot flashes?
Most often, hot flashes and night sweats either improve dramatically or go away completely within five years after menopause. If symptoms don’t improve after five years, you need to work with your doctor to weigh the risks and benefits of continuing hormone replacement therapy as you age.
“Some risks, such as colon cancer or osteoporosis, continue to decrease with estrogen use,” explains Dr. lessman “Other risks, like breast cancer, will increase over time. Some risks, like heart disease, may improve or worsen with estrogen depending on how and when it’s used.”
Because of these risks, hormone replacement therapy is not recommended to treat other menopausal symptoms, such as mood swings. “When it comes to treating depression and anxiety, HRT is far more dangerous than taking antidepressants,” warns Dr. lessman “Counseling and medication are better treatment options for these types of symptoms.”
Is HRT the only treatment for hot flashes?
In addition to HRT, there are some other treatments that have been shown to improve vasomotor symptoms by 50% to 70%. These include:
- Clonidine: a type of blood pressure medication
- Gabapentin: a drug that affects nerve signals and is used to prevent chronic pain and seizures
- Paroxetine: an antidepressant
Herbal remedies, vitamins, exercise, acupuncture, and reflexology can help you deal with hot flashes and night sweats. Unfortunately, says Dr. Lessman, the evidence shows they don’t make these symptoms less frequent or less intense.
How do I treat vaginal dryness?
“Vaginal estrogen is the most effective treatment for vaginal dryness and painful intercourse,” says Dr. lessman “These can be prescribed as creams, tablets or vaginal rings. There are a few other products on the market that treat the same symptoms. But frankly, they are estrogen inferior.”
Regarding lubes, Dr. Lessman recommends using natural oils like coconut or olive oil instead of synthetic lubes. “Even Crisco is so simple chemically that it can soothe irritated vulva and vaginal skin,” she added. “For some women, a dime-sized lump inserted into the vagina twice a day can replace the need for vaginal estrogen.”
Who should I go to for treatment of menopausal symptoms?
Talk to your GP or OB-GYN. Depending on your symptoms, your doctor may be able to provide treatment or refer you to the appropriate specialist. You can also call 800,922,0000 to make an appointment.