Menopause

Menopause is an event in women that, while completely natural and not life threatening, can cause major discomfort and lifestyle disruption.

 
HOW IT WORKS

Women are born with a finite amount of eggs in their ovaries. The exact amount varies from woman to woman, but most females number around 300,000 at birth. These eggs are eliminated over time, either through ovulation or by dying spontaneously (the fate of the overwhelming majority of eggs), called natural atresia.  This decline in egg number and the egg’s hormonal production culminates in the phenomenon of menopause, which marks the permanent end of the body’s ovulation cycle and results in elimination of the major source of estrogen production.

This major change in a woman’s life is a personal event that differs in each individual, typically occurring at an average age of 51, with a range from 45-55 years.  This results in a drastic drop in production of estrogen.  Since significant progesterone production only occurs with ovulation, progesterone production after menopause is virtually non-existent. These hormonal changes produce significant physiologic effects and can lead to many symptoms.

SYMPTOMS

Approximately 90% of women living in North America will develop symptoms of menopause, the majority of which are listed below.

  • Hot Flashes
  • Sweats
  • Irritability
  • Mood Changes
  • Sleep disruption
  • Cognitive changes (such as difficulty focusing or with memory)
  • Fatigue
  • Sense of diminished well being
  • Weight gain and increased central fat deposition
  • Loss of Libido
  • Vaginal dryness and discomfort

Women often come into the gynecologist with reports of the aforementioned symptoms, as well as a noticed cessation in menstrual activity.  It is not a disease or ailment, simply a part of life, so there is no ‘cure’ for menopause. However, there are treatments for reducing the symptoms.

TREATMENT

To combat these symptoms, doctors will often prescribe supplemental hormones. There are many FDA approved “bioidentical” supplemental estrogen and progesterone preparations which can be tailored to fit any woman’s needs.  These hormones are available in many forms and dosages, including orals, transdermal gels and creams, vaginal rings and creams, and even transdermal sprays.  They are also available as individually compounded preparations. Each individual needs to decide in conjunction with her doctor whether hormone therapy is right for her depending on the severity of her symptoms and potential benefits/risks of particular preparations.

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