July 24, 2018

Managing Menopause

Managing Menopause

For many years, menopause was known as “the change,” that time in a woman’s life when her body transitions out of the childbearing years. Some of the menopause’s changes might be welcomed (no more periods!); others range from merely irritating to downright oppressive. One thing is certain, though: These symptoms can make this simple “change” feel like a Category 5 hurricane.

The physical discomforts — hot flashes, vaginal dryness, and decreased libido, to name a few — can lead to insomnia, restlessness, and stress. It’s no wonder that some women report feeling anger, anxiety, and frustration during menopause, which typically happens in a woman’s early 50s.

The good news: Not every woman in menopause experiences those symptoms, and many who do experience them find them manageable, says Brad Youkilis, MD, an OB/GYN with Baptist Health Medical Group Women’s Care Center in Lexington.

But what if your symptoms aren’t manageable? Dr. Youkilis has some tips.

Talk to Your Doctor, Candidly

The best thing you can do for yourself, Dr. Youkilis says, talks openly to your doctor about your symptoms. Discussing vaginal dryness or painful intercourse might not be the easiest conversation, but it is a necessary one.

The bottom line: Your doctor can’t address what’s bothering you if you don’t talk about it bluntly. And even if you’re a little embarrassed, your doctor won’t be.

“I take time to talk to patients and try to understand what’s really happening,” Dr. Youkilis says. “If I don’t do that, I can’t help them.”

Don’t Be Afraid of Hormone Replacement Therapy

Hormone replacement therapy used to be the go-to treatment for symptoms of menopause. Then a study suggested women who took hormones could be at greater risk for certain cancers and other health problems. The study focused on women who used hormones for six or more years — longer than the average menopausal woman would need them, Dr. Youkilis says.

The data doesn’t show a large increased risk for cancer when women take hormones for fewer than six years, he says.

“Now we have taken a lot of people and deprived them of hormones — which can be very helpful in alleviating those symptoms — for fear of a problem that probably is not borne out by the data,” Dr. Youkilis says.

That doesn’t mean that hormone replacement therapy is always the answer. The key is to match treatment to both the symptom and the patient. For example, when vaginal discomfort or painful intercourse is a woman’s only symptoms, “there are a lot of ways to give people relief with medicines that have fewer risks or costs,” Dr. Youkilis says.

Antidepressants and anti-anxiety medications can also help alleviate symptoms that affect a woman’s stress levels and ability to cope with stress. You can buy over-the-counter creams such as Vagisil to help with dryness or itching, and phytoestrogen supplements may help to reduce hot flashes. Personal lubricants can make painful sex more comfortable, as can increase foreplay. And black cohosh or evening primrose oil might be useful for sleeplessness, Dr. Youkilis says.

“In general, though, the more severe the symptoms, the less effective those over-the-counter remedies are,” he says.

Self-Care Is Queen

The building blocks of taking care of yourself — healthy nutrition, managing stress, moderate exercise — can all help alleviate symptoms of menopause, Dr. Youkilis says.

“If someone is eating a high-fat, high-soda, high-fast-food-intake diet, eating better will probably help soften some of those menopause symptoms,” he says.

Good sleep matters, too.

“The symptoms of chronic fatigue often look a lot like menopause,” Dr. Youkilis says.

And as hard as it can be, when hot flashes are keeping you awake at night, remember that you are not alone.

“Most women are able to find relief,” Dr. Youkilis says. “If they are struck by the problems of menopause, though, there are many solutions with very little risk that their healthcare providers can work through with them. They don’t have to be miserable.

Learn more about menopause on our Baptist Health For You blog.

Learn More.