What a doctor tells you about menopause

CNN
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Menopause is a nearly universal experience for women who live into middle age. In the United States, an estimated 1.3 million women Every year, menopause occurs. 90% of women Experiencing menopausal symptoms such as hot flashes, trouble sleeping, mood changes, and weight gain.

The condition is experienced by any woman who had ovaries during puberty, but many people report not having enough information about it: About 94% of women in the United States report that they were never taught about menopause in school. 2023 SurveyNearly half said they felt completely unaware of it.

We spoke with CNN health expert Dr. Leana Wen to find out the facts. What is menopause and when does it occur? How is it diagnosed and what are the typical symptoms? How can you best manage your symptoms? And where else can you get reliable, accurate information? Dr. Wen is an emergency physician and adjunct associate professor at George Washington University. She previously served as Baltimore City's health commissioner.

CNN: Can you explain what menopause is and why it happens?

Follow Dr. Wen on: Menopause is the time in a woman's life when menstruation stops. For most women, this natural biological process occurs as part of middle age when the ovaries stop producing certain reproductive hormones.

In some cases, menopause is induced by surgery or treatment. For example, cancer patients may need to have their ovaries removed, or undergo chemotherapy or radiation treatments that have the same effect as shutting down the ovaries.

One of the effects of menopause is a decrease in blood levels of two important hormones, estrogen and progesterone. Decreasing estrogenIn particular, it can cause common symptoms of menopause.

CNN: At what age does menopause occur, and how long does it typically last?

Wen: The timing of menopause varies greatly from person to person. Most women go through menopause between the ages of 40 and 58, but the average age at which women experience menopause is 51. North American Menopause Society.

Some women reach menopause earlier due to the medical and surgical conditions mentioned above. There are also other factors – for example, women who smoke often reach menopause two years earlier than non-smokers. There is also a genetic component – women whose mothers or sisters went through menopause early are more likely to do so.

Menopause is normal About 7 yearsHowever, the period can be up to 14 years. The period depends on factors such as race, smoking, and age at onset of menopause.

CNN: Is there a way to diagnose menopause? If I'm having irregular periods or feeling fatigued, should I get tested to see if I'm in menopause?

Wen: No special testing is needed for menopause. The diagnosis is generally made later and is defined as the absence of menstruation for 12 months. This means that if you're still menstruating, you're not in menopause yet. You could be in menopause, or you could have another cause for irregular periods and fatigue.

Testing may be justified in some circumstances. If you're under 40 and your period has stopped, you can consider testing. Testing may also be justified to rule out other illnesses. For example, a medical professional may want to rule out anemia or hypothyroidism in someone who is feeling fatigued. Also, just because a woman is going through menopause doesn't mean that all her symptoms are due to menopause.

CNN: You mentioned menopause. What is that?

Wen: Menopause does not usually occur suddenly, unless it is induced by surgery or illness. Four to eight years before menopause, there is a period called perimenopause. During this time, many women experience irregular menstrual periods and begin to experience menopausal symptoms.

CNN: What are the classic symptoms of menopause?

Wen: The most common symptom associated with menopause is hot flashes – a sudden feeling of heat that may be accompanied by sweating, flushed skin, and increased heart rate.

Related to this are night sweats, which are hot flashes that occur during the night. Women may wake up covered in sweat, which can make it difficult to get back to sleep, leading to sleep disorders and irritability.

Another common symptom is dry, thinning vaginal tissue, which can cause discomfort during sex. Menopausal women may also experience more frequent urinary tract infections. Some women may also experience mood changes, dry skin, and weight gain.

It is important to note that these symptoms can be severe. 25% of women Women who suffer from hot flashes often experience symptoms severe enough to seek medical attention. Approximately one in three women 10 or more hot flashes One day.

It is also important to note that after menopause, the incidence of chronic diseases such as cardiovascular disease and osteoporosis increases, which is thought to be due to the protective effect of estrogen against these diseases.

CNN: How can women best manage their symptoms?

Wen: I think it's really important for women to know that they don't have to suffer from these conditions, there are a variety of treatments available.

First, we need to discuss hormone therapy, which was unfortunately the standard treatment for menopause-related symptoms until one study was published. MisunderstoodNumber of hormone therapy prescriptions rejectionMany women were unable to find relief from their symptoms.

Earlier this year, some of the study's authors wrote a paper JAMA, Provided new analysis and thorough explanation of when and how to use hormone therapy, clarifying that combined estrogen and progesterone hormone therapy is safe, effective, and appropriate for treating women with hot flashes and other bothersome menopausal symptoms when initiated before age 60 in women without contraindications (e.g., estrogen-responsive cancer).

In addition to hormones taken as pills, patch Others offer similar benefits: Women over 60 who experience vaginal symptoms can also opt for vaginal creams or suppositories that deliver hormones.

Non-hormonal treatments also exist. U.S. Food and Drug Administration approved A drug called fesolinate is prescribed to reduce hot flashes. Women suffering from osteoporosis Pharmaceuticals There are specific treatments for osteoporosis, and lifestyle changes such as improved diet and exercise, quitting smoking, and even yoga and acupuncture can help.

CNN: Where else can you advise women to go for reliable, accurate information?

Wen: It is best to ask your doctor or gynecologist (if you have one) any questions. However, Research suggests Many health care providers are not trained to offer all menopause treatment options.

If you can't get the answers you need from your doctor, I highly recommend the North American Menopause Society. Among their many resources are: Clinician Database A physician who has special training in treating women going through menopause and has a special interest in guiding women as they go through this important change in their lives.