Menopause looks different for everyone who goes through it.
Women can start menopause at a range of ages and experience a variety of symptoms, both physical and mental.
Dr. Lindsay Shirreff, an obstetrician/gynecologist at the Mature Women’s Health and Menopause Clinic at Mount Sinai Hospital in Toronto, told Global News the average age of menopause in Canada is 51 years old.
“Genetics often impacts the onset of menopause,” she told Global News. “For example, the age a woman’s mother or sister went through menopause can influence when she might expect menopause to happen for herself.”
She added that a small portion of women — about one per cent — can also experience premature ovarian insufficiency, where menopause happens before age 40.
“Usually, there is no obvious cause,” Shirreff said. “Sometimes, however, it can be related to genetics, an autoimmune condition, or be secondary to treatments like radiation or chemotherapy that women have undergone for cancer.”
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During menopause, there is a drop in estrogen produced by a woman’s ovaries. This typically is followed by symptoms such as hot flashes, night sweats, vaginal dryness and lower libido. Women may also lack energy, experience joint aches or have difficulty with regular sleep, mood or memory.
“While we may not be able to tell at first, the drop in estrogen around the time of menopause can lower bone density and alter the architecture of our blood vessels, potentially affecting heart health,” Shirreff said.
What is perimenopause?
Lisa O’Neill, 48, of Calgary, first experienced symptoms of what she thought was menopause two years ago.
“I probably had signs earlier than that but didn’t notice,” she told Global News. “For me, it started with irregular periods and night sweats. I was always that person who was cold (and started) waking up at night soaking wet.”
O’Neill thought she was too young to go through menopause.
“I had thought I would be in my 50s,” she continued. “A wave of heat would come over me and my arms and face would turn bright red… then it would subside and I would be really cold.”
She was later told by her doctor that she was experiencing perimenopause, the transition period to menopause. Shirreff said that during perimenopause, a women’s menstrual cycles become irregular and they begin to experience some of the well-known symptoms of menopause.
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O’Neill added that doctors told her her menopause will officially start in November.
Like O’Neill, Susan Knox first began to feel symptoms at an early age. The 42-year-old of Kitchener, Ont., said she started to physically and mentally feel like a different person when she was 39.
“I noticed my body odour was changing,” she explained. “I smelled all the time and it wasn’t just regular body odour, it was horrific. I had to start carrying deodorant with me everywhere.”
This was followed by some memory loss, constant fatigue and eventually insomnia with night sweats. Knox said the irregular periods came next.
“I had no idea when or where it was going to happen. I would sometimes bleed for 26 days straight,” she said. “Now it was like PMS and menstruation 24/7.
“The worst of all the symptoms is the rage and the feelings of hopelessness and doom.”
Shirreff added that if you are feeling symptoms before 51, talk to your doctor.
“If a woman experiences any bleeding after one full year without a period, she should seek medical attention.”
Hormone therapy
Hormone therapy is one of the most effective treatments for bothersome hot flashes and night sweats, Shirreff added.
“We aim to individualize treatment and offer women the lowest hormone therapy dose to provide relief from her symptoms.”
She said that as long as a woman has no contraindications to starting hormone therapy and is within 10 years of her last period, this type of therapy is safe and effective.
“Women who still have their uterus are typically prescribed estrogen and progesterone,” she said. “The estrogen is often given through the skin in the form of a patch or gel to decrease the risk of blood clot and heart attack that was previously attributed to hormone therapy.”
Taking progesterone, she said, is important to protect the lining of the uterus from the development of any pre-cancer or cancer lesions. However, if a woman has had a hysterectomy, she will not need progesterone.
Shirreff said there are some precautions women should take if they are undergoing the therapy.
“If a woman decides to take hormone therapy, it is imperative she continues her breast screening with regular mammograms as hormone therapy can increase the risk of breast cancer slightly,” she said.
“Once she starts hormone therapy, she should see her doctor regularly to ensure her hormone therapy regimen does not need to be changed or stopped.”
O’Neill said her doctor was hesitant to prescribe hormone replacements, so she tried an antidepressant instead.
“I didn’t like the side effects that came along with them so I asked for hormones,” she explained. “I am on a very low dose and it has relieved the hot flashes and night sweats.”
But the changes she feels aren’t just physical.
“I have recently discovered that body image comes into play,” O’Neill added.
“I have never really been one to worry about how I looked until last year. I have considered off and on about having a breast augmentation… I mourn my youth.”
Coping tips
Again, menopause is different for everyone. Some women are fine with their symptoms and it does not heavily impact their day-to-day.
For women who are having difficulty with their symptoms, it’s important to talk to your healthcare provider. With the common bothersome symptoms of menopause, like hot flashes and night sweats, Shirreff said lifestyle modifications can help.
“Suggestions include carrying a fan, using moisture-wicking sheets, maintaining a healthy weight, refraining from smoking, reducing alcohol consumption, lessening anxiety and stress, having acupuncture and doing hypnosis.”
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Other natural options include consuming soy foods or black cohosh — an herbal remedy — although these are not terribly effective, she added.
Shirreff said there are prescription medications other than hormones that can help.
“Examples include some antidepressant medications at low doses, a blood pressure medication (clonidine) and gabapentin,” she said.
The best treatment for vaginal dryness is “estrogen placed directly in the vagina,” she explained.
arti.patel@globalnews.ca
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