In her late 40s, Janet Ko began experiencing heart palpitations, night sweats and 30 hot flashes a day, she said.
Scared she was having heart problems, the Mississauga, Ont., resident saw multiple doctors, but none had linked her symptoms to perimenopause at the time.
Ko, now 55, said it took several years of not feeling healthy before she got the help she needed.
“I went into menopause in my late 40s, had perimenopausal experiences, but I had no idea that there was something called perimenopause,” she told Global News.
In the hope for other women to not be “blindsided” the way she was, Ko started the Menopause Foundation of Canada in January 2022 to help raise awareness about the hormonal changes that affect nearly half the Canadian population.
“We do not want women to be blindsided in the prime of their lives,” she said.
“We want women to receive options and choices to help them manage their menopause their way,” she said, adding that there are many safe and effective treatments for women that they are largely unaware of.
A new national report released Oct 6 by the Menopause Foundation of Canada found that nearly 50 per cent of women feel unprepared for menopause, while more than half were unaware of the common menopausal symptoms.
Of the 41 per cent of women surveyed between the age of 40 and 60 who sought medical advice, 72 per cent found that was not helpful or only somewhat helpful, the report showed. Nearly 40 per cent of women also felt their symptoms were undertreated.
Dr. Wendy Wolfman, a professor in the department of obstetrics and gynecology at the University of Toronto, said it’s very important to assess the general health of women around and during the time of menopause to be able to identify any risk factors, “silent health issues” and discuss treatments.
This will improve women’s aging years and quality of life when they are most productive, she said.
“A lot of the diseases of aging may actually start for women in the perimenopause – and so the goal is preventative and trying to optimize health,” Wolfman said.
What is menopause?
Most women hit menopause — marked by not having had a menstrual period for one year — between the ages of 45 and 55.
Wolfman said a test for menopause is not really needed as the diagnosis can be made once women start experiencing menopausal symptoms, like hot flashes, and their periods start getting lighter.
During menopause, a woman’s ovaries stop producing eggs every month, which results in a drop of hormone levels.
Perimenopause is the transition period, lasting six to eight years, leading up to menopause when a women’s menstrual cycles could become irregular as the hormone levels fluctuate.
In Canada, the average age of menopause is 51.5 years. But most women are in perimenopause between the ages of 40 and 50, according to the Menopause Foundation of Canada.
And women can continue experiencing symptoms into their 60s and 70s, Wolfman said.
In the United Kingdom, a parliamentary group recommended this week that women should be invited for a menopause assessment when they turn 45.
Ko said Canada can learn from the example of other countries, like the U.K., to better support women in menopause and bridge the knowledge gap.
What are the symptoms?
Women experience a variety of symptoms, both physical and mental.
Some of the common symptoms of menopause include irregular periods, hot flashes, night sweats, headaches, mood swings and joint pain.
Women in menopause may also have trouble sleeping and lack sexual desire, which can happen within about 24 months of their last menstrual period, Wolfman said.
In 50 per cent of women, genitourinary syndrome of menopause (GSM) can result in vaginal dryness, bladder symptoms, effects on the pelvic floor, as well as sexual ramifications, she said.
Meanwhile, one of the hallmarks of perimenopause is abnormal uterine bleeding or changes in menses.
And women may also experience more migraine, headaches and vaginal discharge during perimenopause.
There are also long-term health risks associated with menopause, such as osteoporosis, diabetes, heart disease and GSM.
“There is this myth that menopause happens and then you get through it and it’s over,” Ko said.
“So I think it’s really important that we emphasize that menopause is a continuum and that there are health matters that women need to be aware of and that they need to be focused on with preventative care, lifestyle choices and certainly evidence-based treatment options.”
Treatments
From over-the-counter medications, prescription drugs to lifestyle changes, there are several ways to treat symptoms of menopause.
However, Wolfman said the most effective treatment is hormone therapy, which can be administered by pills or transdermally via a patch or a gel.
This treatment is approved by Health Canada and given by prescription. However, there is a risk of initiating hormone therapy for women over the age of 70, which is why it’s typically not given to them, Wolfman said.
“We’re giving it to women who are newly menopausal or in the perimenopause, that is women around the age of 50,” she said.
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.
Ko said HT proved be a “lifesaver” for her.
Antidepressants and other medications like Gabapentin, Oxybutynin, and Clonidine, can also treat menopause symptoms but none work as well as hormone therapy, Wolfman said.
Yoga is also recommended but exercise has not shown to be that effective, she said.
“Women are spending a lot of money on a lot of therapies which really haven’t been shown to have great effect. And that’s not really fair to women.”
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