A common complaint of the majority of menopausal women is the hot flash. It is also called hot flushes or night sweats, and the medical term used would be vasomotor symptoms (VMS). Most women will relate a feeling of great heat that overtakes their entire body, and this can last up to 5 minutes. These flashes can begin a few years before menopause and can last for many years after. There is great variability as to the number and intensity of these flashes, but most women who experience these hot flashes all consider them a problem that is disruptive to their lives. The exact cause of these flashes is not completely known, but the decrease in estrogen in menopause plays the main role.
Read more about menopause hot flashes and menopause.
As a woman ages, her ovarian function begins to decrease, and as the follicular activity starts to wane, the production of estrogen and progesterone goes down. The decrease in these hormones will eventually lead to no more menstrual cycles, and menopause is defined as 1 year of no menstrual bleeding. This is a natural part of every woman’s life as the 50’s approach and the average age of menopause is 51 to 52. With our ever increasing life spans, women may spend 30 to 40 years in this postmenopausal state.
The American Cancer Society (ACS) recently updated their breast cancer screening guidelines for women who are at an average risk of developing the disease. It was published in the October 20, 2015 issue of JAMA (Journal of the American Medical Society).
Here are the recommendations:
Women with an average risk of breast cancer should undergo regular screening mammograms starting at age 45
Starting at 40, have annual screenings if the woman desires
For women aged 45 to 54, the screenings must be annual
For women over 55, mammograms every 2 years or annually if the women desires
Screen as long as the overall health of the women is good or if her life expectancy is 10 years or greater
For average-risk women at any age, ACS does not recommend clinical breast exams for breast cancer screening
These recommendations have refueled the debate over what are the best guidelines, and these differ from the other major health organizations. It can be confusing, but I think it opens more discussions between women and their health care providers concerning the best way to screen for breast cancer for each individual. Please continue to speak to your health care provider about your breast health and come up with a plan best suited for you.
A recent small study of menopausal women with frequent hot flashes may show a relationship between these flashes and an increased chance of developing heart disease. Frequent hot flashes meant that the women experienced these flashes 5-6 times per day.
In the study, changes were seen in the vessels of the cardiovascular system. This again points to the importance of menopausal women having regular visits with their health care professionals to assess their cardiovascular health!
The risk of suffering from a heart attack increases for women after going through menopause. It seems that estrogen is heart protective, and after the menses stops, estrogen production greatly decreases. Therefore, heart problems become more of a concern.
It is important to remember that more women die of heart disease each year than men. This may be attributed to the fact that women do not seek medical attention as quickly as men when possible heart concerns develop. When suffering a heart attack, most men will describe crushing or squeezing chest pain while women will have no chest pain or simply a fullness feeling in the chest. Many women during a heart attack may complain of dizziness, shortness of breath, nausea, and weakness.
Please be alert for a woman’s special signs of a heart attack, and do not delay a trip to the ER. Your family and close ones need you!
…..Many menopausal women suffer from osteoporosis. Osteoporosis is the thinning of bones which causes them to become weak, brittle, and more susceptible to fractures. Women have an increased risk of osteoporosis throughout their lifetime. Risk factors include:
Low body weight
…..There are various methods of prevention and treatment for osteoporosis. There are medications such as the bisphosphonates (Fosamax) and selective estrogen receptor modulators (Evista). Supplements such as calcium and Vitamin D are important additives. Helpful lifestyle changes include the cessation of smoking, decreased alcohol use, and weight-bearing exercises.
…..Evista is a medication used to treat osteoporosis in the selective estrogen receptor modulator class. It mimics the beneficial effects of estrogen by increasing bone density. Many studies have also shown that Evista decreases the risk of certain types of breast cancer. The side effects of Evista are hot flushes, leg cramps, and infrequent blood clots or strokes.
…..Speak to your health care provider to see if Evista can be of benefit for you to treat osteoporosis and prevent breast cancer.
…..A new medication, called Brisdelle (paroxetine), has been approved by the FDA as the first non-hormonal treatment for moderate to severe hot flushes (vasomotor symptoms). This is a common problem in perimenopausal and menopausal women.
…..Brisdelle contains the same ingredient as Paxil, but at a much lower dosage. At this dosage, this medication is not indicated to treat any psychiatric condition but solely is for the hot flushes.
…..Many perimenopausal women suffer from severe hot flushes daily. Brisdelle has been proven to decrease these attacks significantly. It is reported to be a safe, non-hormonal option, and one capsule at bedtime is the advised treatment.
…..Pregnancy and some medications may prevent you from trying this medication. As always, before starting a new medication, review your current medications with your medical provider. So speak to your health care professional about the various treatments for menopausal symptoms and perhaps this new medication may be right for you.
…..Postmenopausal women are at an increased risk for urinary tract infections (UTIs) because of a decrease in their estrogen levels. This lower hormone state is associated with specific physical and physiologic changes that increase this risk:
Thinning of the mucosa of the vulva (vaginal tissue)
Changing of the normal bacteria that usually inhabit the vagina, especially a decrease in lactobacillus colonization
An increase in the pH of the vagina
Vaginal colonization of E. coli.
…..There have been multiple studies which have found a decrease in these UTIs with the use of estrogen intravaginal creams. There are many variations on the types of estrogen used and many commercial products available.
…..If you are in the menopausal time of your life and suffer from recurrent UTIs, ask your medical professional about the possible use of a vaginal estrogen preparation.
Weight control is a major concern for most of us. As menopause approaches, many women experience an increase in their weight, with about 70% being overweight. Body mass index (BMI) is a commonly used calculation that quantifies where our weight is, and when using this classification, about 50% of perimenopausal and menopausal women are considered obese.
Using a person’s height and weight, body mass index can be calculated, giving us a guide to where we stand with regards to our weight. A BMI of 24 to 29 is considered overweight, and over 30 is obese. Let us look at where some weights fall:
At 5 ft. 1 in. a BMI of 24 to 29 corresponds to a weight of 130 to 150 lbs.
At 5 ft. 1 in. a BMI of 30 corresponds to a weight of 160 lbs.
At 5 ft. 6 in. a BMI of 24 to 29 corresponds to 155 to 180 lbs.
At 5 ft. 6 in. a BMI of 30 corresponds to a weight of 185 lbs.
Remember that this BMI number is not an exact measurement of body fat but it alerts us to where our weight status lies and gives us an indication of our risks for developing the complications of obesity. These include diabetes, hypertension, heart disease, and many other medical conditions.