Menopause, Choices for good living

By Irfane Khatib, MD

Menopause is a natural, gradual process that every woman goes through, although the degree of symptoms may vary from woman to woman.

Throughout a womanÍs life, her ovaries produce different hormones to help keep her body healthy and strong. Two important hormone types produced by her body are estrogen and progestin. Theses hormones have a powerful influence in a womanÍs overall health, bone strength, and reproduction. Both of these hormones also play an important role in her physical and emotional well-being.

As a woman enters menopause, her ovaries stop producing estrogen and progestin. As a result, her menstrual cycle will start to change and will eventually reach a point when she stops having her period. This is a perfectly normal change that all women go through, usually between the age of 45 and 55. A woman knows that she passed menopause when she has not had her period for one full year.

During menopause, a womanÍs body goes through a series of changes as it readjusts to the loss of estrogen and progestin. During this readjustment period, she may experience a wide range of symptoms including hot flashes, irregular menstrual cycle, night sweats, vaginal dryness, and temporary loss of sex drive. Again, these changes are perfectly natural and are a normal part of menopause, but vary in degree from woman to woman.

Taking hormone replacement therapy (HRT) will help restore the estrogen and progesterone that the woman had prior to menopause. By replacing these hormones, HRT can help relieve many symptoms associated with menopause and actually prevent some of the long-term health risks.

Women have used hormonal replacement therapy for nearly a half-century, assured that the drug provided protection against osteoporosis and heart disease, in addition to treating the symptoms of menopause. Now, since the National Institutes of Health suddenly discontinued the WomenÍs Health Initiative trail of estrogen and dedroxyprogesterone due to the discovery of an increased risk of coronary heart disease, stroke, pulmonary emboli, and breast cancer, there are many questions and fewer options. For millions of women who take combined estrogen and progesterone therapy, the womenÍs Health Initiative results significantly changed their clinical treatment option for the relief of menopause symptoms and prevention of osteoporosis.

The new recommendation now advises that these products are not indicated and should not be used to prevent coronary heart disease. When used solely for prevention of post-menopausal osteopororisis, alternative treatment should be carefully considered. These options should include smoking cessation, exercise, proper diet, calcium and vitamin C supplements and prescription medications if necessary such as Fosamax.

The use of HRT should be limited to the shortest duration consistent with the treatment goals and risk for the individual woman and should be periodically reevaluated.

For management of hot flashes in post-menopausal women, non-hormonal alternatives such as selective serotomin uptake inhibitors, clonidine, or Bellergal-S may be helpful. Other alternative agents such as black cohosh and soy have been proposed, but their safety is not established. ñGood living practicesî including a healthy diet, exercise, smoke cessation and supplement of vitamins and calcium are very important and should be part of any health management plan.

Hormones still remain a valuable component within our therapeutic options for short term (less than five years) use for specific symptoms presenting a favorable benefit-to-risk profile.

For more information, call Obstetrics-Gynecology Clinic of Eau Claire é 715.833.4926