By Patricia McLelland, M.D.

Menopause is a natural process that most women will experience. What should a woman expect? How should a woman approach menopause?

Women go through menopause at an average age of 51. This has not changed in 100 years. The definition of menopause is no period for a year. Periods stop due to a decline in hormone production. This definition does not address symptoms because most women experience symptoms very differently. The most common symptoms that women experience include hot flashes, night sweats, vaginal dryness, sleep disturbance and mood swings. Many women may begin having symptoms long before they stop having periods.

There is no fool-proof way to predict the severity of symptoms. Most women will have some symptoms that are mild to moderate. Few women will have severe symptoms that are debilitating. For most women, these symptoms are worse around the onset of menopause and slowly improve over time. Stress can intensify the symptoms of menopause. Surgical menopause (ovaries removed) at a young age is often associated with severe symptoms.

Timing of menopause is often not predictable. A woman will go through menopause early if she has her ovaries removed before natural menopause. She may go through menopause at a younger age if she smokes, if she has a family history of early menopause, or if she has received certain types of chemotherapy or radiation.



The duration of symptoms is also not predictable. Symptoms may last several months. For some, they may never completely go away.



Symptoms are often the main focus of menopause; however there are disease risks that increase after menopause. These include heart disease, breast cancer and osteoporosis. Evaluating your personal risk for these diseases can be done with the help of your doctor.

Menopause is not a disease that has to be treated with medications. Lifestyle changes may prevent or minimize symptoms and disease risks. Helpful changes include exercise (30-45 minutes 5-7 times/ week), stress reduction (consider yoga especially if stress levels are high), quitting smoking and limiting caffeine and alcohol. Diet changes should include increasing complex carbohydrates (for example, eat whole grain bread instead of white bread), fiber, whole foods (such as an apple instead of apple juice) and water. It is also a good idea to eat more organic fruits and vegetables (hopefully reduce exposure to pesticides) and try to eat meat and dairy that are hormone free.

Many women try supplements such as calcium and vitamin D, soy, melatonin, St John's Wort, vitamin E, C, black cohosh, flax seed, and omega 3 fatty acids to decrease symptoms and disease risks. Studies looking at the benefits of supplements give us mixed results, some studies show benefit and some do not. In moderation these supplements are unlikely to be harmful in healthy women. If they are helping, most women prefer to continue.

Since menopause is a natural process that most women will go through, it is an excellent time to reevaluate our lifestyles and improve our overall health.



For more information:

www.menopause.org

http://www.4woman.gov/

http://www.hormone.org/

www.mayoclinic.com

Patricia McLelland, MD, board certified in obstetrics, and gynecology, is currently a practicing physician at Galen OB/GYN in East Brainerd, TN. She received her medical degree in 1994 from the Vanderbilt University School of Medicine in Nashville, TN. She has been a member of the Chattanooga & Hamilton County Medical Society since 2004.

Contact her at: 1651 Gunbarrel Road, Suite 201, (423) 899-9133