Hot Flashes

Hot flashes and night sweats occur when heat production is increased due to changing estrogen levels. They occur when small blood vessels in the skin dilate to get rid of excess heat. Skin temperature can rise 6-7 degrees but the core body temperature does not change or may even lower slightly. Hot flashes can happen more frequently due to exercise, excitement, stress, eating, warm weather, alcohol, and warm clothing or bedding. Women's experiences vary as to how intense the hot flashes will be, how often they will occur or how long they will last.

Helpful Hints:

Menstral Cycle Changes

Sudden cessation of menstrual periods can happen but is not the norm. The menstrual cycle can vary widely from shorter, less frequent periods, to longer more frequent periods and all variations in between.

What Can Help

• If anemia is a concern, your hematocrit should be monitored. Do not take iron supplements unless anemia is a problem and your practitioner recommends the supplements.
• Birth control is recommended for at least 1 year after the last menstrual period. The newer lower dosage birth control pills are safe for women into their mid 50s who don't smoke and are an excellent way of dealing with menstrual cycle changes and night sweats because they provide a consistent level of Estrogen

Changes in the Urinary Tract

The level of estrogen in the body affects the cell structure of the vulva, vagina, bladder, and urethra. These cells become thinner, paler and less elastic as estrogen levels decline. This can cause vaginal dryness, itching, discomfort with vaginal penetration, pain with urination, and incontinence, especially stress incontinence (losing urine when coughing or laughing). Remember, not all women have problems with these changes.

Helpful Hints

• Use lubricants liberally for vaginal dryness. Most drugstores have products specially designed for perimenopausal women. Cocoa butter, coconut or sesame seed oil, or a water-soluble jelly may be effective. Use only water-soluble lubricants with condoms, dental dams, and diaphragms to avoid the breakdown of latex.
  
• Longer periods of foreplay alone or with a partner may help. Open communication with your partner is very important due to possible changes in sexual desire or responsiveness.
  
• Regular sexual activity and orgasm, either alone or with a partner is one of the best ways to keep the genital-urinary tract in good condition.

Osteoporosis

Osteoporosis, which literally means porous bones, is a normal aging change for both women and men starting around age 35. Decreasing estrogen levels cause an increase in bone loss but many factors, such as diet, exercise, use of tobacco and alcohol are just as important. So determine your risk factors with your care provider. The more risk factors you have, the more aggressive you should be in your effort to slow bone loss.
Bone density screening is now available. Also, weight-bearing exercise is one way to increase bone density and to help prevent fractures. Adequate calcium intake of 1000mg to 1500mg per day is essential. Dietary sources of calcium are more easily absorbed than supplements. Supplements will help, especially in combination with Vitamin D and magnesium. Ask your pharmacist which supplement would be most effective. Fifteen minutes of sunshine each day helps the body store vitamin D, which is essential for calcium absorption.

Increasing the amount of Boron in the diet helps reduce the loss of calcium and magnesium, according to the Human Nutrition Research Center of the USDA. Good dietary sources of Boron are apples, grapes, pears, beans, nuts and many vegetables. Research also shows that adequate calcium intake from infancy on has a major effect in bone density throughout life.

Risk Factors

• Smoking tobacco doubles your risk of osteoporosis and may also cause early onset of menopause. So it you smoke, try to stop or dramatically decrease the amount.
  
• Heavy alcohol intake, even occasionally, increases bone loss and can increase the risk of fractures. Evidence shows that moderate alcohol intake, 1-2 drinks per day, may have a positive effect by increasing the production of estrone, a type of estrogen that is produced in fatty tissue.

Emotional Changes

The time in life when menopause occurs is often a time when many other changes are occurring. Children may be leaving home, or returning home. Older parents may need more support. Relationships with significant others may be changing. Career and/or job situations may provide new challenges.

Helpful Hints

• All changes contribute to stress. Exercise, meditation, yoga, progressive relaxation and creative visualization can be helpful throughout life.
  
• The understanding and support of peers and family can make a difference. Being open and honest about your feelings and concerns to those who care about you is very important.
  
• Think positive! At this time of life even small changes in health habits can bring obvious results.
  
• Some women express relief to experience no more periods, no more PMS and no more fear of pregnancy. Menopause may signal a time when priorities can be reevaluated and rearranged; energy can be turned toward a new relationship with your body and more personally rewarding endeavors.
  
  

Hormone Replacement Therapy

Hormone Replacement Therapy (HRT) is now much discussed due to all the Baby Boomers reaching menopause. This is good because more reliable research is being done. HRT can help with the treatment of early menopause and has been shown to help with long term-improved quality of life.

Long-term effects include a decrease in risk of heart attack by 1/3 - 1/2 (heart disease is the leading cause of death for older women) and no risk of breast cancer. HRT over time reduces bone loss and lowers fracture risks. A broken hip can be deadly. HRT may decrease risk of colon cancer and improve memory and possibly decrease the chances of Alzheimer's disease. Every woman is different and HRT is a personal decision. Find a healthcare provider willing to take the time to help you with this most important decision.

One woman's viewpoint