Menopause checklist: Things to do
In this day and age, menopause is not so dreaded by most women as it used to be. Some even look forward to it as a time of freedom from the worry of becoming pregnant. Heck, there is even a musical about it now.
Regardless of whether you are looking forward to it, dreading it or simply resigned to it, there is more to menopause than hormones and hot flashes and there are many things you can do to make the transition (called perimenopause) as smooth as possible.
When you start to notice symptoms of perimenopause (irregular periods, heavy bleeding, worsening PMS, sleep disturbances, hot flashes, vaginal dryness or changes in libido), bring it up with your doctor.
It may be time to check your bone density and your risk factors for heart disease since osteoporosis (thin bones) and heart disease both become more common in menopause years.
Heavy or very frequent bleeding can also be a sign of abnormal changes in the lining of the uterus and should always be evaluated.
If you are concerned about bone loss, you can make dietary changes, take supplements and exercise to help increase bone density. There are medications now (some in pill form and some as an injection) that can help reverse bone loss.
To reduce your risk of heart disease, make dietary changes (a Mediterranean-style diet or something along the lines of the Pink Ribbon diet for example), stop smoking, exercise (at least 30 minutes a day), manage diabetes and if you need it, take medications to help you lower your blood pressure and cholesterol.
The first step in dealing with sleep disturbances is to practice good sleep hygiene and eliminate anything that may be interfering with a good night’s sleep.
For example, if you exercise at night, try switching exercise to the morning. It also helps to limit your caffeine. Get more healthy sleeping tips at WebMD (www.webmd.com).
Some perimenopause symptoms can be mitigated with birth control pills. Depending on which pill you go on, the hormone doses can be lower than in hormone replacement therapy (HRT).
If you are over 35 and smoke or have had blood clots, heart or liver disease or uterine or breast cancer, birth control pills are not a recommended option.
After the Women’s Health Initiative study revealed that there may be some serious risks to HRT as a treatment for menopause symptoms, women have had to decide whether HRT is right for them.
Women with similar risk factors are making very different decisions these days. My friend’s aunt stopped taking her hormones and has adjusted to the hot flashes, while her mother said, “They can pry my hormones out of my cold, dead hands.”
It is not that she thinks herself invulnerable to the increased risks (endometrial cancer, blood clots, stroke, gallbladder disease, increased blood pressure and breast cancer), but that she found the fatigue of sleep disturbances from hot flashes and night sweats intolerable.
Besides relieving menopause symptoms, there are some other good reasons to use HRT. It can help prevent bone loss, lower the risk of colon cancer and possibly lower the risk of macular degeneration.
Recent information from the Women’s Health Initiative indicates that women in their 50s taking estrogen-only HRT and who have had a hysterectomy may not be increasing their risk of breast cancer.
It is not easy to decide whether to take HRT or which HRT to take, you need to make your decision based on your personal risk factors and what is most important to you: Talk to your doctor, make lists of the pros and cons and ask other women who are going through it or have gone through it.
No matter what your symptoms, dietary changes, regular exercise, better sleep hygiene and stopping smoking can all help, will make you feel better (even if menopause is a way off) and are good ideas for all of us.
As one of my friends says, “I am always working towards a healthier lifestyle because I want to have an enjoyable and active old age. If it ends up reducing future menopause symptoms too, that is just a bonus.”