Before menopause, 85 percent of women experience perimenopausal changes or symptoms that accompany hormonal fluctuations. Perimenopause can last from two to 15 years, sometimes longer. Some women enter menopause earlier than the average age of 52, and some enter menopause through surgery or because of medical treatment. Although menopause is a normal developmental transition, a majority of women experience some symptoms. Some women express extreme debilitation and others only minor changes that are easily managed through diet and lifestyle changes.
Common symptoms experienced prior to menopause:
• Mood swings, irritability, depression, anxiety
• Decreased libido (lack of or decrease in sexual desire)
• Vaginal dryness with the potential for painful intercourse
• Menstrual changes with heavier or irregular periods
• Fuzzy thinking, poor concentration or attention
• Weight gain or difficulty losing weight, increased food cravings
• Joint and muscle stiffness or pain
• Headaches or menstrual migraines
• Breast tenderness, breast cysts
• Scalp hair loss, unwanted facial hair; dry skin and hair; acne
• Pelvic or urinary changes, incontinence, urinary tract infections
• Increased allergies
• And of course, hot flashes.
In the United States, about 85 percent of women experience hot flashes or night sweats during the years leading up to menopause. More than half of these women will continue to have hot flashes for years after menopause. Understanding the triggers that might initiate hot flashes can give women a sense of more control. Avoiding the triggers and taking care of ourselves through exercise, sleep, diet and stress reduction can make a big difference. Our body works well to protect us from overheating. With hot flashes we are not really overheating, the temperature regulating center just thinks we are n so our vessels dilate, and our heart rate speeds up in an effort to cool us down. Our skin temperature can actually increase several degrees although our core temperature remains in a normal range.
What you can do:
Monitor your hot flashes and try to determine your triggers. It may help to keep a journal. Track the timing of your hot flashes; look for stress, dehydration or not eating/drinking regularly. Are there certain times of the day or night when hot flashes occur? Are there foods or fluids, or the lack of them that trigger symptoms? Common food and environmental triggers include: spicy foods, alcohol, caffeine and nicotine (tobacco users have increased symptoms), beverages or foods that are warm or hot, an environment that creates heat, such as exercise, hot tubs, overheated bedrooms or stressful events. If you can identify triggers, you can begin addressing some of the underlying issues.
Lifestyle modifications, and stress reduction:
Stress is a major contributor for hot flashes. Stress reduction through meditation, anger reduction, biofeedback, exercise (with an appropriate cool down period), yoga and breathing techniques can reduce the severity and frequency of hot flashes and night sweats. Acupuncture and traditional Chinese medicine have been used successfully for the symptoms experienced in menopausal transition. Learn to value your own well-being enough to set better boundaries. Use your wisdom and intuition to identify ways to provide self-care. Cultivate practices that will perpetuate positive lifestyle changes
Hormone replacement therapy:
For severe hot flashes and menopausal symptoms that persist despite the above efforts, prescription hormone replacement therapy (HRT) remains an option. Recent studies are more promising, suggesting that risks may be lower than previously thought.
Remember, take care of yourself, reduce stress, begin making lifestyle changes that create better health and seek additional information from your healthcare provider if you continue to experience symptoms that negatively impact your ability to function.
Marcia Hanks is a certified nurse-midwife and an advanced practice registered nurse at St. Patrick Hospital and Health Sciences Center. Questions for our clinicians? Please send them to info@saintpatrick.org.
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