Getting Through Menopause

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Women’s Guide to

What Is Menopause?

You already know that menopause is when your monthly periodscease. You might be looking forward to not having to deal withhaving your period anymore, or you might be mourning the end of your childbearing years. If you are like many women, you might feel a bit of both sides of the spectrum!

Menopause itself takes place a full year after your last menstrualperiod. Because your periods might be quite irregular, you mightthink you’re in menopause after several months of having no period, but in order to be sure that you are truly post-menopausal, you do need to wait the full 12 months after your last period. In the United States, the average age of menopause is 51, but it normally occursanytime between the ages of 45 and 55.

The months and years leading up to menopause are called perimenopause. Symptoms of perimenopause can begin as early as the late 30s, but generally start sometime in a woman’s 40s.

Symptoms of Perimenopause

As you approach menopause, you’ll likely notice symptoms that you haven’t had before. Some can be disconcerting, so if you are worried, check with your doctor. The typical signs that menopause is likely to occur soon include:

• Hot flashes• Night sweats• Insomnia• Vaginal dryness• Less interest in sex

It’s important to remember that until you have gone a full year since your last menstrual period, it is possible, though unlikely, to get pregnant. Talk to your healthcare provider about what types of birth control are safest and most effective for you to use if you oryour partner have not been surgically sterilized.

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• Mood swings• Weight gain• Dry skin• Thinning hair• Skipped or irregular periods

Why Is This Happening? The Hormones Responsible for Menopause

When you were a preteen or young teenager and you began getting your period, you understood that hormones were responsible for your acne, your moodiness and the changes in your body. Now that you are winding down on your childbearing years, your hormones need to change once again.

The main hormones responsible for keeping your menstrual cycle regular during your childbearing years are estrogen and progesterone. During perimenopause and, later, menopause, the levels of these hormones fall, causing the various symptoms that are attributed to middle age and menopause. With the exception of follicle-stimulating hormones (FSH) which increases with age, lower levels of these hormones can affect your sex drive and will make you less fertile as you go through the perimenopausal years.

Many of the characteristics that are considered youthful, such as thick hair, supple skin, firm breasts, a strong libido and a fit figure, are helped along in part by these reproductive hormones. Once estrogen and progesterone levels wane, you are likely to experience more wrinkles, age spots, drooping breasts, weight gain and other indicators of age. These falling hormone levels can also impact your heart, brain and bones.

While most women go through menopause naturally during their late 40s or early 50s, some reach menopause earlier. Some reasons include:

The good news is that with certain lifestyle changes and hormone replacement therapy, you can not only protect your physical body, but also enjoy feeling well into your 50s, 60s and beyond. You might not have the skin tone that you did when you were 20 or 30, but you can stave off some of the signs of aging by taking good care of yourself through perimenopause, menopause and the post-menopausal stages of life.

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Ovarian Insufficiency: About one percent of women will reach menopause in their 30s. This not only puts a damper on family planning for those who wanted to have children during thisdecade, but it can also make heart disease, dementia and osteoporosis more likely at an earlier age.

Hysterectomy: If you have a hysterectomy that includes the removal of your ovaries, you will go into menopause immediately. In some cases, it’s possible to have your uterus removed withoutthe removal of your ovaries; in this case, you will not go into the hormonal stage of menopause immediately, even though your periods will cease. Symptoms of menopause are often more dramatic after a total hysterectomy, as they occur immediately and all at once, instead of gradually over time.

Chemotherapy and Radiation: Premature menopause can be a side effect of some cancer treatments. Talk to your oncologist about whether your treatment is likely to have this effect on your reproductive system.

Weight Gain: Defeating Middle Age Spread

It’s prevalent enough that it’s become a cliche: As women enter their 40s, they tend to get a little (or a lot) thicker around the middle. Why does this happen? And what can you do about it?

First, an explanation of some of the hormones involved with middle age spread: Insulin is one of the major players, and insulin resistance, a condition common in both men and women as reach middle age, can cause the body to hold onto fat. As fat levels rise, estrogen levels rise, causing, you guessed it, further weight gain. Fat accumulates in the abdomen, hips and thighs, and the health issues that go along with weight gain or obesity follow. It’s a vicious cycle; women often feel discouraged, frustrated and even depressed when the healthy lifestyle habits they’ve developed over the years no longer work to keep their weight in check.

All hope is not lost, however! Boosting your metabolism can help, and so can getting your hormones under control. Since losing weight safely is not always easy, it helps to have a healthcare professional overseeing your weight loss journey. Do not start a new weight lossregimen without speaking to a doctor.

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Nutrition: Since your metabolism will likely slow as a normal part of the aging process, you may find that you can’t eat what you used to and still maintain a healthy weight. Drastic calorie cuts can be dangerous, but sticking to a moderately low-calorie diet plan can help. Focus on eating mainly vegetables (2/3 of your plate), lean protein, like fish and poultry (1/3 of your plate) and a small amount of healthy fat such as avocado, nuts, coconut oil and olive oil. Limit fruit to occasionally (we are only meant to eat fruit when it is in season). Grains and simple carbohydrates (bread, rice, pasta) should be eaten rarely. Low fat foods are usually very high in sugar and should be avoided.

Detoxes can be effective when used under medical supervision; they can jump-start your weight-loss efforts and make it easier for you to stick to a healthy eating plan.

Vitamin and mineral supplements also play a role in keeping you well nourished even if you are cutting calories. Ask your practitioner which supplements are right for you.

Exercise: The Centers for Disease Control and Prevention recommend that adults get 30 minutes of moderate cardiovascular exercise most days of the week, and strength training exercise a few days per week. If you have been sedentary to this point, don’t just jump into a rigorous training program! Talk to your healthcare practitioner about what activity level is right for you at this time. This is particularly important if you are overweight or if you have underlying health conditions.

Exercises like bike riding, walking and swimming are easy on the joints while providing a good cardiovascular workout. If you are looking for something more intense, you might consider jogging or tennis singles. Yoga, pushups, sit-ups and various resistance exercises are good for strength training and require little or no equipment.

Hormone Therapy: Depending on your age and specific hormonal deficiencies, a customized hormone replacement plan could literally change your life -- and your waistline! Ask your doctor to test your thyroid, adrenal glands and reproductive hormone levels. With that information, your healthcare provider can come up with an individualized plan so you get the hormones that you need to improve your health and help you lose weight.Middle age spread is common, but it does not have to be your default. With medical supervision as you develop new habits along with appropriate hormone therapy you can maintain a healthy weight now and into the next decades.

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Components of an Effective Weight-Loss Program

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Hormone Replacement: Benefits vs. Risks

Whenever your doctor prescribes a medication or a procedure, he or she first determines whether the benefits outweigh the risks. Hormone replacement therapy, or HRT, is no exception. For some women, HRT will carry risks that outweigh the potential benefits, and for others, the benefits will clearly outweigh the risks. While it’s important to educate yourself about any procedure or medication you are considering, remember that your doctor will largely influence your decision.

What Is Hormone Replacement Therapy?

As women approach menopause, their female hormones (estrogen and progesterone) begin to diminish. This can cause various symptoms that are associated with this change in a woman’s life, including heart palpitations, hot flashes, night sweats, insomnia, mood changes, vaginal dryness, weight gain and more. Hormone replacement therapy is a combination of medications that can relieve these symptoms.

Benefits of Hormone Replacement Therapy

If you are suffering from a lower quality of life from your menopause symptoms, HRT can make you feel much better. It can suppress some of the symptoms of menopause and can raise your libido and make sex more comfortable.

Certain women can benefit from HRT more than others. These individuals include:

• Those who went into menopause before the age of 40.• Those who have had their ovaries removed before the age of 45.• Some women who have lost bone mass.

For those at risk of complications of menopause, particularly early menopause, HRT can reduce the risks of:

• Coronary heart disease• Parkinson’s disease• Loss of bone mass (osteoporosis)• Anxiety• Depression• Early death from different causes

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Risks of Hormone Replacement Therapy

All medications, natural or synthetic, carry risks that must be considered before you take them. HRT is no exception; it carries risks that should be weighed against the potential benefits.

Some of these risks might include:

• Breast cancer• Blood clots• Stroke• Heart attack

There are different types of HRT, so while one type might be too risky for you to take, particularly if you have a family or personal history of the aforementioned health conditions, it’s possible that another type would be safe. Your healthcare provider is the one who can answer these questions.

At Focus Women’s Health, a woman-centered partner of Focus Total Health, we conduct comprehensive and individualized testing to develop a custom-built HRT regimen, depending on each client’s needs. This means that you will not receive too little or too much of any hormone; your regimen will be as safe and effective as possible, since it will be created just for you.

We take your health and safety seriously. If you have any questions about the safety or efficacy of the hormone replacement therapies we provide, please call us at 210-305-5075.

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ABOUT THE AUTHOR

Dr. Melissa Miskell is a board-certified obstetrician and gynecologist who specializes in total body wellness, anti-aging and weight loss. Dr. Miskell is an expert in the use of bio-identical hormones to combat the symptoms of aging and menopause and created her practice, Focus Total Health, to specifically target these issues.

Dr. Melissa Miskell is a board certified Obstetrician/Gynecologist (OB/GYN) who specializes in hormone replacement therapy, anti-aging and overall wellness. She graduated from Texas Tech University with a B. A. in Chemistry and a B.S. in Zoology. She then worked in the Biochemistry department at Texas Tech Health Science Center while earning an M. S. in Interdisciplinary Studies. Dr. Miskell graduated from University of North Texas Health Sciences Center and completed her 4-year residency in obstetrics and gynecology at Texas Tech University Health Science Center where she was Chief Resident.

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