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Physician Chronicles

Menopause: What You Should Know

By Alan S. Peterson, MD
Walter L. Aument Family Health Center

What is Menopause?

Menopause is when a woman stops having her period and her ovaries stop working to produce estrogen.  This means she can no longer become pregnant. Frequently before a woman stops having her period, she may go an increasingly longer time between having her period. This can also be the beginning of menopause or a period called the perimenopausal time. We commonly say that after 1 year without a period one is truly menopausal, but most women know it before that! 

When does it happen?

The average age of menopause is 52 years, but it can begin at any time from age 40 up to age 58. It is common to start menopause at about the same time as your mother did. Menopause, once again, can happen over a long period of time, sometimes several years. There is a blood test called a follicle stimulating hormone or FSH that sometimes can be helpful in diagnosing menopause also.

What can I Expect?

Menopause affects every woman differently. Some women have few or no symptoms. Others may have irregular vaginal bleeding (eg, spotting), hot flashes, and vaginal dryness. Others may experience longer amounts of time between menses.

How are the symptoms treated?

Your doctor may have you start taking hormones if you have severe symptoms. This may include estrogen or estrogen combined with another hormone (progesterone). Hormone therapy can help your symptoms; however, it is not for most. Taking estrogen can cause problems like heart disease and cancer along with increased risk for blood clots. Ask your doctor about the risks and benefits of taking hormones. If you cannot take estrogen, there are other medicines that may help you. Your doctor can help you find the right medicine for your symptoms. One over-the-counter medicine that has had favor in the past is called black cohosh, however, recent studies do not show this to be helpful and can also have side effects of its own.

Are alternative therapy's safe?

Some people think that because plant estrogens and herbal supplements are “natural,” makes them seem safer than hormonal therapy; however, there have been very few scientific studies to test this. Talk to your doctor before you use them, because they may interfere with other medicines or other diseases that you might have. Also remember that non-prescription medicines are not regulated by the FDA and thus you are trusting the company that makes it to make sure that it is a pure supplement or herbal preparation. In the past there have been multiple instances where this has not been true. 

When should I see my Doctor?

You should see your doctor during and after menopause. It is important to get regular tests to check for cancer of the cervix (until a certain age), colon and breast. 

What else should I do after Menopause?

You should quit smoking, lower your blood pressure, exercise, and eat a healthy diet. This will help to prevent heart disease, which is the leading cause of death in women. Taking enough calcium and vitamin D every day can help prevent osteoporosis, which causes weak bones that can break easily. Vitamin D can also help prevent certain types of cancer as well as increase one’s immunity. There is now a blood test that can be done to make certain that you have sufficient amounts of vitamin D. It’s called a 25-hydroxy vitamin D level. Your doctor can test the strength of your bones in your spine and hip to see if you have adequate density. This is done with what we call a bone density test or a DEXA. If you are younger but want a screen for osteoporosis, an ultrasound of the heel can be done. Regular exercise with strength training and weight-bearing activities like walking and jogging can be especially good for you. Obviously if you are taking up exercise such as jogging, one needs to consult with your physician first.

Where can I get more information?

Please direct any questions to your primary care provider. The National Institutes of Health also has an excellent website at http://www.nih.gov/about/contact.htm. Their telephone number is 1-301-496-4000. The American Academy of Family Physicians also has information on its website at http://familydoctor.org.


Dr. Peterson is a doctor of Family and Community Medicine at the Walter L. Aument Family Health Center, 317 S. Chestnut St., Quarryville.


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