According to Stats Canada, there are close to 4 million women approaching menopause. In fact, one-third of our lives as women is spent in menopause.

Misconceptions surrounding menopause

Many women ask me if they are “through menopause”, but menopause is not a doorway that a woman walks through. It is a stage of life, with “menopause” being the final menstrual period, and “postmenopause” as the phase of life after menopause.

We tend to blame many complaints on menopause, but is it that alone, or is it aging?

Menopause vs. aging

As we age, the metabolic rate slows down; in women, we often see redistribution of weight to our mid-section with estrogen loss.  

Mood swings early in menopause can be related to estrogen depletion. Although, in well-established menopause, we cannot blame mood swings on estrogen loss alone.

“Many women ask me if they are “through menopause”, but menopause is not a doorway that a woman walks through.” 

What we can lay squarely on the shoulders of estrogen depletion are night sweats and hot flashes.  Many of these symptoms will start before menstrual cycles stop.

Estrogen and your sex life

Urinary discomfort and urinary urgency may be related to estrogen loss as well. One progressive symptom that will not go away on its own is atrophy of the vagina and vulva (the outer area of the vagina), often referred to as VVA, which is directly related to estrogen depletion.

Estrogen loss is the major contributor to symptoms such as vaginal dryness, itching, burning, discomfort, and pain during intercourse.

A recent published study called the CLOSER study (Clarifying vaginal atrophy’s impact On Sex and Relationships) highlighted that the majority of women with atrophy avoid intimacy, and many will self-treat or avoid discussing their concerns.

There are options

The good news is that there are treatment options for these symptoms ­— both prescription and non-prescription. Options for women without special medical concerns, such as underlying cancers, can use different forms of low-dose estrogen applied directly to the vagina. Usage in breast cancer patients must be individualized as often estrogen therapy is not indicated in these women.

Non-hormonal options include both lubricants (used during sexual activity) and moisturizers (these line the vaginal wall to maintain moisture and are to be used regularly), which can be combined with hormonal treatments.

Estrogen applied directly to the vagina can restore the elasticity of vaginal tissues. These products all work locally and there is minimal absorption of estrogen into the blood stream.

For women with hot flashes and night sweats using higher doses of systemic estrogen, these will usually treat vaginal dryness, although some women still need additional low-dose vaginal estrogen treatment.

It’s not all bad

Menopause can be a great time of change and an opportunity to take charge. Watching your weight, eating well, and exercising are all important for you to incorporate into your lifestyle. Talk to your health care provider for your personal management.