Marla Shapiro On The Menopause Transition
Education and Advocacy Many of my patients will ask me if they are through their menopause, as if menopause was a doorway that one entered and went through.
In fact menopause, while defined as starting one year after the cessation of menses, is a transition in which you will spend this next part of your life. We often use the phrase being in menopause with a constellation of symptoms. Once many of these symptoms subside, many women assume that the menopause is over. A more accurate description of this would be the menopause transition with about 95 percent of women entering this transition after age 45.
‘The Study of Women’s Health Across the Nation’
There is much research looking at this period in a woman’s life. The Study of Women’s Health Across the Nation (SWAN) is a multi-site long term, epidemiologic study designed to examine the health of women during their middle years. The study examines the physical, biological, psychological and social changes during this transitional period. The goal of SWAN’s research is to help scientists, health care providers and women learn how mid-life experiences affect health and quality of life during aging.
The onset of the menopause transition is a period of flux called the perimenopause and this can last several years. The early stage of the menopause transition is characterized by menstrual cycles that vary in their length and is accompanied by hormones that fluctuate. Typically the later phase of the menopausal transition is accompanied by so called vasomotor symptoms.
Knowing what to expect
While women are quite familiar with hot flashes and so called night sweats, estrogen impacts on multiple organ sites such as our brain, breasts, liver, heart , bones, skin and reproductive organs. With estrogen deficiency, there is atrophy and dryness of the vagina. Commonly called vulvovaginal atrophy or VVA, this is now included in a term called the genitourinary syndrome of menopause (GSM) that recognizes there are also changes to both the genital and urinary systems of our body.
“Healthy lifestyles encompassing exercise and proper nutrition are exceptionally important.”
Many women also note mood changes, a lowered libido, memory concerns, weight gain and joint aches. Bone health is exceptionally important as during the menopause transition and early menopause we see accelerated changes in bone loss related to estrogen decline.
It is also important to tease out which symptoms are related to estrogen decline, the process of aging or a combination of both.
A proactive approach
I also remind my patients that it is never too late to take charge of your health. Healthy lifestyles encompassing exercise and proper nutrition are exceptionally important. Be an active participant in your own health by working in partnership with your physician to find the best management, be it a combination of lifestyle and medication that is best suited for you!