Physical Changes & Contemporary Therapies

Hot Flashes

  • 85% of women have hot flashes, usually lasting 1-2 years.
  • 25% last over five years and some last forever.

Hormone therapy should be considered when the symptoms of menopause are interfering with quality of life. Estrogen works better than anything else to relieve hot flashes and improve quality of sleep. Most health care providers are recommending the lowest dosage for the shortest amount of time. Many are recommending estrogen in the form of a patch and micronized progesterone (Prometrium). The advantages, disadvantages and risks of HRT must be discussed with our health care provider. The decision to take HRT (Hormore Replacement Therapy) should be reviewed each year at the time of your annual exam. The following are suggestions to be used with or without HRT.

  • Identify triggers and keep a diary:
    Foods: citrus, tomatoes, strawberries, chocolate, spicy foods, hot drinks, caffeine, alcohol
    Stress and anxiety
    Warm temperatures
    Smoking
  • Exercise
    One study showed 55% decrease in hot flashes after starting regular exercise.
  • Dress in layers, wear natural fibers, carry a fan
  • Relaxation techniques such as meditation, yoga, paced respiration
  • Phytoestrogens
    Plant compounds that have estrogen-like biologic activity and a chemical structure similar to that of estrogen. Soy and Red Clover are the most widely used.
  • Vitamin E, 400 IU/day
    Inconclusive evidence but may be helpful for mild to moderate hot flashes.
  • Progesterone
    Progesterone alone helps 50% of the time, oral or topical cream (400 mg/oz), no standardization or research that supports the use.
  • Nutraceuticals
    Nutritional supplements/botanicals used as medicinal agents such as Remifemin, which is Black Cohosh and herbal supplement distributed by Smith-Kline Beecham. Remember, herbs are not standardized and take 6-8 weeks to work, all may have side effects and affect other medication you are using.
  • Antidepressants such as Effexor, Paxil, Prozac and others seem to work in some cases when estrogen is not appropriate.
  • Flaxseed 1-2 T/day, fish oil

Night Sweats

  • Causing frequent waking and resulting fatigue
  • Avoid hot beverages or alcohol in the evening
  • Warm bath at bedtime helps
  • Ice water at the bedside
  • Using flannel sheets
  • Lavender, Melatonin and Velerian

Remember that Menopause is a natural change and you may not need to use any of these suggestions. Above all, discuss your choice with your health care provider.

Irregular Bleeding

Occurs in the peri menopause period and can be controlled with oral contraceptives if appropriate with persons health history.

Aching Joints and Leg Cramps

Vaginal Dryness

Vaginal walls become thinner with aging and lose some of their elasticity, lubrication decreases; this may lead to painful intercourse; become more susceptible to infection and irritation.

  • Estrogen restores vaginal tissue, this can be used in vaginal cream or ring if HRT is not appropriate or desired.
  • Water soluble vaginal lubricants such as Replens, KY Jelly, Lubrin
  • Vaginal moisturizers: Replens, KY Long lasting Vaginal moisturizer
  • Oral Zinc 15 mg/day (foods rich in zinc are seafood, meat, wheat germ, oats)
  • Warm, moisturizing baths before sexual relations

Skin and Hair

Estrogen maintains the thickness of skin. Skin becomes thinner and dryer with aging. 30% of skin collagen is lost in the first five years after menopause, the epidermis becomes thinner and it’s ability to retain water is diminished. Hair becomes thinner and finer.

  • Protection from the sun
  • Avoid smoking
  • Daily use of moisturizers and 4-6 glasses of water each day
  • 2 tsp. flaxseed oil daily
  • Dong Quai may help hair loss, Rogaine for balding

Weight Gain

After menopause, women begin to lose their muscle mass at a faster rate and to gain fat tissue instead. There is a decline in the number of calories that the body uses at rest. Under these conditions, weight gain is likely unless we work to maintain muscle strength and the way we eat. We should reduce our calorie intake by 200-400 daily.

Smaller portions, fewer calories and aerobic exercise and strength training. Weight gain around our middle, may lead to greater risk of Cardio Vascular Disease, diabetes, and hypertension.

We recommend the following books by Miriam Nelson as a good resource: Strong Women Stay Young
Strong Woman Stay Slim

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