By Tracy Jons, MS, PA-C, MSCP – physician assistant and menopause society certified practitioner, who has worked with the Sheridan Memorial Hospital Women’s Clinic since 2007, specializing in obstetrics, gynecology and hormone therapy.
While perimenopause and menopause are natural processes unique to each individual, many women are not prepared to understand the abundance of information filtered to them on social media. It is important to ensure your information is based on evidence, not industry.
Eighty-five percent of women experience menopausal symptoms. For some this starts in their 40s, and some much earlier or later. As I walk patients through what happens during their reproductive years, and then into perimenopause and menopause, I see them light up – finally understanding their symptoms. Sometimes first symptoms are increased anxiety or irritability, not sleeping as well, joint pain, weight changes or changes in their menstrual cycle. Women notice hot flashes, night sweats and struggle to think clearly through the brain fog. They don’t feel like themselves – experiencing vaginal dryness, painful sex and their sexual desire goes down. Perimenopause represents a time when women’s reproductive hormones are no longer a smooth even rhythm, and instead become more volatile with narrowing higher highs and lower lows. It’s like another round of puberty!
Every story is unique, but there are steps you can take to ease these natural processes.
In 2002, a large study on hormone therapy, called the women’s health initiative, stopped due to concerns about stroke risk. This was shocking because researchers started the trial assuming they would prove hormone replacement therapy decreased the risk of cardiovascular disease. The study also reported an increase in breast cancer risk. This caused a wave of panic and suddenly everyone feared taking hormones. It has taken the last 20 years to look at the data and new research to understand what happened. We know a whole lot more now.
Menopause hormone therapy (what we used to call hormone replacement therapy or HRT) for most women is the safest and most effective option to help them feel more like themselves again. A wide variety of options allow for the healthiest formulation for each woman whether it be estrogen, progesterone and/or testosterone.
For example, if we time initiation within 10 years of the last menstrual period and use a transdermal approach, there is not an increased risk for cardiovascular disease or stroke. We also know that for women who took estrogen only, there was no increased risk of breast cancer, but for women who took estrogen and progestin the risk increased slightly. Now, we have options to reduce this breast cancer risk. These discussions provide reassurance and allow women to feel more in control.
For some women however, hormone therapy is still off the table. Women with a history of cardiac disease, blood clot, stroke or breast cancer still have several new treatments available to relieve their symptoms. These are exciting times in this area of medical research.
When you meet with your healthcare provider to talk about symptoms, ensure that provider is committed to staying up to date on the best way to care for you during a time that feels so strange. Discuss lifestyle measures, eating well, exercise, keeping your heart and bones strong, preventing cancer and your menopausal experience. You should be in control of your medical care and your body.
If you’re noticing changes in your body that leave you feeling unsure or overwhelmed, you’re not alone. The experienced team at Sheridan Memorial Hospital’s Women’s Clinic is here to listen, support, and help you find real answers. Your health matters—and so does your story. If you would like to make an appointment call or text 307.672.2522.