It’s not in your head—it’s hormonal
The underestimation of menopause symptoms has contributed to a pervasive practice of gaslighting women. They are frequently told that their experiences are exaggerated, imagined, or simply a result of aging, leading to frequent misdiagnoses of depression or anxiety. As a consequence, many women are prescribed unnecessary medications and receive inadequate treatment. Physical symptoms such as hot flashes, night sweats, and vaginal dryness are often dismissed as inevitable, leaving women to cope with chronic discomfort, sleep deprivation, and diminished well-being.
It is essential to recognize that menopause is a natural biological process driven by hormone fluctuations, not a mere inconvenience or exaggeration. By acknowledging and addressing the challenges associated with menopause, we can provide women with the support and care they deserve.
Menopause is a complicated transition.
During early perimenopause, menstrual cycles start to vary by about a week. In late perimenopause, cycles can become irregular by more than sixty days. Menopause is officially reached after twelve months without a period. During this transition, women often experience:
- Vaginal changes: Drier, thinner vaginal tissue can cause itching, burning, pain during intercourse, and increased susceptibility to infections.
- Weight gain: Hormonal shifts and decreased physical activity can contribute to weight gain.
- Osteoporosis: Declining estrogen levels increase the risk of bone loss, leading to osteoporosis.
- Sleep disturbances: Hot flashes, night sweats, and racing heart can disrupt sleep, leading to fatigue, mood swings, and difficulty concentrating. Chronic sleep deprivation can also contribute to weight gain and depression.
- Decreased libido: Hormonal changes can lead to a decline in sex drive, impacting intimacy and overall well-being.
- Misdiagnosed depression/anxiety: Menopause-related changes in mood along with fatigue, difficulty concentrating, and sleep disturbance can manifest as depressive symptoms and anxiety. Commonly, women are prescribed antidepressants when often hormone therapy will treat the root cause of their symptoms.
The many benefits of hormone therapy.
Hormone therapy can be an effective treatment for managing menopausal and perimenopausal symptoms. The benefits significantly outweigh the risks if started during perimenopause or up to ten years after menopause and before age sixty.
Hormone therapy is personalized to address specific symptoms and individual health risks. Replenishing estrogen levels reduces vasomotor symptoms such as hot flashes and night sweats. This stabilization improves sleep, mood, and overall quality of life. Hormone therapy also prevents bone loss associated with osteoporosis. And since women have estrogen receptors all over the body, hormone therapy has been shown to reduce cardiovascular risk and heart palpitations, relieve new-onset musculoskeletal pain, reduce the onset of diabetes, reduce the incidence of frozen shoulder, alleviate genitourinary symptoms, improve skin health and even alleviate an odd symptom in some menopausal women – itchy ears.
Overall, menopause hormone therapy, if started within the first ten years of menopause and before age sixty, reduces all-cause mortality by 30%!
Vaginal estrogen provides further benefits, including reducing the risk of urinary tract infections (UTIs) by up to 50%, addressing vaginal pain, burning, and itching, and maintaining the structures of the vulva, which will atrophy in the absence of estrogen. Vaginal estrogen is not systemically absorbed and is safe for nearly everyone. It can be used alone or in combination with systemic hormone therapy.
Hormone therapy isn’t for everyone.
Hormone therapy may not be suitable for all women, particularly those with certain medical conditions like a history of a heart attack and current or recent breast cancer. For women who cannot or choose not to take hormone therapy, there are other effective options to manage menopause symptoms.
Medications such as SSRI antidepressants, gabapentin, Veozah, Addyi, and others can help alleviate hot flashes and other symptoms. Additionally, adopting healthy lifestyle habits can significantly improve overall well-being during menopause.
It’s important to note that certain lifestyle factors, such as smoking, excessive alcohol consumption, obesity, and high-stress levels, can interact with hormone therapy and may increase the risk of side effects. For women with these conditions, it’s essential to discuss the potential benefits and risks of hormone therapy with their healthcare provider.
Always consult a healthcare professional.
To determine the best course of action, consult a healthcare provider who specializes in midlife women’s health. They can assess your symptoms, discuss the potential benefits and risks of various treatment options, and recommend strategies tailored to your needs.
Menopause is not a weakness; it’s a powerful, natural part of aging. Every woman deserves to feel supported, respected, and informed as she navigates this transition. By breaking the silence around menopause and equipping women with accurate information, we can dismantle the stigma and empower women to advocate for their health and well-being.
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