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Honest Talk About Menopause

When it comes to menopause, many women are hesitant to seek help for symptoms that can range from uncomfortable to debilitating. Kristina Rath, MD, gynecology, Northeast Medical Group, North Haven, admits menopause can be difficult to talk about, but encourages patients to have honest conversations with their clinician.

“Depending on who you are more comfortable with, you can talk about menopause with your primary care clinician or with your Ob/Gyn,” Dr. Rath said. “Either is a good person to contact. The important thing is to speak to someone because you don’t have to suffer with symptoms that are impacting your quality of life.”

Menopause is the end of a woman’s monthly menstrual cycle, or period. A woman is diagnosed with menopause after 12 months have passed since her last period. The time leading up to the cycle ending is called perimenopause, which is when most people experience common symptoms like hot flashes, sleep disturbances and irregular periods.

“It’s a little unique because we can only diagnose it after the fact,” Dr. Rath said. “That’s why, when most people talk about menopause and symptoms, they’re actually talking about perimenopause.”

Dr. Rath explained that the ovaries start to produce less estrogen between the ages of 45-55. This happens unevenly, which causes the symptoms. “Between half and three-quarters of women will experience hot flashes or night sweats during perimenopause,” she added.

Because the severity of menopausal symptoms varies from person to person, Dr. Rath advises patients to talk with their clinician even if they don’t think it’s too bad.

“Some women have hot flashes and they’re bothersome, but not that bad,” she said. “There are others who have hot flashes all night and are losing sleep, which is impacting their quality of life. We have options for managing perimenopause, so it’s important we know what you’re going through.”

Hormone therapy, or supplementing the hormones that are lost during perimenopause, is a common treatment, but Dr. Rath said it’s typically reserved for people experiencing several symptoms that impact their quality of life. There are other treatment options for those who only have one or two symptoms, the most common of which she said was hot flashes or night sweats, adding that antidepressant medications like venlafaxine can reduce the frequency and severity of hot flashes.

“We don’t prescribe these for depression, rather we’ve found at lower doses they’re effective for treating hot flashes and night sweats,” Dr. Rath said. “There is also a blood pressure medicine called clonidine that works on the blood vessels to help prevent the vasodilation that causes the flushing, or hot flashes.”

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