You Don’t Have To Suffer With Symptoms of Menopause

November 28, 2021

older woman fanning herself with an orange fan

Menopause and the time leading up to menopause – known as perimenopause – can be challenging. Changes in hormones can lead to symptoms such as hot flashes, joint pain and mood swings.

These symptoms affect your quality of life so it’s important to discuss them with your health care provider, says University Hospitals OB/GYN and certified menopause practitioner Corinne Bazella, MD. Whether you are menopausal or perimenopausal, there are many quality treatments available.

What Are the Most Common Menopause Symptoms?

The average age of menopause onset is 51, but it can happen anytime between age 40 and 60. During this time, many women experience symptoms like irregular cycles, hot flashes, mood swings, brain fog and trouble sleeping.

Once menopause occurs, the postmenopausal phase begins and lasts for the rest of a woman’s life. Symptoms such as hot flashes and night sweats are most common in the first 4 to 7 years after menopause and tend to ease over time, though the timeline varies from person to person. Other changes – like bone loss, increased belly fat, shifts in sexual desire, urinary tract infections, frequent urination and vaginal dryness – often appear in early or late post-menopause and can be monitored and treated.

Treatment Options

When menopause symptoms are mild, they may not require treatment. But for bothersome symptoms, a number of prescription and non-prescription treatments are available.

Hormone therapy (estrogen) is the primary treatment for symptoms, as well as progestogen to protect the uterine lining.

Some women are concerned about health risks of hormone therapy. Women who start hormone therapy after age 60 and more than 10 years after menopause have a slightly elevated risk of heart disease.

Treatment options include:

Non-hormonal medications: Neurokinin antagonists, antidepressants (like SSRIs or SNRIs), gabapentin, and oxybutynin are potential treatments for patients and can be tailored based on symptoms.
Lifestyle modifications: Regular exercise, a balanced diet, stress reduction techniques and good sleep hygiene are important for health maintenance, however these measures do not decrease menopausal symptoms. All menopausal therapies should be in addition to these basics of health promotion.
Cognitive behavioral therapy (CBT): Proven to help with mood changes, sleep disturbances and the disruption and irritation from hot flashes and night sweats.
Vaginal treatments: Non-hormonal lubricants and moisturizers, or vaginal estrogen therapy, can relieve vaginal dryness and discomfort during sexual actives and decrease the occurrence of urinary tract infections in menopausal women.
Acupuncture and integrative therapies: These can offer symptom relief for some women, especially when combined with other approaches.

Genitourinary Syndrome of Menopause

Many postmenopausal women experience genitourinary syndrome of menopause (GSM), which can affect the vagina, vulva and lower urinary tract. It often is unrecognized and undertreated, Dr. Bazella says.

Symptoms are vaginal dryness, itching, irritation, frequent urination, trouble with lubrication, arousal, orgasm or pain with sexual play.

GSM affects at a minimum 50 percent of all postmenopausal women. Unlike hot flashes and night sweats that should eventually go away, this will continue throughout your life.

The good news, however, is there are a number of prescription and non-prescription remedies. Over-the-counter lubricants and moisturizers are an option for mild vaginal symptoms.

For more moderate symptoms or urinary symptoms, a prescription for vaginal estrogen, vaginal DHEA, or oral ospemiphene are safe and effective options without any increased risk of heart disease or cancer.