Menopause Q&A With Women’s Health Expert

Menopause. It’s such a weighted word. Most of us don’t even want to say it out loud, let alone discuss it with our friends, family, or healthcare providers. Let’s be real. Menopause seriously stinks. There, we said it. Now that the feeling is unanimous, we can actually talk about it.

Even if you’re not going through menopause right now, you may want to tune in anyway, because the reality is, if you’re a woman, you’re destined for menopause whether you like it or not. But it’s okay, you’re not going to go through it alone. Half the human population is destined for this not-so-sexy chapter of life, and we (all your fellow female friends) will help get you through it.

Margaret Whitney, MD, NCMP, a board-certified obstetrician-gynecologist in Women’s Health, a clinical partnership between UT Health Austin and Ascension Seton, answers the most frequently asked questions about menopause.

What is menopause and when does it occur?

“Menopause, by definition, is the ceasing of menstruation,” says Dr. Whitney. “This is a period of a woman’s life (typically between the ages of 45 - 55) that marks the end of her reproductive period.”

When do women usually come in to discuss menopause with their doctor?

“Most women visit their doctor when bothersome symptoms begin to present themselves,” shares Dr. Whitney. “But some patients who are delaying fertility to their later 30s and early 40s begin to inquire about menopause as it relates to fertility at younger ages.”

How long does menopause usually last?

“Menopause is diagnosed after 12 consecutive months without a menstrual cycle, or period, and occurs, on average, at age 52. The menopausal transition can last for many years and is the result of declining estrogen production from ovarian follicles,” explains Dr. Whitney. “During this transition, women will often see changes in their menstrual cycle and may experience symptoms commonly associated with menopause, such as hot flashes and mood and sleep disturbances as well as changes in libido.”

What are some of the signs that it’s time to see a professional?

“Heavy prolonged bleeding or bleeding between periods should always prompt a woman to seek evaluation, as should absence of menses prior to age 40,” says Dr. Whitney. “Any bothersome symptoms, such as hot flashes, mood and sleep disturbances, changes in libido, or vaginal dryness, can often be treated to improve your quality of life.”

Are you seeing any difference in how women are being diagnosed?

“While there are tests out there that can provide some information about ovarian reserve, these do not predict when a person will become menopausal,” shares Dr. Whitney. “So, we diagnose it after you have experienced 12 consecutive months without a period. Hormone levels during the menopausal transition are erratic and unpredictable and do not typically add value in the setting of menopause evaluation, though there can be some exceptions. Generally, the symptoms you are experiencing guide the treatment and are the main focus of care.”

Several years back there was some controversy with using hormone replacement therapy (HRT) and its correlation to heart disease – are those concerns still valid?

“These risks are most notable in women who are older, such as those older than the age of 65, or those who have a high risk at the baseline,” explains Dr. Whitney. “The decision to use HRT should include an informed discussion between each patient and their provider, and the decision to use and/or continue HRT should be individualized based on the severity of symptoms and the degree of risk.”

Are there any new treatments, medications, or procedures that women should be aware of?

“There are currently many treatments, medications, and procedures in different stages of development,” says Dr. Whitney. “Some of these, such as vaginal laser treatments, have not been fully vetted and are best administered on a study protocol because safety and efficacy is still under investigation.”

Along with the physical aspects of dealing with menopause (difficulty sleeping, weight gain, etc.), does Women’s Health offer help regarding the psychological affects menopause may cause?

“Psychological effects of menopause are also considered in treatment, as this can be a difficult time for some women,” shares Dr. Whitney. “Here, at Women’s Health, our care team includes behavioral health specialists who practice in the same space as our providers. This allows us to collaborate and discuss your needs in real time in order to tailor care specifically to you.”

What else do you think is important for women to know about menopause?

“A variety of treatment options exist depending on your primary issue, and there is still ongoing research to address gaps in knowledge. As such, there is no single option that fits every woman, and care through Women’s Health is tailored to address the needs of each individual patient,” says Dr. Whitney.

Symptoms of Menopause include:

• Hot flashes - Hot flashes cause you to feel a sudden rush of warmth in your face and upper body. They can last a few seconds, minutes, or even longer. They can also occur several times a day or just a few times a month.
• Night sweats - Hot flashes during sleep can result in night sweats, which can cause sleep disturbances that result in feeling fatigued during the daytime.
• Trouble sleeping - Sometimes sleep problems, such as insomnia, may occur independent of night sweats.
• Moodiness - Emotional changes may cause mood swings, irritability, or mild depression.
• Irregular periods - Heavy or lighter periods, or having no periods at all, are all part of menopause transition.
• Vaginal dryness - Vaginal dryness, discomfort during sex, low libido, and an urgent need to urinate may also occur.

Before you start dreading what’s to come or wallow in sorrow for what’s already in motion, remember that menopause is your body’s way of saying, “Hey, thanks for all the awesome work you’ve put in all these years. Now, it’s time to transition into low power mode so you can put that valuable energy towards more enjoyable things in life.” So, next time a hot flash hits, just think about all the great things that lie ahead and know that you’re not alone.

If you are experiencing symptoms of menopause or are looking for a care team to help you manage your menopause treatment options, Women’s Health is dedicated to providing comprehensive, compassionate care and ongoing support all women deserve to live healthier more fulfilling lives.

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