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Women's Health Jan 15, 2019

Menopause Q&A with Women’s Health Experts

The most common questions clinicians get about menopause answered

A stylized graphic reading "Menopause."

Menopause. It’s such a weighted word, most of us don’t even want to say it out loud let alone talk to our friends, family and healthcare providers about it. Let’s be real, menopause seriously stinks. There we said it, we can all agree unanimously, so now let’s actually talk about it. Even if you’re not going through it right now, you may want to listen up anyway because 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.

So what’s the deal with menopause - what is it exactly, what can you expect during menopause, and what can you do about it? We met up with our experts in Women’s Health, a clinical partnership between UT Health Austin and Ascension Seton, which included obstetrician-gynecologist, Margaret Whitney, MD, NCMP, and physician assistant, Teresa Reed, PA-C, to pick their brains about the topic. Below are some of the most frequently asked questions they get and their answers about menopause and how it might affect you.

What is menopause?
Menopause, by definition, is the ceasing of menstruation. 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, but some patients who are delaying fertility to their later 30s and early 40s are beginning 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 period and occurs on average at age 52. The menopausal transition can last for many years and occurs as a result of declining estrogen production from ovarian follicles. During this transition, women will often see changes in their menstrual cycle and may experience the symptoms commonly associated with menopause, such as hot flashes, 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. Any bothersome symptoms such as hot flashes, mood and sleep disturbances, changes in libido and vaginal dryness can often be treated with the goal of improving 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, 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 around?
These risks are most notable in women who are older, such as those older than age 65, or those who have a high risk at the baseline. 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 the symptoms and the degree of risk.

What’s new on the market for women with menopause? New treatments, medications, procedures, etc.?
There are currently many treatments, medications and procedures in different stages of development. 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 it can be a difficult time for some women. 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 the modern woman 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 here at UT Health Austin is tailored to address the needs of each individual patient.

Symptoms of Menopause include:

  • Hot flashes - These can 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 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 and fatigue during the daytime.
  • Trouble sleeping - Sleep problems such as insomnia may occur sometimes independent of night sweats.
  • Moodiness - Emotional changes may cause mood swings, irritability or mild depression.
  • Irregular periods - Heavy or lighter periods, or not periods at all are part of menopause transition.
  • Vaginal dryness - Vaginal dryness, discomfort during sex, low libido and an urgent need to urinate are all symptoms that may occur.

I’m sure those of you reading this are like “great, so basically I’m looking forward to 10 years of torment followed by my own death…” No! Menopause does not have to be terrible or signify old age, let’s throw that stigma out the door and right into the trash. Menopause is your body saying “hey, thanks for all the awesome work all those 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 imagine you’re having a short private little vacation to the tropics, basking in the sunshine with a piña colada (or drink of choice) in hand 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. For more information or to make an appointment, call 1-833-UT-CARES (1-833-882-2737) or visit here.

About the Partnership Between UT Health Austin and Ascension Seton

The collaboration between UT Health Austin and Ascension brings together medical professionals, medical school learners, and researchers who are all part of the integrated mission of transforming healthcare delivery and redesigning the academic health environment to better serve society. This collaboration allows highly specialized providers who are at the forefront of the latest research, diagnostic, and technological developments to build an integrated system of care that is a collaborative resource for clinicians and their patients.

About UT Health Austin

UT Health Austin is the clinical practice of the Dell Medical School at The University of Texas at Austin. We collaborate with our colleagues at the Dell Medical School and The University of Texas at Austin to utilize the latest research, diagnostic, and treatment techniques, allowing us to provide patients with an unparalleled quality of care. Our experienced healthcare professionals deliver personalized, whole-person care of uncompromising quality and treat each patient as an individual with unique circumstances, priorities, and beliefs. Working directly with you, your care team creates an individualized care plan to help you reach the goals that matter most to you — in the care room and beyond. For more information, call us at 1-833-UT-CARES or request an appointment here.