By Randi Mann, WHNP-BC, NCMP, APNP
If you are a woman in your late 30’s or 40’s you may begin to experience a whole new set of hormonal symptoms as you begin the gradual transition between your reproductive years and menopause (the cessation of menstrual periods) called perimenopause. For most women this transition can last many years and can be associated with some unpleasant changes such as shorter menstrual intervals or irregular menses, night sweats, moodiness anxiety, insomnia, weight gain, fatigue, low sex drive and other symptoms. For some women, these symptoms are troublesome enough to warrant medical help and it may make sense to get tested for other causes of symptoms that can mimic perimenopause, such as thyroid disease.
Menopause is Normal
Menopause is a normal, natural event. It’s defined as the final menstrual period and is confirmed when a woman has not had her period for 12 consecutive months. Women in the US will likely experience natural menopause between ages 40 and 58, averaging around age 51. Some women, however, reach this phase in their 30’s, others in their 60s. Typically, women reach menopause around the same time as their mothers and sisters.
What is Early Menopause?
Menopause, whether natural or induced (i.e. after surgical removal of the uterus), is called premature when it happens at or before age 40 and happens to approximately 1% of women in the United States. Premature menopause that is not induced can be genetic, metabolic, autoimmune, or the result of other poorly understood conditions. Should a woman reach menopause before age 40 the cause should be evaluated by a woman’s medical provider as she is at higher risk for osteoporosis, heart disease and sexual dysfunction due to the decrease in levels of female hormones estrogen, progesterone and testosterone.
Hot Flashes – The Most Recognizable Menopause Symptom
The most common and recognizable menopause-related symptom is called a hot flash. Hot flashes are thought to be due to changes in the gland that regulated the body’s temperature called the hypothalamus gland. If this gland detects that a woman is too hot it begins a series of events to help lower her temperature. Her blood vessels close to the surface of her skin dilate to increase blood flow to her skin to help release some body heat. This may cause a reddening of the face and neck for some women. She may also begin to sweat to help cool her body down. She may have an increased heart rate and for a few women may also feel anxiety or nausea. She may feel a chill after a hot flash. If the same mechanism is at play during the night she may experiences night sweats. If she wakes up in time to throw off the covers she may avoid actually breaking out in a sweat.
How Long Does a Hot Flash Last?
Studies tell us that the duration of hot flash episodes can be as brief as 6 months or last as long as 10 years or more. A small number of women will have hot flashes daily for the rest of their lives without treatment. If your hot flashes are mild to moderate in intensity you may find relief by changing your lifestyle.
Lifestyle Changes Recommended to Help Reduce Hot Flashes:
- Exercise several times per week to reduce stress and improve sleep (may be too stimulating within 3 hours of bedtime)
- Avoid hot rooms, hot foods and drink, alcohol, caffeine, excessive stress and smoking
- Practice formal relaxation with meditation, yoga, prayer or massage
- Dress in lightweight fabrics and layers that are easy to remove and put back on.
- Moving air can be very helpful in the form of a ceiling fan, desktop or bedside fan.
- Topical sprays and gels that are cooling can be helpful as can sleeping on the Chillow pillow.
- Try slow paced respiration – a slow deep breath deep from your belly 5-7 times in a minute to abate or lessen the hot flash.
- Non-prescription remedies to try include: one to two servings of soy (tofu, soy milk, roasted soy nuts) may be helpful (but not advised if you have a thyroid condition).
- Herbs such as black cohosh (one brand name is Remifemin) and a rhubarb supplement (brand name Estrovera) have been helpful to many women.
Prescription hormone therapy with estrogen is the most effective treatment for hot flashes and night sweats.
Studies have shown that the benefits outweigh the risks for most healthy women under age 60 with moderate to severe hot flashes. Female hormone therapy offers both symptom alleviation and long-term benefits. Standardized dosed synthetic and bio-identical hormones and customized bio-identical hormones may be offered and hormone testing can help guide initial treatment and follow up care.
NAMS Certified Menopause Practitioners
It is highly recommended that women seek hormone treatment from a knowledgeable health care provider who is a North American Menopause Society (NAMS) Certified Menopause Practitioner and who understands your symptoms and appropriate individualized treatment options for you. If hormone symptoms are getting you down please seek help – you will be so glad you did!
Randi Mann, WHNP-BC, NCMP, APNP, is a woman’s hormone expert and the owner of Wise Woman Wellness LLC, an innovative wellness and hormone care center at 1480 Swan Road, De Pere. Mann is the author of the eBook: A Guide to Gluten and Going Gluten Free. She is a board certified Women’s Health Nurse Practitioner and NAMS Certified Menopause Practitioner, one of a handful in Wisconsin and less than 1600 worldwide to achieve this distinction. She combines the best of conventional, functional and integrative medicine to help women with female, thyroid and adrenal hormone issues to live healthier, more abundant, joy-filled lives using a blend of compassion, cutting edge science, practical guidance and humor. Contact her at 920-339-5252 or via the Internet at www.wisewomanwellness.com. Attend the introductory seminar, “End Hormone Havoc – Crazy Hormones Cause Fatigue, Weight Gain and Brain Fog and How to Fix Them!”, offered monthly, to learn about specialized thyroid, adrenal and female hormone testing and customized, bioidentical hormone treatments to achieve lifelong optimal hormone balance, increased vitality and longevity.