Surviving and Thriving through Menopause. by Obstetrician/Gynecologist Leigh Bauer, D.O. Cuyuna Regional Medical Center

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1 Surviving and Thriving through Menopause by Obstetrician/Gynecologist Leigh Bauer, D.O. Cuyuna Regional Medical Center

2 As women enter their 40s and 50s there are a number of changes going on within their bodies Each woman will experience a different menopause Becoming knowledgeable about the signs, symptoms, and treatment options it the first step to ensure you manage your menopause rather than it managing you Best tools: Knowledge, communication with your physician and a proactive health and wellness focus

3 Survive: 1. To get along or remain healthy, happy, and unaffected in the spite of some occurrence. 2. To endure or live through an affliction, adversity, misery, etc. Thrive: 1. To prosper, be fortunate or successful. 2. To grow or develop vigorously, flourish. Your survival kit is knowledge paired with action.

4 What is menopause? The permanent cessation of menstruation Usually occurs between 45 and 50 Officially begins one year after the last menstrual period

5 Knowledge: The Phases of Menopause 1. Perimenopause The time leading up to menopause when you body begins producing less of hormones like estrogen and progesterone. As a result women begin to lose their ability to become pregnant. Some symptoms may begin as early as 35 but often begin between 45 and Menopause The period stops and perimenopause symptoms may increase. Menopause is defines as 12 consecutive months without a period (and there are no other causes). 3. Post-menopause Most of the menopausal changes have faded. Hot flashes may seem milder or less frequent; energy and emotional levels may seem to have stabilized. Bone loss and estrogen loss are areas of concern.

6 Types of menopause Natural menopause -- decline of normal hormones Hysterectomy and bilateral oophorectomy (surgical menopause) surgical removal of uterus and ovaries Chemotherapy and/or radiation therapy (chemical menopause) cancer treatments induce menopause and stop hormone production Primary ovarian insufficiency/failure 1% of women, occurs before age 40 and is related to genetics or autoimmune disease, usually no cause can be found

7 Tests Follicle stimulating hormone increase Estradiol decreases Thyroid stimulating hormone can cause menstrual changes and cessation

8 What is perimenopause? Can start up to 10 years prior to menopause The period of time when hormones and fertility decline and signs and symptoms begin, including: irregular periods, decreased fertility, vaginal dryness, hot flashes, breast tenderness, dry, itchy skin, acne, sleep changes, mood swings, depression, anxiety, irritability, panic attacks, weight gain, thinning hair, night sweats, heart racing, decreased libido (sex drive), forgetfulness, headaches, urinary incontinence, fatigue, difficulty concentrating, bone loss

9 When should you see your healthcare provider? If you miss a period and there is any chance you could be pregnant If your symptoms are so severe that they are interfering with normal activities If you have any bleeding after you have reached menopause

10 Health Risks/Concerns Related to Menopause Bone loss Cardivascular disease Vasomotor symptoms Breast Cancer Urogenital Atrophy

11 Osteoporosis 30 Million women affected Risk Factors Diagnosis What to do Calcium and Vitamin D Exercise Stop Smoking

12 Cardiovascular Disease Leading cause of death in women. Risk Factors Hormone Replacement

13 Vasomotor Symptoms Affects 75% of perimenopausal women. Symptoms last 1-2 years after menopause. Results from Estrogen withdrawal.

14 Breast Cancer Most common cancer in women. Lifetime risk is 12%. Use of hormone replacement increases risk.

15 Urogenital Atrophy Symptoms: dryness, itching, pain with intercourse, pain with urination. Can use systemic or local estrogen therapy.

16 Sexual Dysfunction As many as 43% of women experience some form of sexual dysfunction. Physiological, psychological, lifestyle, relationship issues.

17 Symptom Management Lifestyle: Use over-the-counter lubricants Avoid caffeine, alcohol and spicy foods Eat soy-based foods Add calcium and Vitamin D2 supplements and eat foods high in calcium and vitamin D. Eat foods high in fiber Drink lots of water Get regular exercise Do Kegel exercises throughout the day Practice deep breathing and relaxation techniques Quit smoking

18 Hormone Replacement Therapy Oral Patches Cream Bio-identical vs. mainstream

19 Risks vs. Benefits of HRT Heart disease Stroke Blood clots Cancer Osteoporosis Gallbladder disease

20 Side Effects of HRT Vaginal bleeding Bloating Breast Tenderness Headaches Mood Swings Nausea Water Retention

21 Other Options Herbals Estroven, black cohosh, soy, Vitamin E Anti-depressants Effexor, Prozac, Celexa, Paxil Gabapentin Clonidine Bisphosphonates SERMs (selective estrogen receptor modulators) Rank Ligand Inhibitors (Prolia)

22 The Next Phase No more periods In other words... freedom!

23 Conclusion Talk with your doctor about how you feel Track changes and cycles Work with your doctor to determine the right medical or non-medical treatments Possible symptoms and their frequency to discuss with your physician: Hot flashes Rapid heartbeat Incontinence Depression (how long?) Weight gain (how much?) Irritability/moodiness Trouble sleeping (how long?) Extreme fatigue (how long?)

24 Action - Relieve the symptoms by keeping a journal to record changes and anticipate changes - Watch for food triggers like spicy foods or heavier meals - Dress in layers so you can easily cool down if a hot flash attacks - Focus on your health and improve where you can stop smoking, start exercising - Some alternative therapies, such as acupuncture, may have results for some women - Counseling and support groups are an option for women struggling with the changes in their bodies and the associated life-style changes - Hormone replacement therapy can be discussed with your physician if more moderate changes in diet, exercise, and supplements do not offer the level of treatment desired

25 Appointments Monday-Friday, 8 a.m.-5 p.m. Locations Cuyuna Regional Medical Center 320 East Main Street, Crosby CRMC Clinic- Baxter Isle Drive, Baxter

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