July Commentary: Is it Menopause? Well, it’s time to talk about it.
Menopause is the end of a woman’s menstruation and is diagnosed 12 months after the last menstrual period. You may have already known that women are born with all of their eggs stored in their ovaries, but did you know that the number is around 1-3 million eggs? At the time of menopause, women have fewer than 10,000 eggs remaining. Besides storing the eggs, the ovaries also produce estrogen and progesterone, which regulate ovulation (the egg release) and menstrual periods. As menopause approaches, the ovarian production of estrogen decreases dramatically, which is thought to cause many menopause symptoms.
For most women, menopause is a natural biological process that usually occurs between 47-54 years of age but can occur anytime in the 40s and 50s. However, for some women, menopause may be induced earlier if they require ovarian/uterine surgery or if they undergo specific medical treatments such as pelvic radiation or chemotherapy, which affects the function and hormone production of the ovaries. If menopause occurs before age 40, it is called premature menopause. Just as the age of onset of menopause varies for women, so do symptoms.
Vasomotor symptoms, including hot flashes and night sweats, are the classic symptoms associated with menopause. Vasomotor is related to the constriction or dilation of blood vessels. A hot flash is usually the sudden sensation of heat and flushing in the upper chest, neck, and face that can spread to other body parts and be associated with sweating and palpitations. Hot flashes can often last 1-5 minutes and are sometimes followed by chills, shivering, and/or anxiousness. Night sweats are episodes in which women awaken at night drenched with sweat. These awakenings disrupt sleep and can lead to fatigue and mood changes.
Menopausal vasomotor symptoms can be frequent and severe, negatively impacting daily living activities and limiting the quality of life. Vasomotor symptoms are reported by over 70% of peri-menopausal and post-menopausal women. Recent findings suggest that women with frequent hot flashes and night sweats can continue to have these symptoms on average for 7-10 years!
Hormone replacement therapy has been a much-discussed and debated treatment option for menopause symptoms due to the potential risks of breast cancer, heart disease, stroke, and blood clots. There is no one answer for all women. So it is important to discuss all treatment options, including the risks and benefits, with your provider. Luckily there are other options to consider for women who do not want to or cannot take hormone replacement therapy.
A randomized control trial (see link below) found that “a course of acupuncture treatments was associated with a significant reduction in vasomotor symptoms, as well as several quality-of-life measures compared with no acupuncture, and that clinical benefit persisted for at least six months beyond the end of treatment.” Click on the link below to read the article, and then consider talking to your provider to discuss your treatment options.
[HTML] Acupuncture in Menopause (AIM) study: a pragmatic, randomized controlled trial
Menopause. Author manuscript; available in PMC 2017 Jun 1.
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