Menopause is undoubtedly a challenging period for every woman. Women experience menopause differently from one another and have varying symptoms. Some are increasingly bothered by their symptoms the time of life that is beginning. Fortunately, in recent years, the subject has gained attention and awareness among both women and doctors.
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How do I know I've reached menopause?
In general, women enter menopause during their 40s. This is a gradual process in which a woman transitions from her fertile years to life after the ability to conceive, and there isn't one test or specific sign that indicates the beginning of the process.
Usually, a doctor can identify and diagnose that you are in menopause based on the symptoms you are experiencing, considering your age and your menstrual cycle history. It’s recommended to consult a qualified professional such as a general practitioner or gynecologist with the ability and authority to diagnose whether the symptoms are appropriate for the phase,
The classic symptoms are hot flashes, cold flashes, rapid heartbeat, excessive sweating, interrupted sleep, nervousness, and moodiness. However, you might be surprised to know that there are other symptoms not necessarily associated with menopause.
These include joint pain, dry eyes, burning mouth syndrome, and more. Therefore, it is very important to consult a qualified expert and confirm whether the symptom is related to menopause or another condition. Menopause can extend over years and encompass various phenomena like premenopausal syndrome and various emotional states.
What can be done?
Today, there is a wide and diverse range of treatments for menopause and perimenopause symptoms, ranging from pharmaceutical and hormonal treatments to herbal remedies, dietary supplements, behavioral therapies such as CBT, yoga, and more.
Additionally, medications from the selective serotonin reuptake inhibitor (SSRI) or serotonin-norepinephrine reuptake inhibitor (SNRI) families, used to treat mood disorders, anxiety, and depression, are also used to alleviate symptoms associated with disruptions in body temperature regulation, particularly hot flashes, and sweating.
Today, many professional associations agree on guiding principles for menopause treatment, providing a unified approach for patients.
Hormonal therapy is now recognized as one of the effective treatments for preventing osteoporosis and fractures, while also alleviating menopause symptoms. Additionally, it has been shown that hormone intake close to the end of the menstrual cycle and with the onset of symptoms, prevents heart disease, and early death, preserves cognition at the beginning of menopause and addresses many aspects of maintaining women's quality of life during that period.
Myth busting
Unfortunately, misconceptions about the treatment are still prevalent today, claiming that hormonal therapy increases the risk of cancer, especially breast cancer. This has not been substantiated at all. All current data indicate that the first five years of treatment don’t involve any added risk of breast cancer occurrences or relapses if administered at the right time - up to age 60 or within ten years after the woman begins menopause.
It's important to understand that the significant risk of cancer is an individual factor for each woman, including things such as a family history of breast cancer, excess weight, smoking, etc., and not necessarily hormone therapy.
Every treatment comes with side effects, and every woman experiences them differently. Therefore, tailoring the treatment according to individual needs is crucial. Of course, the role of the treating physician is to assess risk factors, possible side effects, and the patient's preferences, and provide them with an appropriate treatment.
Early treatment is critical
I want to emphasize that it's important to seek treatment as early as possible, and it's essential to understand that not every woman will receive the same treatment. Every woman has different health conditions, different needs, and different preferences. Our role as healthcare providers is to tailor the right treatment for each woman, considering all the aspects mentioned before.
There’s a significant health cost to ignoring perimenopausal symptoms, especially hot flashes, which contribute to a chain of events that reinforce each other - disrupted sleep, mood swings, metabolic issues, weight gain, cognitive impairments, and more.
Waiting for the symptoms to pass could be dangerous, and choosing not to receive treatment will have repercussions. What you do now will impact your future, so it's important to support your body through this period in the healthiest way possible.
It's also crucial to have a comprehensive review of your lifestyle, especially physical activity and nutrition. Dietary changes and other habits can prevent symptoms from becoming worse.
Of course, there are women who may prefer to receive alternative treatments. There’s a variety of specialized and non-hormonal treatments for perimenopause symptoms, such as herbal remedies that have been found effective in providing significant and sustained relief.
Non-pharmaceutical treatments like CBT, yoga, acupuncture, and meditation are also legitimate options. The medical world is aware of all the possible symptoms that women may experience during perimenopause, and all pharmaceutical treatments are covered and subsidized by health insurance.
Dr. Merav FreibergPhoto: Ronit Wolfer MegadimYou’re not alone
Everything must be taken into account during menopause. It's an age where many of us reach pivotal moments in our careers, become more financially stable, experience changes in family status, and sometimes care for both our children and aging parents.
All of this happens alongside the physiological changes we're going through, which are mostly unpleasant. This time is also influenced by the environment and our hormones, and every feeling or emotion is legitimate. This is precisely when we should ask questions and clarify any doubts.
Dr. Merav Freiberg is a medical professional and an expert in gynecology and women's health.