In this article, we discuss the warning signs and symptoms of menopause, as well as perimenopause, the various treatment options, and how to get help from your primary care physician.

Menopause symptoms and treatments

When a woman’s ovaries stop producing the hormone oestrogen and, as a result, stop producing eggs, this is the beginning of menopause. This typically occurs in women between the ages of 45 and 55, with 51 being the typical age of menopause. When a woman has gone 12 months without having a period, a doctor will typically diagnose menopause. In the majority of cases, hormone testing and/or other diagnostic procedures are not necessary. Some women may enter menopause at an earlier age than others (sometimes called premature ovarian insufficiency). If you reach menopause before the age of 45, medical professionals consider this to be an early onset of the condition. It is also possible for this to occur after a hysterectomy in which either one or both of the patient’s ovaries were removed.

What exactly is the perimenopause?

The menopause transition has essentially begun at this point. Your oestrogen levels will continue to gradually decline for some time before you have your last period and the start of the menopause. During this time, your periods may become less regular and heavier than they were before.

The onset of perimenopause typically occurs between the ages of 45 and 50 and can last anywhere from four to five years.

Because it is still possible for you to become pregnant even though you are perimenopausal, you should continue to practise birth control.

If you are trying to conceive but are experiencing symptoms of perimenopause, you should talk to your doctor.

Menopause symptoms

The symptoms of menopause are brought on by fluctuating and declining levels of the hormone oestrogen. The most typical symptoms are flushes of heat and sweating during the night. joint and muscle pain vaginal dryness a lack of libido along with low mood or anxiety (lack of interest in sex). After having your uterus removed, you may experience symptoms similar to those of menopause.

Other symptoms associated with the menopause

Certain age-related conditions, such as osteoporosis, heart disease, and loss of muscle strength, can become more severe when a woman goes through menopause.

Getting treatment for menopause symptoms is recommended.

The severity of these conditions and the way they affect your life can differ greatly from one woman to the next. There are treatments available for menopause symptoms, the most common of which is hormone replacement therapy, which you can try if you are having trouble managing your symptoms (HRT).

The following is a rundown of the various treatment options categorised by symptom, with additional information provided below the table:

Various treatment options are available for symptoms of the menopause.
Sweating and flushing at night along with it

HRT, also known as bioidentical hormone replacement therapy

Medication available only with a doctor’s prescription, like Clonidine and Gabapentin Herbal treatments, like black cohosh, isoflavones (found in soy products and red clover), and St. John’s wort

Modifications to one’s way of life, such as alterations to one’s diet and level of physical activity, in order to aid in weight loss, as well as various cooling

Depression and/or anxiety

HRT

CBT stands for cognitive-behavioral therapy (CBT)

Reduce stress using techniques based on mindfulness

Absence of interest in sexual activity

HRT Testosterone

Vaginal dryness

HRT

Vaginal oestrogen (pessary, cream or ring) Vaginal moisturisers or lubricants

Joint or muscle pain

HRT

Replacement of hormones through hormone therapy (HRT)

Hormone replacement therapy is perhaps the most well-known treatment for menopause (HRT). This involves taking synthetic hormones to replace those in the body, and it can limit the severity of more troubling symptoms, such as hot flushes, in addition to helping in general.

The hormone replacement therapy (HRT) comes in many different forms, such as oral tablets, skin patches, injections, body gels or sprays, vaginal rings, and creams or pessaries to apply topically.

You should consult your physician about the delivery method that will work best for you. HRT will typically consist of oestrogen and progestogen (a synthetic form of progesterone) if the patient has a uterus, but will only contain oestrogen if the patient does not have a uterus (or you are getting your progestogen in another way, such as a Mirena contraceptive coil).

If hormone replacement therapy (HRT) is not an option for you because of something in your family history, such as an increased risk of breast cancer or deep vein thrombosis (DVT), your primary care physician should discuss alternative treatment options with you. For additional information on this subject, please refer to our guide for having the menopause conversation with your primary care physician.

Is there a risk with HRT?

The effects of HRT have been studied all over the world, and the most recent research, as stated by the Royal College of Obstetricians and Gynecologists, demonstrates that for the majority of women, HRT is both effective and safe to use. Concerns about an increased risk of breast cancer, heart disease, and blood clots in women taking hormone replacement therapy (HRT) led to the premature termination of a research study in 2002, which set off a wave of alarm.

However, when the study was reanalyzed taking into account the participants’ ages, it was found that the benefits outweighed the risks in the target market, which consisted of women under the age of 60.

Before you begin hormone replacement therapy (HRT), you and your doctor should talk about your personal medical history and any factors that may influence this decision, such as whether or not you have a family history of breast cancer.

There are also other potential side effects of HRT.

The use of hormone replacement therapy (HRT) was once thought to cause weight gain; however, a Cochrane review of clinical research trials found no evidence that HRT had any effect on body weight, in addition to the normal weight gain that occurs during menopause (many women gain weight naturally during menopause).

Options for treating common menopause symptoms are discussed in detail here.

Menopause symptoms and treatments

Sweating and flushing at night along with it

HRT is the treatment that is typically recommended after going over the benefits and risks with your primary care physician. Clonidine, which is a medication for high blood pressure, or Gabapentin, which is an anti-epileptic drug, are two examples of non-hormonal medical treatments for hot flushes that would need a prescription from your primary care physician.

You can talk to your doctor about these other options if you don’t want to use hormone replacement therapy (HRT) or if your doctor determines that it won’t work for you. There is scant evidence to suggest that Clonidine is effective, and additional research is being conducted to determine whether or not Gabapentin is useful.

They may also cause some unpleasant side effects, such as dry mouth, fatigue, fluid retention, and depression (Clonidine). Supplements like black cohosh and isoflavones have been found to be helpful for reducing the frequency and severity of hot flashes and night sweats in some women.

However, the components of these products might be different from one another, and the products’ levels of safety are unknown. Additionally, they might react negatively with any other medications that you are currently taking. For further information, please refer to our guide to alternative HRTs.

Low mood

HRT and CBT are two possible treatments for the emotional symptoms of menopause, such as feelings of depression, anxiety, and erratic mood swings (cognitive behavioural therapy).

The use of HRT is a treatment that is effective. It has also been discovered that cognitive behavioural therapy (CBT), a type of psychological treatment that can include education, paced breathing, relaxation, stress control, and understanding and challenging beliefs about menopause and its symptoms, is effective.

A depressed mood as a result of the menopause is not the same thing as clinical depression.

If you haven’t been clinically diagnosed with depression, there is no evidence that antidepressant medications like SSRIs and SNRIs will be helpful to you.

Absence of interest in sexual activity

HRT that contains oestrogen and/or progestogen can be helpful for women who find that they have less interest in having sexual relations during menopause. However, if hormone replacement therapy (HRT) does not improve your condition, you may be prescribed the hormone testosterone, which has been shown to improve libido in both men and women.

Testosterone is not currently licenced for use in women; however, a physician is able to prescribe it to a patient if they determine after conducting an evaluation that the patient requires testosterone to meet their specific requirements.

Naturally, this would involve thinking about the medicine’s side effects as well as its efficiency (or usefulness).

Vaginal dryness

The skin of your vagina and vulva (the area around your vagina) will become thinner both during and after menopause, which may cause you to experience dryness, discomfort, or even pain during sexual activity.

Even if you are using hormone replacement therapy (HRT), you may benefit from using vaginal oestrogen, which can be applied directly to the vagina in the form of a pesary, cream, or ring. Other types of HRT, as well as moisturising products and lubricants, may also be of assistance.

The benefits and dangers of using HRT

Menopause symptoms and treatments

In a manner analogous to that of the contraceptive pill, hormone replacement therapy (HRT) may marginally raise your risk for certain diseases while simultaneously lowering your risk for others. This is something that is dependent on whether or not you have any pre-existing conditions, what type of HRT you take, and at what age you begin taking it.

The risks involved with HRT and the facts surrounding them

Stroke and coronary artery disease

If you begin taking HRT before the age of 60, it will not increase your risk of developing heart disease, and it will not increase the likelihood that you will pass away from cardiovascular disease. Tablets of hormone replacement therapy, but not patches or gels, have been shown to carry a very small increased risk of stroke (which is already very low in women under 60). If you already have heart disease, you should consult your primary care physician about the possibility of using HRT; however, this answer will vary depending on the specifics of your case.

Cancer of the breast

Oestrogen-only hormone replacement therapy (HRT) may or may not affect the risk of breast cancer. Breast cancer risk may be increased by hormone replacement therapy (HRT) that contains both oestrogen and progestogen; the risk may be even greater if you take HRT for a longer period of time; however, the risk will decrease once you stop taking HRT.

Clots of blood form

Tablets containing hormone replacement therapy (but not patches or gels) have been linked to an increased risk of blood clots, which can occur in the lungs or present themselves as deep-vein thrombosis. This is especially concerning for women who are obese or who have other risk factors for clotting. Before beginning HRT, it is possible for women who have a high risk of blood clots to be referred to a haematologist, a physician who specialises in blood disorders.

The numerous advantages of using HRT

Menopause symptoms and treatments

Reduced likelihood of developing osteoporosis

When your ovaries stop producing oestrogen, which causes your bones to become thinner, menopause raises your risk of developing osteoporosis, which is a condition associated with ageing in which your bones break more easily. This risk can be reduced with the help of HRT. Keep in mind that even for women who are approaching menopause, there is a relatively low risk of breaking a bone. The use of HRT merely lowers the risk to a lower level. This benefit is only going to be of use while you are taking HRT, but it has the potential to be of use for a longer period of time if you have been taking HRT for a very long time.

avoiding a decrease in one’s muscular strength

Although HRT may help to prevent the natural decline in muscle strength that comes with ageing, it is ultimately up to the individual to maintain the highest level of physical strength and fitness possible through regular activity.

Does the use of HRT increase a person’s likelihood of developing type 2 diabetes?

HRT does not make you more likely to develop type 2 diabetes and is not likely to have an effect on how well you manage your blood sugar levels. Those who already have type 2 diabetes should consult their primary care physician about their individual risk and the necessity of seeking specialist advice. Before prescribing you HRT, your primary care physician may send you to a specialist for advice if diabetes-related health issues are affecting your quality of life.

Does hormone replacement therapy increase the risk of dementia?

There is a growing concern about dementia in older age and an ageing population, which has led to the question of whether hormone replacement therapy (HRT) could have a protective effect on an individual’s risk of developing dementia in the future. Although this is not known at the present time, the National Institute for Health and Care Excellence (NICE) has suggested that additional research be conducted in this field.

How long can you use HRT before it becomes unsafe?

There is no predetermined schedule, and the physician or other healthcare professional who treats you should discuss your personal circumstances with you. You have the option of discontinuing hormone replacement therapy (HRT) gradually or all at once, but doing either shouldn’t have a significant impact on the likelihood that your symptoms will return. It is normal for symptoms such as hot flushes to lessen over time (usually between two and five years, although some women may require longer), and your primary care physician may encourage you to think about discontinuing treatment at this point in time. You might require topical (vaginal) oestrogen on a long-term basis, but some women are able to successfully discontinue using it.

How to Get Help: What to Expect from Your General Practitioner

Menopause symptoms and treatments

The symptoms of menopause can range from mild to severe, but you should see your primary care physician if they are interfering with your day-to-day activities. On the basis of your age, symptoms, and the frequency of your periods, your primary care physician should be able to diagnose perimenopause or menopause.

It is more likely that you will be offered blood tests to confirm the diagnosis if you are younger than 45 years old. These tests determine how much of a hormone known as follicle-stimulating hormone, or FSH, is present in the body. Menopause is associated with higher levels of this hormone.

Your primary care physician should provide you with information regarding the following topics: the stages of the menopause, including perimenopause, menopause, and post-menopause; common symptoms of the menopause; how the menopause is diagnosed; changes you can make in your lifestyle that will help alleviate symptoms of the menopause. methods of contraception and treatment for menopause, such as hormone replacement therapy (HRT), along with their potential risks and benefits the likely impact that menopause will have on your future health, such as the state of your bones and the likelihood that you will develop osteoporosis alternative treatments and what you need to know about them before you try them out.

Alternative treatments like red clover and sage are helpful for some women, but your primary care physician should explain that the evidence that they work is not convincing, and that the quality of the products varies widely.

Check out our comprehensive guide to alternative treatments for menopause for additional information and recommendations. Your primary care physician should talk to you about what to anticipate from the treatment that will cause menopause (such as a hysterectomy), as well as the potential impact that it will have on your ability to have children in the future. In addition to providing you with support themselves, they should also refer you to a medical professional who specialises in the menopause.

Referral to a menopause specialist

If the treatments you try do not help or cause unwanted side effects, or if it is not clear which treatment is the best treatment for you, then your primary care physician should refer you to a healthcare professional who specialises in menopause. They should be able to provide you with information regarding other available choices.