A common phrase in the gynecologist office is “Everyone says that I am too young for this, but I am having hot flashes.” While it is true that the average age of menopause is 51, the symptoms can start many years earlier.
Menopause is defined as not having a period for one year without other medical causes. This signifies that your ovaries have stopped producing hormones. However, ovaries can start misbehaving before this.
The fluctuations and later the absence of hormone levels cause the symptoms that a woman feels. A common misconception is that until a woman starts skipping cycles, she cannot be having symptoms of menopause. This is not true!
The most common symptoms of menopause are:
- Hot flashes
- Night sweats
- Menstrual changes
- Vaginal dryness.
The less common symptoms are:
- Hair loss
- Joint pain
- Heart palpitations
The most common symptoms make a diagnosis easy for the gynecologist. At this time, reassurance and/or treatment can be started. The less common symptoms take more time and tests to establish a diagnosis. There is not a “hormone test” that makes the diagnosis. I wish there were! Hormone levels fluctuate widely in the years leading up to the absence of a period.
Hormone testing is just a snapshot of what your ovaries were doing at that particular moment when the blood was taken. I always recommend someone come in for a menopause consult separately from her annual visit. There is simply too much ground that needs to be covered to do a good job. I cannot stress this enough. Menopause is a natural process and does not need to be treated in someone with few symptoms.
Treatment options vary depending on which symptom is most bothersome to the patient. Many years ago, the medical community thought that hormones were good for everything and were given to a majority of women with menopause symptoms. We know now that hormones are not the fountain of youth and should not be used this way. I stress to a woman that we only need to treat what is bothering her. There is no need to undertreat or overtreat.
When you come for a consultation, be prepared to answer a lot of questions regarding your symptoms. I recommend that you spend time thinking about the root of your discomfort instead of assuming the root is hot flashes. In general, 30 % of women have symptoms of menopause severe enough to take hormones; therefore, 70% of women will manage without them. Your gynecologist can help you determine what is severe and if you need treatment. There are great books that we recommend reading prior to coming in for your visit. See the recommended reading section on the website.