Menopause does not necessarily require treatment – it's a natural part of life. For women who have symptoms that impact their quality of life, however, there are good options including alternative therapies (such as lifestyle changes, supplements and herbal products or acupuncture), hormone therapies and other medications. These therapies are tailored to each individual woman based on her symptoms, needs and risks. Working with a specialist who can balance immediate needs and long term goals and health risks is key to optimal health and wellness. Our Swedish physicians are specialists in menopause and gynecology.
A Swedish commitment to women in menopause
Dr. Rebecca Dunsmoor-Su, medical director of menopause services, comes to Swedish with 20 years of practice experience and a focus on menopause, sexual function and general gynecology. She is a North American Menopause Society certified menopause practitioner and a member of the International Society for the Study of Women’s Sexual Health.
Hot flashes (or flushes) are one of the most commonly reported symptoms of menopause. They are thought to be because the temperature monitor in the brain narrows, and the body responds to any stress or temperature change with dilating blood vessels (which feels hot but is designed to release heat and cool you down). These can be rare for some women, or every hour for others. They are not inherently harmful, but they can significantly impact daily life and functioning.
Night sweats are really hot flashes at night. They have significant impact because they will wake a woman from sleep either due to the profuse sweating or because she gets cold after from being drenched and wet. These can interrupt sleep multiple times a night and this has huge impact on daytime functioning, mood, weight gain and more.
Sleep disturbances are one of the most common complaints in peri-menopause and generally as women age. Because sleep impacts so many of our body systems, it is important to deal with poor sleep in order to be healthy. Sleep can be interrupted by night sweats, but women often also find increased general insomnia and middle of the night waking as they age. There are many non-medication interventions that can help sleep.
Especially prevalent in the perimenopausal transition, mood swings, mood changes and even rage and anger are common symptoms. Estrogen and progesterone are both very active in the brain, and many areas controlling mood have receptors for these hormones. It makes sense that changes in hormone levels will impact the brain chemicals associated with mood. Women who have a history of depression, premenstrual syndrome (PMS), premenstrual dysphoric disorder (PMDD), postpartum depression or mood issues are at especially high risk. These symptoms can be managed with many different interventions, and it is important to see a provider who understands this transitional time.
Women often notice gradual (or sudden) weight gain during perimenopause, but they also notice that where they gain weight changes. It also seems like weight can be harder to manage or take off, even with healthy choices. Weight gain in menopause is normal and functional. As ovaries stop making estrogen, the largest source of it in the body is fat cells. It make sense for your body to add some fat, to help both with symptoms and bone health. However there is a fine balance between helpful vs. harmful weight gain. There is a temptation to try radical or strict diets. Our specialists can recommend interventions focused on long term health and fitness rather than short term sudden weight loss (which almost always comes back).
Day-to-day vaginal dryness as well as dryness with intercourse and even sexual pain can appear, most commonly after menopause. It can even start to be a problem years later. (Significant itching or bleeding can be a sign of a more serious condition and should be seen by a gynecologist immediately.) There are many local treatments and therapies including moisturizers, hormones, laser procedures and physical therapy that can make the day-to-day and sexual function comfortable again.
This is a not uncommon change as women transition through menopause. There are many reasons for it, including social, psychological, relationship and physical factors. Seeing a specialist who has a unique understanding of all of these factors and the female sexual response cycle is key to finding the best treatment for you.
Many women notice changes in memory and a general “fog” or fatigue during and after the menopausal transition. This is normal as estrogen and progesterone are very active all over the brain. Women may worry that they will never be the same, or that it can be a sign of more serious conditions or problems to come. However, this common symptom can be managed effectively. Our specialists can talk to you about the difference between temporary changes and long term risks of mental decline.
Whether due to age or the menopausal transition, joint complaints increase during this time of life. The solutions for this can include exercise management, orthopedic or arthritis evaluation and / or medications. Our specialists can work with you to plan a holistic treatment plan.
Urinary complaints increase at this time of life because the vaginal and urinary tissues change as estrogen withdraws. You may experience increasing leakage, bladder discomfort and even increased urinary tract infections. We have hormone and urologic experts who work together to design the best plan for management of your symptoms.