Menopause Q & A (<i>cont'd</i>)
Q: Will these menopause symptoms last for the rest of my life?
A: For most women, the symptoms of menopause last for a relatively short time. However, a woman's level of estrogen naturally remains low after menopause. This can affect many parts of the body, including the sexual and urinary organs, the heart and the bones. So in that sense, the changes of menopause will be lifelong. But eating right, exercising and making other positive lifestyle changes can help a woman feel great and live a long, healthy life after menopause.
Q: What can be done to relieve pain during sex?
A: Sexual penetration may be painful when there is not enough moisture in the vagina or when the tissue lining the vagina becomes fragile because of lower estrogen levels in the body. Several methods are available to relieve pain. It may sound surprising, but frequent sexual activity is one of the most effective remedies for vaginal dryness. Other remedies include taking a warm bath before sex or using lubricants. Short-acting, water-based lubricants, such as K-Y Jelly, supply moisture and are used immediately before intercourse. These products are readily available in grocery stores and pharmacies, usually at a low cost. Long-acting vaginal moisturizers are also available, and can provide extended relief. Vaginal creams, rings or tablets containing estrogen are very helpful in relieving the symptoms of menopause, including vaginal dryness.
Q: Since I began menopause, I've had an embarrassing problem — urine leaks when I laugh or cough. What can be done to prevent this?
A: Some women have problems with bladder control after menopause begins. This happens because the muscles that surround the bladder and hold the urine inside become weaker when estrogen levels are low. Fortunately, simple exercises — known as Kegel exercises — can strengthen these muscles. To perform a Kegel, contract the pelvic muscles as if trying to tighten or close the vaginal opening. Hold the contraction for a count of three and then relax. Wait a couple of seconds and repeat. Fast Kegels (squeezing and relaxing muscles as quickly as possible) can also help. Performing several Kegels a day (try for a total of 50 per day) can markedly improve bladder control — and may even enhance sexual pleasure. Taking estrogen can also help maintain the tone or strength of pelvic muscles, but has not been proven to help with incontinence.
Q: My health care professional has recommended hormone therapy, but I've heard that I'll have menstrual periods again if I take it. Is that true? Is hormone therapy safe?
A: Estrogen therapy may cause vaginal bleeding in some women. This depends on the hormone that is selected and the dose taken each day, as well as each woman's own unique response to therapy. After menopause, low estrogen levels result in a thinning of the uterine lining, which, in turn, stops the monthly period. Taking estrogen after menopause thickens the uterine lining. This lining is shed on the days when estrogen is not being taken, resulting in vaginal bleeding similar to a period. About two-thirds of women who still have a uterus will have a period on the days when they are not taking estrogen. Most women who take continuous estrogen (that is, estrogen every day) plus progestin pills on some days of the month will have a period for the first six to nine months. By month nine, two-thirds of women on continuous therapy will stop bleeding.
Bear in mind, however, that safety of hormone therapy for long-term and short-term use is now under intense study by the federal government. Ask your health care professional for guidance.
Q: Even though my eating habits have not changed, I've gained weight recently. Is that linked to menopause?
A: It may be. The body's metabolism changes during and after menopause. Everyone's metabolism begins to slow during the early to mid-30s. This change occurs slowly, so it may take a while for the impact of eating habits to affect weight. It is important to make a sensible, nutritious diet and healthy behaviors, such as getting enough exercise, a goal for life. There is some evidence that eating a diet that includes lean protein, is low in fat and low in carbohydrates may help.
Q: I seem to be very forgetful lately and I'm worried. What's happening?
A: Many menopausal women have problems with short-term memory like forgetting the location of car keys or eyeglasses, skipping appointments they didn't remember, or losing the end of a thought when speaking or writing. These may be due to a busy lifestyle and/or stress at home or work. Notably, several medical studies have shown distinct differences in memory in women who have active ovaries producing estrogen or are taking estrogen replacement therapy compared to women with low levels of estrogen due to menopause.
Q: How will menopause affect my daily activities and lifestyle?
A: That all depends on you. Menopause is a natural part of life, not a disease or a health crisis. However, menopause may occur when many other changes are happening in your life. For instance, your children may be marrying or leaving home, your parents may be ill or dying or you may be wondering what you'll do when you retire from work. That's why it is probably more helpful to think of how your daily activities and lifestyle will affect menopause. For instance, making sure that you exercise and eat right can make a real difference in how you feel and can even help prevent some of the long-term effects that are linked to estrogen deficiency (like heart disease or osteoporosis). Physical changes do occur with menopause and with aging. But the changes that happen during this period can be minimized by healthy living and a sense of purpose in life.
Copyright 2003 National Women's Health Resource Center Inc. (NWHRC)