Menopause isn’t a new phenomenon, but it has long been something of a mystery—with few clues for women experiencing it and, regrettably, inadequate guidance from doctors. For previous generations of women, concerns and complaints about menopause’s effects were often brushed off. The result was that our mothers, grandmothers and great-grandmothers suffered in silence.

Good news: You don’t have to suffer in silence

With better research and relatively new treatments, your doctor is better prepared than ever to speak to concerns about menopause and recommend remedies that are shown to work.

First, what is menopause? That’s complicated

Menopause happens 12 months after a woman’s final menstrual period. However, a series of changes lead to menopause, typically between ages 45 and 55, and last for about 2-8 years, called perimenopause. These changes, largely due to fluctuations in hormones including estrogen and progesterone, can lead to a range of symptoms. These symptoms can vary widely among women and can include:

• Changes in menstrual cycles
• Hot flashes and night sweats
• Sleep disruption
• Dizziness and heart palpitations
• Urinary urgency 
• Mood changes such as depression

Depending on the person, menopause can be a beast, a blip, or anything in between. What’s more, the severity of symptoms can vary greatly by race and ethnicity. The Study of Women’s Health Across the Nation (SWAN), has followed 3000 women since 1994 to help understand the physical, biological and social changes during women’s midlife, including perimenopause and menopause. To help ensure the data provides insights for different racial and ethnic groups, the study includes African American, Chinese, Hispanic, Japanese and white women. The study shows that women of color “tend to enter perimenopause and menopause at earlier ages than their white peers, have longer transition periods, and experience more intense hot flashes and vaginal symptoms.”

How to talk about menopause with your doctor

The Menopause Strategies: Finding Lasting Answers for Symptoms and Health (MsFLASH) project conducted clinical trials of nine treatments for hot flashes, sleep problems, and other menopausal symptoms. The findings are wide-ranging and have been organized in a very useful tool called MyMenoplan. Enter your symptoms, and the tool will suggest strategies that may help achieve relief. Armed with this information, you can zero in on your symptoms and ask your doctor more pointed questions about a course of action. Here’s a look at the type of guidance MyMenoplan offers for a few common symptoms:

• Hot flashes: Quitting smoking, mindfulness, antidepressants, gabapentin, clonidine, hypnosis and hormone therapy have been shown to help. Other strategies that may help some women include weight loss, cooling therapy, and yoga.
• Mood, depression and anxiety: MyMenoplan reports that cognitive behavioral therapy, exercise, antidepressants and hypnosis have been shown to help, while smoking cessation, yoga, and hormone therapy are among the treatments that may help.
• Pain during sex: Pelvic floor physical therapy, vaginal dilators, vaginal moisturizers and lubricants, vaginal estrogen, and hormone therapy have been shown to be effective. For some women, vaginal laser therapy and yoga may also be effective.

There is now a wide variety of treatments and tactics to discuss with your doctor, and the advice you receive will be tailored to your particular menopausal symptoms.

What’s this about hormone therapy?

You may have noticed that hormone therapy, more formally known as hormone replacement therapy (HRT), appeared in all three of the examples above. HRT is the elephant in the room when it comes to dealing with the symptoms of menopause, and it has a complicated history.

For decades, HRT containing estrogen, progesterone or both was widely used to help relieve menopause symptoms including hot flashes and to potentially reduce bone loss and heart disease. But a study published in 2002 called the Women’s Health Initiative Study (WIH) seemed to indicate that the risks outweighed the benefits due to an increase in breast cancer and cardiovascular risks. Seemingly overnight, HRT use took a nose-dive. The study was later found to have several limitations. Specifically, the study focused on women over 60, while most HRT patients are younger. The risks of cancer were also exaggerated. Though other studies have also found that HRT therapy increases breast cancer risk, the risk is small, according to the Harvard School of Public Health. Unfortunately, the misleading findings of the WIH study still linger for much of the public, and even among medical professionals.

Determining whether HRT is right for you

Just as menopause is a highly personal experience, the decision to take HRT is highly personalized and depends upon your age, personal and family medical history and symptoms. According to the Mayo Clinic, HRT benefits appear to outweigh the risks if you're healthy and start therapy before 60 years of age, or within a decade of menopause. For those who choose HRT, experts generally recommend taking the lowest effective dose for the shortest amount of time. However, every individual is different, which is why it’s important to consult a doctor.

A Food and Drug Administration (FDA)-approved alternative to hormonal therapy is paroxetine, which increases the amount of serotonin, a natural chemical in the brain that helps with mental balance. Paroxetine, however, does not appear to be as effective as HRT.

It’s time to achieve your best health

The fact that menopause has been more acknowledged and openly discussed in recent years is in itself a relief for millions of women. Furthermore, more research is being conducted regarding treatments, including non-hormonal options.

HRT is covered by Horizon insurance. For specific information on coverage, call the number listed on the back of your Horizon card or visit HorizonBlue.com

Horizon Health News is for informational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.