Most Common Symptoms of Menopause

Dr. Jennifer Adams MD FRCSC, Maud’s education lead and a board certified gynecologist, joins us to discuss some of the most common symptoms that women are concerned with during peri-menopause and menopause

A lot of women know about menopause, but don’t often talk about the symptoms they are experiencing nor discuss what treatments may be out there to help. The following three complaints are very common amongst women in the peri-menopausal and menopausal years.

I hope to draw some attention to these issues with the goal that once we talk about things more, more people will seek help when they are having concerns or issues surrounding menopause.

Knowledge is power.

1. MOOD CHANGES/DIFFICULTY SLEEPING

Many women describe increased irritability, stress, fatigue and mood changes as they enter the peri-menopausal years (the years approaching menopause). If you have had depression or anxiety in the past, you are more likely to experience these symptoms. There are many factors that may contribute to this, but a decrease in Estrogen is a big one.

Life style changes such as regular exercise, eating healthy, relaxation exercises (meditation, yoga) have been shown to help.

Seeing your doctor may also help to cope with these issues, and they may prescribe a medication (hormonal or non-hormonal) to help. Certain hormonal medications can also help with sleep, namely those in the Progesterone family.

2. HOT FLASHES

Hot flashes (vasomotor symptoms of menopause) are when you experience a feeling of warmth and heat. Hot flashes do resolve over time, but on average women can experience hot flashes for 7-10 years. They are typically felt in the face, neck and chest and can cause perspiration and flushing and sometimes feelings of anxiousness.

Hot flashes are caused by decreasing Estrogen levels with menopause that leads to the body’s thermostat (hypothalamus) to become more sensitive to slight changes in body temperature. When this system thinks you are too warm, it sets off a cascade of events to help cool you down (ie - a hot flash).

Many women find lifestyle changes such as regular exercise, eating well, stopping smoking, dressing in layers, among others to be helpful. Other women continue to have more frequent or severe hot flashes that can affect their quality of life and decide to undergo treatment. Non-hormonal treatments include Clonidine (blood pressure medication), Venlafaxine (antidepressant), Gabapentin (anti-seizure medication), among others. While these are not as effective as traditional hormone replacement therapy, they have been shown to be effective.

Lastly, the most effective treatment for hot flashes is hormone replacement therapy (HRT) - this may include Estrogen and possibly Progesterone (particularly if you have not had a hysterectomy). Depending on your medical history, you may or may not be a candidate for HRT.

3. VAGINAL DRYNESS, PAIN WITH INTERCOURSE

While hot flashes do improve and resolve over time, changes in the vagina are progressive and typically worsen over time unless they are treated. The changes in the vagina is called ‘atrophy’. It is estimated that 80% of women experience negative effects of changes in the vagina/vulva/urethra with menopause. Common symptoms include: vaginal dryness, pain with intercourse and recurrent urinary/vaginal infections.

Over time, the mucosa of the vagina thins and loses elasticity. Blood flow is reduced and the vagina mucosa gradually becomes more blanched and loses its ruggae (natural folds in the vagina). The pH of the vagina also rises, resulting in a decrease in the vagina and bladder’s natural defence against infection.

The good news is that vaginal atrophy can be treated. Lubricant (water or silicone based) can be very helpful with intercourse to decrease symptoms of dryness in the moment. Vaginal moisturizers used 2-3 times weekly act to keep the vagina moisturized at baseline and helps with day to day dryness. Lubricants and moisturizers are great to help with the symptoms caused by atrophy.

Treatments such as usage of vaginal Estrogen as well as vaginal energy treatments (laser, radiofrequency) has been shown to change the architecture of the vagina closer to a pre-menopausal state. The vaginal mucosa thickens and becomes more elastic and lubricated. The pH of the vagina drops and the body’s natural defence against infection is restored. Both of these treatments (vaginal Estrogen and laser/radiofrequency) have been shown to be safe and effective.

It is important that women are vocal about their intimate symptoms and seek help when they have concerns. As health practitioners, we are seeing more and more women taking charge of their feminine and sexual health, and this is a wonderful thing. Let’s keep the conversation going!

Disclaimer:  The content offered in this post is the content of Dr. Jennifer Adams, with edits for clarity and brevity. 
The information given is not exhaustive and are potential ideas to begin to address sexual topics and concerns. The answers are not meant to replace medical advice, and are included for educational and entertainment purposes only. 
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