Hot flashes and mood swings are common symptoms that come to mind when we think of menopause. Menopause is defined as the end of a woman’s menstrual cycle and is recognized to have occurred after one year of no menses. Typically, women enter menopause after the age of 50, but it is known to start as early as 30 for some.
While in the United States, an estimated 6,000 women reach menopause every day, and over 2 million every year, menopause is still one of those topics that many women are too embarrassed to talk about, including with their doctor. To answer your most pressing menopause concerns, we reached out to some experts to give us the questions — and answers — about your most pressing questions when it comes to menopause.
Why am I so sad? Irritable? Moody? Anxious? Angry?
Mood issues can be exacerbated or appear for the first time during the menopause transition. “The varying and decreasing levels of estrogen affect brain chemistry at the same time the brain is becoming less sensitive to estrogen,” says Dr.Lisa Savage, M.D. of Gennev, a menopause tele-health platform. “Also, social, professional and interpersonal roles may be at a crossroads during this stage of life. This confluence can lead to a variety of mood issues, which can be addressed in the context of what is contributing to them.”
Engaging in a meditation and/or mindfulness practice, staying connected with your friends and family, and having a creative and physical outlet are all positive solutions to helping you cope with your emotional changes.
Is there a test to take to show I’m going through menopause?
The short answer: Yes. “When a woman suspects she’s in perimenopause or menopause, it’s an excellent time to have a complete physical examination by a healthcare professional,” says Pat” Alagia, III, MD, MS, MBA, Senior Medical Director for Quest Diagnostics Advanced Diagnostics and Women’s Health. “In addition to reviewing a woman’s medical history, her menstrual history and other symptoms, a doctor may perform routine blood work such as a CBC to rule out another medical condition. While perimenopause or menopause cannot be diagnosed with tests alone, a doctor may order follicle stimulating hormone (FSH), luteal hormone or estrogen tests from a lab like Quest Diagnostics to provide additional insight that can help make a diagnosis.”
Sex used to be enjoyable but now it’s painful and I just want to get through it. What’s wrong with me?
“With menopause comes decline in ovarian function, including estrogen and testosterone production,” says Dr. Cheryl Iglesia, a urogynecology specialist in the Washington, DC, area. Furthermore, vaginal tissues become thin and the microbiome changes as menopause advances resulting in thinner tissues.”
Solution? Your doctor might prescribe low-dose estrogen to ease vaginal dryness. You might also try a lubricant during sex or ask your partner for more foreplay, including trying a vibrator to stimulate blood flow to the pelvic region.
Do I still need to practice safe sex during menopause?
While you might not be able to get pregnant as a menopausal woman, if you’re not in a monogamous relationship, it’s still a good idea to practice safe sex if you’re sexually active.
“According to the CDC, sexually transmitted diseases are on the rise in people over 50 years old, and seniors have the same risk of contracting HIV as young people,” says Dr. Alagia. “In addition to contraception, it is also important to speak with your physician about whether sexually transmitted disease testing is appropriate.”
Why have I gained so much weight?
“Midsection weight gain is common and is partly an adaptation to the loss of estrogen from the ovaries, since estrogen can be “made” (converted from other hormones) in fat tissue,” says Dr. Savage. “Sleep disturbance can also contribute to metabolic changes and weight gain. An examination of your nutrition habits is a must since what worked before may no longer work, and a commitment to physical activity/exercise is more important now than ever.”
I am passing gas and sometimes leak urine during sex. It’s embarrassing. What’s wrong with me?
“Incontinence and prolapse result from decreased muscle strength within the pelvic floor and weakened ligaments and connective tissue which occur with aging,” says Dr. Iglesia.
There are few things to help your incontinence, including cutting back on caffeine and alcohol consumption, using Kegel or pelvic floor exercise to strengthen your pelvic muscles, and losing weight if necessary to reduce the pressure on your bladder.
In order to reduce bloating and gas during menopause, which might be the result of fluctuating hormones, eat smaller meals, avoid coffee and alcohol, reduce sugar and high carbs, drink more water, and walk regularly.