Denise Hooks-Anderson, M.D.

The next several paragraphs are not just for women but for all of those husbands, partners, friends and family who have been yelled at, cursed at, and called everything but a child of God for no apparent reason at all, simply because their loved one was going through menopause.

“The change”, as it is affectionately referred in polite circles, occurs on average around age 51. However, some women may start having symptoms in their mid-40s.

We recognize these women quite easily because they are the ones fanning, stripping off layers of clothing, and sweating profusely. They are also always asking if anyone else is hot. If left up to them, the temperature in the office and at home would be sixty degrees all year round.  Sound familiar?

In addition, these women are not sleeping well, irritable, and may be experiencing painful intercourse. As you could imagine each of those symptoms could potentially cause marital problems if the partner did not understand the huge hormonal shift occurring in their significant other. Some of my male patients have actually thought their marriage was over because their wives seemed distant and angry.

Therefore, in honor of Women’s History Month and as a gift to my Y-chromosome friends, let’s talk about these complicated beings called women and this out of body experience upon which they have embarked. Knowledge is indeed power and if we can understand the science behind the madness, family and workplace conflict could potentially be avoided.

In this country, average age of girls starting their period is 12, but it can begin as early as 8 and as late as 15. Menstruation, monthly bleeding occurring every 21-35 days, usually begins two-three years after breast growth begins. The hormone estrogen rises at the beginning of a woman’s menstrual cycle and causes the lining of the uterus to get thicker. When women or young girls menstruate, they are actually shedding the lining of their uterus. Because of the hormonal shift of women during this time, women may experience headaches, feelings of sadness, crankiness, and pain. This phase of life for women lasts for about 35-45 years and varies in intensity as the woman ages.

The next phase is called perimenopause and it is during this time that women may begin to miss periods and experience the infamous hot flashes, an overwhelming sensation of heat that emanates from the inside out. Hot flashes have been described by some women as an internal fire raging out of control. If you are in proximity of these women, you can actually feel the heat from their bodies.

Menopause begins when periods have ceased for one year. Getting to this point can be frustrating for many women because it is not uncommon to miss a period several months in a row but then have the period resume as if it had never stopped. I have a few 54-year-olds that are still having periods! It is important to point out that during this perimenopausal time that ovulation is occurring, although irregularly. Therefore, women can get pregnant in this phase of the lifecycle. I’m sure each of us knows someone who is now on Social Security but who has a child still in high school. They had to learn anatomy the hard way!

So what can women do to help with the myriad of symptoms associated with menopause?

Try dressing in layers and not wearing overly restrictive clothing. Many women also choose to sleep in cool rooms at night and use fans directed toward their side of the bed. I have also heard of women using frozen vegetables as ice packs during those warm moments. Avoiding warm liquids before bed help as well.

Try over the counter lubricants such as Astroglide for vaginal dryness. In addition, drinking plenty of water and avoiding douching will help alleviate dryness. If you want to improve your sex drive, then consider a regular exercise routine. Exercise releases endorphins in the brain and causes people to feel better in general which results in increase interest.

Try taking an over the counter supplement such as Black Cohosh or prescription medication such as Paxil or Clonidine to help with the hot flashes and mood issues. These meds are not addictive and can be stopped once the symptoms subside. If symptoms are severe and there are no contraindications, hormone replacement therapy (HRT) can be prescribed.

Hormone replacement therapy is not first line treatment anymore because of the increased cancer risks. Yet, for some women the benefit outweighs the risks and this decision to start HRT must be thoroughly discussed with their primary care provider or gynecologist.

Menopause is a natural progression of a woman’s life cycle yet it can cause some disruptive changes for not only women but also the people around them. Nevertheless, for the majority of women, menopause can be managed with lifestyle modifications, medications, and cognitive behavior therapy.

Yours in Service,

Denise Hooks-Anderson, M.D.

Assistant Professor

SLUCare Family Medicine



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