Treating the Symptoms of Early Menopause
Menopause and its accompanying symptoms and changes can be distressing and confusing at the best of times. It is a stage in which many women report feeling ‘betrayed’ by their bodies; a time of significant upheaval when feelings of worry and concern are understandable but not always warranted. After all, menopause is an inevitable and natural consequence of growing older, and many women find effective ways to adapt and cope with new health challenges along with physical and emotional change.
An early menopause, on the other hand, is particularly hard to accept, and in some cases the wide-ranging effects and manifestations can be an overwhelming shock to the system. It’s important to remember, however, that whilst menopause is a universal reality, treatment does exist to address the underlying hormonal causes responsible in turn for bringing about such wide and varied symptoms.
Fertility and Pregnancy
Women with unrealized aspirations of motherhood are often hit hardest, although many subgroups with a diagnosis of an early menopause or premature ovarian failure (POF) do still have some hope of conception. It’s nonetheless important to remember that early menopause in common usage is often an umbrella term for many related but widely varying sets of individual circumstances. Certain surgical procedures or medical treatments can induce an immediate menopause. In a large portion of cases, however, the early and total cessation of periods occurs naturally (i.e. with no such obvious external cause). What unifies all menopausal women, early or not, is the absence of menses (your periods). Try our causes and ‘what is early menopause?’ pages if you’d like to learn more.
Conversely, despite having post-menopausal hormone levels, women with POF may still ovulate. Similarly, in perimenopause symptoms such as hot flashes, night sweats and weight gain may be present, and whilst your hormone levels are likely fluctuating, you are still ovulating. Some women in this position hope for spontaneous pregnancy whilst others actively seek fertility treatment.
To speak with other members of EarlyMenopause.com in a situation similar to yours try the pregnancy and infertility treatments section of our boards. Remember to seek the advice and support of your doctor.
Hormone Replacement Therapy (HRT)
In the early 2000s large studies undertaken in the US and UK (by the Women’s Health Initiative and the NHS/Cancer Research UK respectively) showed an elevated risk of breast cancer, heart attack and stroke in women taking certain forms of HRT. The WHI study found that women using Prempro (combination estrogen/progestin) had a “scientifically significant” increase in risk of these three health events; whilst those taking estrogen alone appeared to assume no added risk of heart disease or breast cancer, though the risk of stroke was elevated.
It is important to note that although these risks were increased in those women taking HRT, the absolute risk of each remains low even in the presence of therapy. Study participants taking combination estrogen/progestin also had a decreased risk of developing colon cancer or of suffering a hip fracture.
The ‘Million Women Study’ conducted in the UK didn’t look at one specific form of HRT, rather the women were taking various kinds and dosages including estrogen only; combined estrogen and progestin; and tibilone. The finding in this instance was an elevated risk of breast cancer across all groups, with the most significant increase found in those taking combination estrogen and progestin.
Since both these studies followed older women (50-79 and 50-64 respectively) experiencing menopause at a ‘normal’ age, it is difficult to analyze the real implications for younger women experiencing early menopause or POF. Many professionals maintain that the study findings simply cannot be made directly applicable to younger women, who by all accounts are in a very different situation. Unlike the women in the study, those of us experiencing early menopause and using HRT are extending our exposure to estrogen during a period in which our ovaries would otherwise have secreted it. Others, however, believe that the risks of combination estrogen/progestin are cumulative and apply to women of all ages.
More recent research has suggested that timing of HRT is perhaps the most significant factor in disease risk, according to an AAD study linking hormone therapy taken soon after menopause to a protective effect against dementia. Another separate, recent trial found that HRT taken by women in their 50s may in fact lower the risk of heart disease. No such protective effect was found in older women, and those aged 60 or above may in fact compound their risk by commencing hormone therapy. In addition, the trial demonstrating a potential cardio-protective effect showed a simultaneous increase in breast cancer risk, similar in magnitude to that found by the WHI study.
At this stage the best advice to take on board is a reminder that plenty of options and avenues of treatment remain open and the one that is right for you will likely depend on your specific set of circumstances. Seek your doctor’s advice and consider reading our thorough discussion of the relevant studies and what they mean for you.
Another keenly discussed aspect of the HRT debate is the merits and drawbacks of an array of confusing and seemingly endless products. Maybe you’ve heard of phytoestrogens, natural vs. synthetic or deliberated over gels, patches and pills. If this sounds familiar, consult your doctor and try our ‘Making sense of HRT’ guide for a digestible comparison!
Finally, for those confused by the pros and cons of birth control pills and HRT respectively in hormone replacement, check out our guide, ‘Birth control pills vs HRT’, for our factsheet explaining the differences and advantages/disadvantages of each.
As we stress often at EarlyMenopause.com, there is no ‘one-size-fits-all answer’ to the symptoms and effects associated with menopause. Particularly since the WHI/NHS studies, doctors have increasingly reserved HRT (especially combination estrogen/progestin) for short, low-dose blasts of treatment when symptoms are severe. This is intended to minimize the risk of adverse effects noted in the large studies discussed earlier.
Those of us going through early menopause or POF often find ourselves in dramatically different circumstances, however, and each decision regarding long-term health and treatment needs to be taken seriously and on its individual merits. What makes perfect sense for one woman may simply not be applicable to another. Surgical menopause at an early age, for example, is obviously drastically different to typical age-related cessation of periods around the age of 50. As always we recommend consulting your doctor, presenting your concerns and working together to find what suits your needs. There is a literally endless set of variations in a course of treatment, with some women opting for a specific type of hormone therapy in isolation; others combining HRT with phytoestrogens, vitamins or natural alternatives; and those again who choose to cycle different approaches.
A growing proportion of women (particularly since concerns over the safety of HRT) opt to tackle the symptoms and effects of menopause through a combination of nutritional supplements and holistic remedies along with changes in lifestyle and eating habits. Whilst this is a valid approach in many circumstances, you should still see your doctor regularly for check-ups and advice. Although menopause itself is unavoidable at some stage, many of its undesirable symptoms are highly treatable with less drastic intervention. Hot flashes (discussed at greater length in our symptoms guide), though a near universal trademark of menopause, can be mitigated in many cases with phytoestrogens, supplements and minor lifestyle changes. Likewise all manner of physical and emotional symptoms can be eliminated, or at least reduced, with alternative treatment and changed habits.
It is important, however, to remember that you should consult your doctor before altering a course of treatment or commencing a new regimen.
Menopause is often characterized by its immediate and obvious physical symptoms such as hot flashes, night sweats and dryness. However another area of concern is long term risks associated with the hormonal changes our bodies undergo. It is important to plan ahead for the best chance of good heart and bone health in later life. We believe in taking steps to tackle symptoms, but we also recommend you consider your long-term health.
Long-term concerns help-sheets:
- Fighting osteoporosis
- Calcium: what you need to know
- Heart disease and early menopause
- Weight management
At EarlyMenopause.com we make it our goal to provide an unbalanced and impartial presentation of facts to help you, along with your doctor, make informed decisions about your future. We hope to help in the process of analyzing pros and cons en route to finding a regimen or course of treatment that suits you. Consider joining our community to discuss your thoughts, concerns or experiences with other women in a similar situation to your own.
If you’re starting out on a new regimen or treatment plan, also consider keeping a diary on EarlyMenopause.com to share your feelings, keep track of progress, and hopefully stay motivated!