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HILDA YVONNE HUTCHERSON, M.D.
Board Certified, OB/GYN
Columbia Presbyterian Medical Center
Author and Advisory Board Member, Vagisil Women's Health Center®
A New York-based obstetrician and gynecologist with Columbia Presbyterian Medical Center, and author of the best-selling book, "What Your Mother Never Told You About S-E-X" (G.P. Putnam's Sons, 2002), is working with the Vagisil Women's Health Center® (VWHC) as a member of the medical advisory board. She will author six personal health columns to be posted throughout 2003 focusing on women's lack of knowledge about common feminine health concerns.
Hormone replacement therapy is not the only way to control menopausal symptoms
Menopause is the period in a woman's life when she stops having periods and can no longer get pregnant. For many women, this transition occurs with few, if any, symptoms. For others, however, the entry into menopause is heralded by hot flashes, night sweats, mood changes, vaginal dryness, decreased libido, and weight gain. For decades, physicians have prescribed estrogen replacement therapy to relieve annoying menopausal symptoms and to protect women from heart disease and bone loss. Recently, the Women's Health Initiative study found that a combination of estrogen and progestin hormones increased the risk of heart attacks and strokes in the first two years of hormone use, increased the risk of an abnormal mammogram, and slightly increased the risk of breast cancer. On the positive side, the hormones also decreased the risks of colon cancer and osteoporosis.
Since the release of the Women's Health Initiative study, many women and their doctors have sought alternatives to estrogen replacement therapy to deal with the symptoms of menopause. Below, I have listed tips that I not only give to my patients, but have also found to be useful in controlling my own symptoms.
Note: All of the symptoms that we typically attribute to menopause may also be caused by other medical problems like thyroid disease, diabetes, depression, and adrenal disease. Before self-medicating, make sure that you see your doctor for an exam and evaluation.
Hot flashes and night sweats. Of all the symptoms of menopause, hot flashes are perhaps the most troubling. Since every woman's experience is different, I recommend that you keep a "symptoms" diary to determine what triggers your hot flashes. Typical triggers include caffeine, alcohol, spicy food, heavy meals, stress and smoking. Each should be avoided. Layer your clothing to make it easier to shed a piece or two as needed for cooling. I have found some relief with acupuncture, meditation and yoga.
Mood changes. Many women, but not all, complain of depression, moodiness and anxiety during the transition to menopause. Antidepressants may alleviate the mood changes as well as hot flashes and night sweats. Talk to your doctor about your particular concerns and do not feel too embarrassed to seek help from a professional counselor or therapist.
Vaginal dryness. Decreasing estrogen levels can cause vaginal dryness and painful sex. And if sex is painful, it is unlikely that you will desire it. To increase your pleasure, and get your sex life back on track, use a water-based lubricant during sex. Vagisil® Intimate Lubricant is a greaseless, long-lasting vaginal lubricant that instantly relieves vaginal dryness, making sex more pleasurable. Apply liberally before sex and reapply as needed during sex. Vagisil Intimate Lubricant can also be applied daily to your vulva and vagina as needed to keep your delicate tissues moist.
Weight gain. As you age, your metabolism slows and it becomes easier to gain weight. And because your estrogen level is low, any additional weight gain settles in your mid-section, increasing your waist line.
To maintain a healthy weight, it is important to exercise regularly and keep an eye on the calories that you consume. A diet that includes whole grains and fresh fruit and vegetables will not only help to keep the excess pounds away, but will make you feel healthier and more energetic.
Osteoporosis. Bone loss is common during menopause. To keep your bones strong and healthy, make sure that you exercise regularly. Weight bearing exercises like walking and lifting free weights at least three times a week is recommended for optimum bone health. Speak to your doctor about calcium and vitamin D supplements, as well as medications such as biphosphonates, that you might take to further protect your bones.
Heart disease. Heart disease is the leading cause of death for women. To keep your heart healthy, eat balanced meals, watch your weight and cholesterol, and exercise regularly. I recommend that you get a complete physical exam yearly, and make sure that you talk to your doctor about the signs and symptoms of heart disease.
Alternative Therapies/Natural Remedies. Natural herbs for the treatment of the symptoms of menopause have dramatically increased in popularity. Soy products and black cohosh, an herb derived from the root of a plant used by Native American Indians, have been shown in studies to be effective in some women. Dong quai, chasteberry, red clover, and St John's Wort have had mixed results in controlled scientific studies. It is important to keep in mind, that herbs may be natural but are also strong medicine. Herbs should not be used unless prescribed by a physician or professional herbalist.
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