Menopause can be a confusing time, with many changes going through your body and mind. You are bound to have many questions for your doctor—questions that come up as you go through the process.
Here are some questions you might have for your doctor, with Probable Answers to help you get an idea of what your doctor might say:
1. What do I do about all of these hot flashes?
Probable Answer: Hot flashes are common throughout the menopausal period. You can take hormone replacement therapy if the hot flashes are severe. There are also herbal remedies such as black cohosh that may reduce the incidence of hot flashes. If you do not want to take any oral treatment for hot flashes, you simply need to practice lifestyle changes, such as having a portable fan for, wearing layers of cool breathable fabric clothing, such as cotton that can be peeled off in the event of a hot flash, and using light bed linens for nighttime hot flashes.
2. Should I take hormone replacement therapy?
Probable Answer: Hormone replacement therapy means taking estrogen and possibly progesterone to control hot flashes. They replace the hormones the ovaries are no longer making. While these are effective medications with hot flashes, they do have some risks. There is evidence that taking hormone replacement therapy can increase the risk of heart disease in some women. It can also not be taken in women who have had blood clots, uterine cancer, breast cancer, or heart disease.
3. What do I do about night sweats?
Probable Answer: Night sweats can interfere with sleep as they cause you to awaken with drenched bed clothing and sheets. You need to wear light cotton bed clothing and use light cotton sheets with a light blanket over the top. If you take hormone replacement therapy, the hot flashes that result in night sweats will diminish.
4. What can I do about the mood swings I am experiencing?
Probable Answer: Mood swings are common during and prior to menopause. Some women can get by with things like stress reduction or talking to a therapist. Others need medication. Selective serotonin reuptake inhibitors (SSRIs) such as Prozac, Lexapro, Paxil, and Celexa can be taken if you have many depressive symptoms, while anti-anxiety medications, such as Xanax, Ativan, Valium, and Klonopin can be sued if most of your systems are related to anxiety. Sometimes hormone replacement therapy can be used to control the mood swings.
5. I have terrible vaginal dryness. What can I do?
Probable Answer: Vaginal dryness can be combatted by using a vaginal moisturizer several times per week or by using vaginal lubricants. There are vaginal estrogen products, such as vaginal cream, vaginal tablets, and a vaginal ring that can thicken the vaginal mucosa so that vaginal dryness can be controlled. The vaginal estrogen products do not help hot flashes as very little of the estrogen from these products gets into the bloodstream.
6. I have pain on intercourse. What can I use for this?
Probable Answer: Pain on intercourse comes from vaginal dryness. Prior to having sex, you can use a vaginal lubricant such as KY jelly or Astroglide, among other similar water-based products. Do not use a petroleum-based lubricant like KY jelly, especially if you use condoms because they can cause condoms made of latex to break. You can also use vaginal moisturizers that do not need to be used just before sex but are used regularly throughout the week.
7. I am suffering from brain fog in menopause. Am I going crazy?
Probable Answer: It is normal to feel some cognitive deficits during menopause and to feel as though you might be going through Alzheimer’s disease. There is no treatment for this problem but you are not going crazy. Try to keep lists of things you need to remember and try to be patient with yourself if you forget things or find your mind going blank.
8. I have urinary incontinence. What can I do?
Probable Answer: Urinary incontinence is a normal part of menopause and is due to sagging of the bladder and a decrease in the thickness and elasticity of the urethra. You can help this somewhat by doing Kegel exercises. These involve voluntarily contracting the muscles of the pelvic floor as if you are trying to hold back your urinary stream. This can strengthen the pelvic floor so that urinary incontinence isn’t much of a problem.
9. What do I do about increased bladder infections in menopause?
Probable Answer: Bladder infections tend to increase in menopause. You can prevent these by making sure you wipe from front to back after voiding and by using some form of vaginal estrogen cream, which can build up the urethral tissues. Some women with recurrent bladder infections during menopause take preventative antibiotics all the time in order to keep the bladder infections from coming back.
10. I cannot sleep now that I am in menopause. What can I do?
Probable Answer: Insomnia is a common finding in menopause. You can combat this without medications by practicing good sleeping habits. This means going to bed at the same time every night and waking up the same time every morning. Keep your bedroom cool and quiet or use a noise machine to block out any extraneous noises. Do not eat a heavy meal before going to bed, drink caffeinated beverages, or drink alcohol before bedtime. Exercise sometime during the day but not right before going to bed at night. If good sleep habits do not help, you can try a medication called Ambien or take non-addicting trazodone or Vistaril prior to going to bed.
11. What is perimenopause?
Probable Answer: Perimenopause is the period of time before actual menopause. It can last several years before menopause actually takes place. During this time, you will have irregular periods because the ovaries sometimes will ovulate and sometimes will not. You may also have menopausal symptoms, such as hot flashes, night sweats, mood swings, and decreased libido.
12. How do I know that I have gone through menopause?
Probable Answer: Menopause is defined as not having a menstrual period for twelve consecutive months. During this time, you may have the typical menopausal symptoms of hot flashes, night sweats, mood swings, insomnia, and decreased libido.
13. Will I have decreased libido during menopause?
Probable Answer: Not every woman will have a decreased libido during menopause but many do. The only real treatment for this is testosterone therapy, which can be given in small doses to women in order to stimulate their libido.
14. Am I still fertile if I have gone through menopause?
Probable Answer: After you have officially gone through menopause, the ovaries do not ovulate and you will not be fertile. During the perimenopausal years, however, the ovaries will sometimes ovulate and you may still be fertile. For this reason, if you do not want to get pregnant, you should use some form of birth control until the periods have stopped for at least twelve months.
15. What can I do about weight gain during menopause?
Probable Answer: Some women will gain weight during menopause. The best thing you can do is to eat a well-balanced healthy diet containing plenty of fruits and vegetables, as well as whole grains, legumes, and lean meats or fish. Try to stay under 2000 calories per day. In order to increase your metabolic rate, you should also be exercising. Try to exercise about 30 minutes per day on most of the days of the week. Try doing aerobic exercises, which involve brisk walking, jogging, cycling, swimming, or any other activity you enjoy doing that gets your heart rate and respiratory rate up. Weight lifting or using weight machines can also increase your muscle tone and will increase your metabolic rate.
16. How do I get social support around my menopausal symptoms?
Probable Answer: Menopause can be a lonely time, especially if you are having a lot of symptoms. Some HMOs, clinics, or hospitals will have menopause support groups that will help you meet other women who are going through the same symptoms. You can get advice from other women who are trying to get through menopause themselves.
17. I think menopause is making me depressed. What can I do?
Probable Answer: Sometimes just talking to someone can help decrease depressive symptoms you may be experiencing because of menopause. If this does not help, antidepressants may be in order, such as Prozac, Celexa, Lexapro, or Paxil.
18. I have had anxiety and panic attacks since entering menopause. What should I do?
Probable Answer: Panic attacks and anxiety are common problems in perimenopause and menopause. You can always talk to a therapist about these symptoms or you can take selective serotonin reuptake inhibitors (SSRIs) to combat the panic attacks and anxiety. Sometimes a short course of a benzodiazepine can help, such as Ativan, Valium, Xanax, or Klonopin. Because they can be addictive, they are often used only when the symptoms are severe and for a short period of time.
19. Can I take herbal remedies for hot flashes?
Probable Answer: Herbal remedies like black cohosh or soy supplements can decrease the hot flashes you are experiencing. These are not addictive and can be purchased at the local pharmacy or health food store.
20. Can I take herbal supplements for insomnia during menopause?
Probable Answer: There are many herbal remedies you can take for insomnia during menopause. Valerian root can help these symptoms, as can melatonin supplements. Some women will find effectiveness by taking chamomile tea prior to bedtime, which can be relaxing. In some cases, kava can be used to relax you enough so you can get to sleep.
21. How long does menopause last?
Probable Answer: Perimenopause, the period of time before menopause, can last for several months or up to 5 years prior to actual menopause. After you have stopped having periods for 12 consecutive months, you will be postmenopausal and many of your menopausal symptoms will go away.
22. What does premature menopause mean?
Probable Answer: Premature menopause occurs in some women. It means you are going through menopause prior than 40 years of age. If you go through premature menopause, you are at a higher risk of having osteoporosis because the ovaries have stopped functioning prematurely.
23. How can I avoid getting osteoporosis because of menopause?
Probable Answer: After menopause, there is an increased risk of suffering from bone loss to the point where you get osteoporosis. You can combat this by taking in extra calcium and vitamin D in your diet or by taking these in supplement form. If you already have osteoporosis, there is medication you can take, such as the bisphosphonate medications, which prevent further loss of bone. You should also be doing weight-bearing exercises on most days of the week to strengthen the bone.
24. How much calcium should I be taking after menopause?
Probable Answer: The recommended daily allowance for calcium is 1,500 milligrams of calcium per day. Because this is difficult to get in the diet, you should try taking supplements of calcium along with 1000-2000 International Units (IU) per day in order to help keep the bones well mineralized.
25. What is the role of exercise in menopause?
Probable Answer: Exercise can benefit menopause in many ways. It can help you sleep better and can prevent the weight gain associated with menopause. If you practice weight-bearing exercises, you can help prevent osteoporosis. You should try to exercise on most days of the week for thirty minutes at a time.
26. When does menopause usually occur?
Probable Answer: The average age of menopause is 51 years of age but women can go through menopause as early as age 40 or as late as age 59 and it is still considered normal menopause. Menopause prior to the age of 40 is considered premature menopause.
27. What is the major risk of taking hormone replacement therapy?
Probable Answer: Some women can take hormone replacement therapy and can safely take it. The Woman’s Health Initiative, however, was a study in the 1990s that indicated an increased risk of heart disease among woman taking hormone replacement therapy. If you have a family history of heart disease or a personal history of heart disease, you shouldn’t take hormone replacement therapy. You should also not take this form of therapy if you have a history of blood clots, stroke, or breast/uterine cancer.
28. I had my first period late in life. Does this mean that I will have menopause later in life?
Probable Answer: There is no relationship between the onset of menses in your teen years and the onset of menopause. You can have menopause at any time between aged 40 and age 59, regardless of when you began to have your periods.
29. How long can I take estrogen replacement therapy?
Probable Answer: You should take estrogen replacement therapy as long as you continue to have symptoms of menopause. Because there are risks to taking this form of therapy, you should not take it indefinitely but should try it for a few months and then try going off it.
30. Should I just take estrogen replacement or should I take progesterone along with it when I take hormone replacement therapy?
Probable Answer: If you do not have a uterus, there is no reason to take progesterone and you can just take estrogen for menopausal symptoms. Because unopposed estrogen can cause endometrial cancer in those who have their uterus, progesterone should be taken along with the estrogen to thin the uterine lining and prevent cancer of the uterus from occurring.
I have created a printable PDF version of this checklist that can be used as a worksheet.
You can download it here... Menopause Doctor Checklist
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