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Managing menopause at home

Perimenopause - self-care; Hormone replacement therapy - self-care; HRT- self-care

Menopause is most often a natural event that normally occurs between the ages of 45 and 55. After menopause, a woman can no longer become pregnant.

What to Expect at Home

For most women, menstrual periods will slowly stop over time.

  • During this time, your periods may become either more closely or more widely spaced. This pattern may last for 1 to 3 years.
  • Menopause is complete when you have not had a period for 1 year. Before that time, women are considered postmenopausal.

Your menstrual flow may come to a sudden halt after surgeries to remove your ovaries, chemotherapy, or certain hormone treatments for breast cancer.

Symptoms of menopause vary widely. Some women have no symptom, while others have symptoms that are moderate to severe. Also, some women may have symptoms for 1 to 2 years, and others may have ongoing symptoms.

Common symptoms include:

  • Hot flashes
  • Mood disturbances
  • Sexual problems

Taking Hormones

Talk to your provider if your menopause symptoms are very bad. You and your provider can weigh the risk and benefits of hormone replacement therapy (HRT) to see if this option would be right for you.

If your health care provider has prescribed HRT for menopause symptoms, take these medicines as directed. Ask your provider what you should do if you miss a dose.

When taking hormones:

  • Follow up carefully with your provider.
  • Ask about when you need mammograms or a test to check your bone density.
  • DO NOT smoke. Smoking will increase the chance of blood clots in your legs or your lungs.
  • Report any new vaginal bleeding right away. Also report menstrual bleeding that comes more often or is more severe.

Managing hot Flashes

The following non-hormonal treatments can help you manage hot flashes:

  • Dress lightly and in layers. Try to keep your environment cool.
  • Practice slow, deep breathing whenever a hot flash starts to come on. Try taking six breaths per minute.
  • Try relaxation techniques such as yoga, tai chi, or meditation.

Watching what you eat or drink can improve your symptoms and help you sleep:

  • Eat at regular times each day. Eat a healthy diet that is low in fat and includes lots of fruits and vegetables.
  • Milk and other dairy products contain tryptophan, which may help induce sleep.
  • If you can, avoid coffee, colas with caffeine, and energy drinks completely. If you cannot avoid them, try not to have any after the early part of the afternoon.
  • Alcohol may make your symptoms worse and often leads to a more disrupted sleep.

Nicotine stimulates the body and will make it harder to fall asleep. This includes both cigarettes and smokeless tobacco. So if you smoke, consider quitting.

A class of antidepressant medicines called SSRIs has also been shown to help with hot flashes.

Intimacy

Vaginal dryness may be relieved by using a water-soluble vaginal lubricant during intercourse. DO NOT use petroleum jelly.

  • Over the counter vaginal moisturizers are also available and can help to improve vaginal dryness.
  • Ask your provider about vaginal estrogen creams.

Once you have not had a period for 1 year, you are no longer at risk of becoming pregnant. Before that, use birth control to prevent pregnancy. DO NOT use mineral oils or other oils if you use condoms, as these may damage latex condoms or diaphragms.

Kegel exercises can help with vaginal muscle tone and help you control urine leakage.

Continuing to have sexual intimacy is important to keep the normal sexual response.

What Else

Reach out to other people. Find someone you trust (such as a friend, family member, or neighbor) who will listen to you and offer support. Often, just talking to someone helps relieve some of the anxiety and stress of menopause.

Get plenty of exercise. It can help you feel healthier and will keep your bones strong.

You need enough calcium and vitamin D to prevent bone thinning (osteoporosis):

  • You need about 1,200 mg of calcium per day from food sources or supplements. Eat high calcium foods, such as cheese, leafy green vegetables, low-fat milk and other dairy, salmon, sardines, and tofu, or take a calcium supplement. You can make a list of calcium contained in your food to find out how much calcium you usually get from your diet. If you fall below 1,200 mg, add a supplement to make up the rest.
  • You need 800 to 1,000 IU of vitamin D a day. Diet and sunlight provide some. But most menopausal women need to take vitamin D supplements.
  • Calcium and vitamin D supplements can be taken as separate supplements or combined as one.
  • If you have a history of kidney stones, talk with your provider first.

After menopause, a woman's risk for heart disease and stroke goes up. Ask your provider about what you should do to control your blood pressure, cholesterol, and other risk factors for heart disease.

When to Call the Doctor

Call your health care provider if you find you are unable to manage your symptoms of menopause with home care only.

Also call if you have any unusual menstrual bleeding, or if you have any spotting or bleeding at all 1 year or more after your last period.

References

ACOG Practice Bulletin No. 141: management of menopausal symptoms. Obstet Gynecol. 2014;123(1):202-216. PMID: 24463691 www.ncbi.nlm.nih.gov/pubmed/24463691.

Lobo RA. Menopause and care of the mature woman: endocrinology, consequences of estrogen deficiency, effects of hormone therapy, and other treatment options. In: Lobo RA, Gershenson DM, Lentz GM, Valea FA, eds. Comprehensive Gynecology. 7th ed. Philadelphia, PA: Elsevier; 2017:chap 14.

Skaznik-Wikiel ME, Traub ML, Santoro N. Menopause. In: Jameson JL, De Groot LJ, de Kretser DM, et al, eds. Endocrinology: Adult and Pediatric. 7th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 135.

The NAMS 2017 Hormone Therapy Position Statement Advisory Panel. The 2017 hormone therapy position statement of the North American Menopause Society. Menopause. 2017;24(7):728-753. PMID: 28650869 www.ncbi.nlm.nih.gov/pubmed/28650869.

  • Menopause

    Menopause

    Animation

  •  

    Menopause - Animation

    You're a woman nearing middle age. It's that time in your life when your periods are starting to stop and your body is going through changes. You may be starting to have hot flashes that you've heard about before. Could menopause be around the corner? So, what is menopause? Menopause typically happens to women somewhere around the ages of 45 to 55. During menopause, your ovaries stop making eggs and produce less estrogen and progesterone, hormones that play a vital role in pregnancy and how your body uses calcium and maintains healthy cholesterol levels, among other things. Changes in these hormones cause menopause symptoms. You will often begin having fewer periods, and eventually they stop. Menopause is complete when you have not had a period for over a year. Women who are post-menopausal can no longer get pregnant without a donor egg. Symptoms can vary from woman to woman. And these symptoms may last 5 or more years. Also, some women have worse symptoms than others. The first thing you may notice is that your periods start to change. They might occur more often or less often. Some women get their period every 3 weeks during menopause. These changes may last several years before periods completely stop. Other common symptoms include your heart pounding or racing, hot flashes, night sweats, skin flushing, and problems sleeping. You may have a decreased interest in sex, develop forgetfulness, have headaches, and suffer from mood swings, and have vaginal dryness and painful sexual intercourse. Treatment for menopause depends on many things, including how bad your symptoms are, your overall health, and your preference. It may include lifestyle changes or hormone therapy. Hormone therapy may help if you have severe hot flashes, night sweats, mood problems, or vaginal dryness. Hormone therapy is treatment with estrogen and, sometimes, progesterone. Talk to your doctor about the benefits and risks of hormone therapy. Hormone therapy may increase your risk of developing breast cancer, heart attacks, strokes, and blood clots. Topical hormone therapy has some of the benefits and fewer of the risks. Your doctor can tell you about other options besides taking hormones, including antidepressants, a blood pressure medicine called clonidine, and Gabapentin, a seizure drug that can help reduce hot flashes. Lifestyle changes may help in reducing your menopause symptoms, though it's not been proven. You might consider trying to avoid caffeine, alcohol, and certain spicy foods. Or to try eating soy foods and other legumes, because they contain phytoestrogens. You'll want to remember to get plenty of calcium and vitamin D in your food or supplements, and plenty of exercise especially during this time. Consider Kegel exercises every day to strengthen the muscles of the vagina and pelvis. Practice slow, deep breathing if you feel a hot flash coming on. Yoga, tai chi, or meditation may also helpful. After menopause, you may be at risk for bone loss, higher cholesterol, and heart disease, so make sure you work with your doctor to manage or even prevent these problems.

  • Menopause

    Menopause

    Animation

  •  

    Menopause - Animation

    You're a woman nearing middle age. It's that time in your life when your periods are starting to stop and your body is going through changes. You may be starting to have hot flashes that you've heard about before. Could menopause be around the corner? So, what is menopause? Menopause typically happens to women somewhere around the ages of 45 to 55. During menopause, your ovaries stop making eggs and produce less estrogen and progesterone, hormones that play a vital role in pregnancy and how your body uses calcium and maintains healthy cholesterol levels, among other things. Changes in these hormones cause menopause symptoms. You will often begin having fewer periods, and eventually they stop. Menopause is complete when you have not had a period for over a year. Women who are post-menopausal can no longer get pregnant without a donor egg. Symptoms can vary from woman to woman. And these symptoms may last 5 or more years. Also, some women have worse symptoms than others. The first thing you may notice is that your periods start to change. They might occur more often or less often. Some women get their period every 3 weeks during menopause. These changes may last several years before periods completely stop. Other common symptoms include your heart pounding or racing, hot flashes, night sweats, skin flushing, and problems sleeping. You may have a decreased interest in sex, develop forgetfulness, have headaches, and suffer from mood swings, and have vaginal dryness and painful sexual intercourse. Treatment for menopause depends on many things, including how bad your symptoms are, your overall health, and your preference. It may include lifestyle changes or hormone therapy. Hormone therapy may help if you have severe hot flashes, night sweats, mood problems, or vaginal dryness. Hormone therapy is treatment with estrogen and, sometimes, progesterone. Talk to your doctor about the benefits and risks of hormone therapy. Hormone therapy may increase your risk of developing breast cancer, heart attacks, strokes, and blood clots. Topical hormone therapy has some of the benefits and fewer of the risks. Your doctor can tell you about other options besides taking hormones, including antidepressants, a blood pressure medicine called clonidine, and Gabapentin, a seizure drug that can help reduce hot flashes. Lifestyle changes may help in reducing your menopause symptoms, though it's not been proven. You might consider trying to avoid caffeine, alcohol, and certain spicy foods. Or to try eating soy foods and other legumes, because they contain phytoestrogens. You'll want to remember to get plenty of calcium and vitamin D in your food or supplements, and plenty of exercise especially during this time. Consider Kegel exercises every day to strengthen the muscles of the vagina and pelvis. Practice slow, deep breathing if you feel a hot flash coming on. Yoga, tai chi, or meditation may also helpful. After menopause, you may be at risk for bone loss, higher cholesterol, and heart disease, so make sure you work with your doctor to manage or even prevent these problems.

    Self Care

     

    Review Date: 3/28/2019

    Reviewed By: John D. Jacobson, MD, Professor of Obstetrics and Gynecology, Loma Linda University School of Medicine, Loma Linda Center for Fertility, Loma Linda, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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