Women's health • November 11, 2016

Everything has a transition – including menopause

Inger Øverlie, gynecologist Dr. Med.

Gynecologist, PhD

“You saved my life,” a patient once told me. The women who come to me experience typical symptoms of menopause. It usually starts with irregular periods and hot flashes, but they can also experience depression, mood swings and palpitations. We need to take these symptoms more seriously.

A full 25% of menopausal women have such severe symptoms that they affect their quality of life. The women I treat tell of waves of heat that hit them while they are giving a presentation at work, for example, and they find it absolutely terrible. They get sweaty and red in the face, lose concentration, and feel the need to undress and open the windows. Such experiences clearly affect their self-esteem.

Hot flashes can also make you wake up completely soaked at night, and it can be so bad that you have to get up and change your bed sheets. Some people also feel depressed and cry over the smallest things without fully understanding why. Some people complain of flu-like symptoms, lack energy and do not feel well. Hormone therapy quickly removes these symptoms.

Most positive aspects of hormone therapy

Many of the women who come to me want treatment and know that it is possible to get hormones. At the same time, many of them have heard that it can be dangerous, and that it can increase the risk of blood clots, breast cancer and cardiovascular disease. One woman told me that she doesn't tell her friends that she is getting treatment, because she is afraid they will say, "What, are you crazy, you could die from it!"

But countless studies show that the risk of such complications is very small if you start hormone therapy when you reach menopause, that is, when you are around 50. In fact, there are more positive aspects of hormone therapy than negative ones.

Simple treatment with plaster

The hormones can have a protective effect on the heart and blood vessels. In addition, women have an increased risk of osteoporosis after menopause, but estrogen reduces the risk and can have a long-term, positive effect on bone mass if you receive long-term treatment (more than five years). It is also not the case that short-term treatment (less than five years) increases the risk of breast cancer, as many believe - in fact, the risk of breast cancer decreases after stopping treatment.

I recommend that most of my patients who have major problems start with hormone therapy, preferably transdermal therapy. This means that they are given a patch that is attached to the skin so that the hormones enter the blood directly, without going through the liver and the gastrointestinal system. This way, other hormones in the body, such as testosterone, are not affected, and it reduces the risk of blood clots.

The symptoms disappear within days.

If you suffer from hot flashes, hormone replacement therapy is definitely the most effective. Once you start treatment, the hot flashes will disappear within days. It also helps with dry mucous membranes and reduces the risk of urinary tract infections, which can also occur during menopause.

Some women get depressed and I definitely recommend trying hormone supplements before other treatments. Many feel that they "become themselves again" shortly after starting supplements. Simply put, if your mood doesn't improve with this, you should consider whether there could be other causes for the depression than menopause.

In addition to hormone therapy, it will also help if you make simple changes to your daily life and lifestyle. Eating healthily and regularly, quitting smoking, and not least staying physically fit can reduce, for example, hot flashes.

For many women, menopause is not a problem, and many get through it without any major problems. In fact, most say afterwards that it wasn't as bad as they feared. Because menopause is just that – a transition. You "go back" to who you were. But like so many other transitions in life, you may need a little help to get through it.

Fact box: Women's menopause

Menopause often begins with irregular periods and subjective complaints such as hot flashes and depression. It can occur long before menopause.
Towards menopause, your ovaries will produce less and less of the hormones estrogen and progesterone, eventually so little that menstruation stops. When you have not had a period for 12 months, you have entered menopause.
Menopause usually begins after you turn 45, and the average age for menopause is 52 years.
Around 1% of Norwegian women enter menopause before they turn 40, so-called early menopause.

Everything has a transition – including menopause

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