Stephanie S. Faubion - Mayo Clinic The Menopause Solution: A doctors guide to relieving hot flashes, enjoying better sex, sleeping well, controlling your weight, and being happy!

Table of Contents

MAYO CLINIC

The
Menopause
Solution

PREFACE

The idea for this book has developed over the last few years and is based on my experiences working with women going through the menopausal transition. In my practice, Ive been struck by the lack of unbiased, reliable information available to women about menopause and its treatment. Women often have a talk in elementary school about their menstrual cycles and some limited sex education, and they may have a review about whats happening to their bodies when they have a baby, but theres no class to prepare for what happens to their bodies at midlife! Not infrequently, I see women who travel across the country to find an explanation for their bothersome and mysterious symptoms, only to find out that what they are experiencing is, indeed, a normal process.

Knowledge is powerful. Simply understanding whats happening, and that its a natural part of life, can be reassuring. Although theres still much to learn about menopause, including what exactly causes a hot flash, more is being understood every day. One thing is very clear, however there isnt a single solution for the menopausal symptoms that women experience. Today, more than ever, treatments for menopause are personalized and individualized, based on womens symptoms, medical and family history, and personal values and preferences.

With hormone therapy, for example, one size does not fit all. Some women will never need hormone therapy. They might not have bothersome hot flashes or night sweats or difficulty with sleeping, concentrating or mood issues some never have a single hot flash. But most women do have some symptoms that accompany this transition phase. And when the symptoms are troublesome enough to consider hormone therapy, the regimen, dose and route of administration may vary depending on her specific circumstances.

For some women, menopause may not occur at the normal time, but may come early whether its related to removal of the ovaries, treatment of cancer or due to early loss of ovarian function for unclear reasons. For these women, symptoms may be especially severe, and unless theres a clear reason to avoid it, treatment with hormone therapy is particularly important to prevent the long-term health consequences of losing estrogen too soon.

There also are women who may have very bothersome menopausal symptoms, but are either unable or choose not to take hormone therapy. For these women, there are effective nonhormonal options for managing symptoms that this book will share.

Its becoming clear that menopausal symptoms arent as limited in duration as was previously thought. In fact, its now understood that hot flashes and night sweats last, on average, for more than seven years. This is why its important to find a solution that works for you, as the symptoms may be around for a while! Even more bothersome than hot flashes and night sweats can be some of the other signs and symptoms related to menopause, including weight gain, fatigue, sleep disturbances, mood changes and sexual function changes. Understanding what is happening to your body and what you can do about it is key. I often tell my patients, The rules of your body have changed and no one told you. Thats why this book was written: To tell you whats happening to you and what you can do about it.

Stephanie S. Faubion, M.D. Medical editor

This book was inspired by the women with hormonal and sexual health concerns I see every day in the Womens Health Clinic at Mayo Clinic in Rochester, Minnesota and by my colleagues who have devoted their clinical and research careers to helping women through this life phase. I hope you find it informative and useful, regardless of whether you are perimenopausal and starting to notice some changes, are in menopause and wondering what to do about your symptoms, or are still premenopausal and just want to learn more about what may be in store.

Thank you to my womens health colleagues at Mayo Clinics campuses in Rochester, Minnesota and in Scottsdale, Arizona for sharing their time and expertise to make this book a comprehensive guide to menopause.

Getting a head start on menopause

Menopause is a time of significant change. Your body may be acting in ways you arent used to, and perhaps youre feeling moody, stressed and tired. Just like when you first got your period, the physical changes and feelings youre experiencing may be confusing, overwhelming and even embarrassing. But they dont have to be. By taking a proactive approach and working collaboratively with your health care provider, you can find ways to make this period of your life not only manageable but also actually enjoyable.

This chapter will help you get a handle on the basics of menopause and what you can do to get a head start in managing your symptoms and taking charge of your health. The following five steps will prepare you to face the menopausal transition with confidence.

LEARN

Knowledge is power. Learning more about menopause and your bodys changes during this transition will help you feel more in control.

The essentials

MENOPAUSE IS NATURAL. Menopause isnt a disease or condition to be cured its a natural and expected phase of every womans life. Some women will go through this period with relative ease, while others will seek treatment in order to manage their symptoms.

YOU ARE NOT ALONE. Menopause is an experience shared by women around the world. Over 2 million women a year enter menopause every year thats 6,000 women a day! As life expectancy has increased, women are now living a third of their lives beyond menopause. There will be over 20 million postmenopausal women in the U.S. by the year 2020. For many women, this can be a rich and fulfilling time of life.

YOUR BODY IS CHANGING. As you approach menopause, your body is nearing the end of your fertile years. Your ovaries contain fewer eggs, and the levels of the hormones they produce estrogen and progesterone start to fluctuate dramatically and eventually decline to very low levels.

SYMPTOMS ARE COMMON. Because estrogen influences many parts of your body, its declining levels can result in many bothersome symptoms. Symptoms you might experience include irregular periods, hot flashes and night sweats, skin changes, problems sleeping, weight gain, loss of muscle mass, vaginal dryness, changing interest in sex, memory and concentration issues, and mood swings.

THESE CHANGES IMPACT HOW YOURE FEELING. Youre going through a significant life transition and its normal to experience a wide range of emotions. While you may be anxious or sad about the end of your fertile years, this change may feel liberating to some. Your fluctuating hormone levels may be affecting how you feel, and its likely that your mood is affected by the intensity of your menopausal symptoms.

A WIDE VARIETY OF TREATMENTS ARE AVAILABLE. There are many options to help manage your symptoms. No option is permanent. Working with your health care provider, you can come up with a plan thats right for you and revisit it as necessary.