"Will menopause change me? People tell me it'll make me act differently."
Possibly. It depends on the individual.
Menopause is defined as the absence of menses for one year. It is signified by low levels of progesterone and estrogen made by the ovaries. Almost all of the changes an individual may undergo can be attributed to these hormonal alterations.
Hot Flashes, Night Sweats & Insomnia
The most common associated symptoms of menopause are hot flashes (flushes), night sweats and insomnia. These are otherwise known as vasomotor symptoms. Hot flushes are characterized by the sudden reddening of the face and upper torso for a short time period. Insomnia quite often is associated.
These symptoms are a consequence of withdrawal from estrogen and progesterone in the thermoregulatory center of the brain.
Approximately 25-30% of all women will remain symptom-free. The remaining symptomatic patients my expect the most severe symptoms to subside within 2 years.
Combination hormone replacement therapy should be reserved only for those individuals with very severe symptoms that interfere significantly with their activities of daily living. Even then, treatment should use the lowest effective dose and a short time period to minimize risk from these medications.
Vaginal Dryness and Discomfort
Another common problem attributed to menopause is vaginal dryness and discomfort. Again, not all women will experience this. It is caused by the tissues and glands in the lower genital tract being affected by low estrogen levels.
Treatment may include non-hormonal methods, such as vaginal menopausal gels that help retain moisture, or specific estrogen hormones delivered to the vagina in the form of creams, tablets or slow release systems. Since the estrogen hormone is delivered locally to the genital tract and in a much lower dose, the treatment is more effective and safer than taking oral forms of estrogen replacement.
Finally, bone loss may be a significant part of menopause. 20% of all bone mass may be lost in the first five years of menopause. Not all women will experience this.
Risk factors include a family history of osteoporosis, sedentary lifestyle, Caucasian ethnicity, smoking, significant alcohol consumption and low Vitamin D levels. Other medical diseases may also affect the rate of bone loss.
This condition can be screened for with DEXA scans on a regular basis.
It is important to consume an adequate amount of dietary and supplementary calcium and Vitamin D along with a weight bearing exercise program. The need for medical therapy is individualized. While combination hormone replacement therapy is helpful in preventing bone loss, it should not be used as primary drug therapy for osteoporosis. There are a number of non hormonal medications available to treat this condition.
The most important factor in preventing osteoporosis is good bone health in the formative years. Adequate calcium, Vitamin D and weight bearing exercise may help prevent the development of osteoporosis in later years.