Menopausal Management

Making Sense of Menopause

Natural levels of hormones drop dramatically as we age. Women experience a 30% drop in hormones from age 40 to 50, while estrogen, progesterone and testosterone production decrease much more significantly during and after menopause.

A woman officially hits menopause when her menstrual period ceases for a period of 12 months or more. Although menopause is a natural stage of a woman’s reproductive life, during the months – or even years – leading up to menopause, and throughout the menopausal years, a number of very unpleasant symptoms may be experienced. The most common symptoms include hot flashes, night sweats, irregular bleeding, vaginal dryness, weight gain, thinning hair, difficulty sleeping, osteoporosis, mood swings, anxiety and decreased sex drive. Individual symptoms range from mild to extremely disruptive.

In the past, in order to combat the symptoms of menopause, doctors would routinely prescribe hormone replacement therapy (HRT) in order to supplement the female hormones estrogen and progesterone which the body was no longer producing after menopause. Then, the findings of a 15­year study called the Women’s Health Initiative (WHI) were released, proclaiming that HRT was actually more harmful than good for some women, especially older, postmenopausal women. Even though the metrics of the WHI study were later found to be faulty, treatments for post-menopausal women containing both estrogen and progesterone have been shown to put a woman at a greater risk for breast cancer, stroke, blood clots and the same heart disease it was thought to prevent. Naturally, estrogen-progesterone HRT is no longer prescribed to prevent any diseases, but estrogen-only hormone therapy can still be helpful for some women in treating menopause.

Our treatment of peri-menopause, menopause and the resultant symptoms is on an individualized basis, taking into consideration your personal history, family history, severity of symptoms, and the existence of any other medical issues.  Because of our focus on your individualized needs, we offer several approaches to address unpleasant symptoms.

Systemic Estrogen Therapy/ Hormone Replacement Therapy (HRT)

Systemic estrogen therapy – which is available in pill or patch form – is effective in reducing hot flashes, restoring bone density and treating the vaginal symptoms of menopause in women who are otherwise healthy. This form of HRT is considered safe, but it is important to note that the risk is low only when the smallest dosage of estrogen is taken for the shortest amount of time possible. You should probably not use estrogen therapy if you have ever had a stroke, heart attack, heart disease or liver disease, as these conditions can be exacerbated by the hormone.

As with any medication, both risks and benefits exist with the use of HRT. We will discuss all aspects with you during your visit and help you decide whether hormone replacement therapy utilizing prescription medication is right for you.

Bioidentical Hormone Replacement Therapy (BHRT)

We also offer Bioidentical Hormone Replacement Therapy (BHRT) as an alternate option to treat menopause. Bioidentical hormones are derived from plant sources and offer a natural way for patients to regain hormonal balance. They exactly mimic the structure and function of the hormones inside the body, and can be individually dosed. Additionally, this form of hormone replacement therapy is considered by most to be safe and effective for long-term use.  Our BHRT program offers two delivery options:  Bioidentical Hormone Pellets or Compounded Bioidentical Hormone Creams.

Vaginal Rejuvenation with the Juliet Laser

Juliet is a minimally invasive treatment that has shown success in treatment of some of the symptoms of menopause. Vaginal dryness, itching, painful intercourse, poor lubrication, decreased libido and poor vaginal muscle elasticity and tone are symptoms which are amenable to treatment with Juliet.   Essentially, treatment with Juliet stimulates neocollagenesis. This leads to a restoration of the metabolism of connective tissue and to an improvement in the condition of the mucosa. Click here to learn more about Juliet.

For symptoms of menopause, no one-size-fits-all solution exists – that’s why we personalize each patient’s care and tailor our treatments to meet your individual needs.