It's Cold but I'm Still Hot: Leading Your Best Life During Menopause

The cultural shift toward destigmatizing women's health includes the care given to women approaching or navigating midlife. Menopause and the transition leading up to it are getting more attention, which means more options for women. Learn how to take control of your hormones with Paula Duncan, MD a certified menopause specialist with Cone Health Center for Women’s Healthcare in this 2 Your Well-Being conversation with WFMY.

Am I Starting Menopause? Understanding the Timeline

We typically think of women in their early fifties reaching menopause, but many women begin to experience symptoms much earlier. This transition period is known as perimenopause. This can occur as early as the mid-thirties, though more commonly toward the mid-to-late forties.

• Perimenopause is a phase of four to seven years when a woman still has a menstrual cycle, but it becomes irregular, leading up to her final period. Signs include:
  • Hot flashes two to three years prior to your last period.
  • Menstrual cycle changes.
  • Subtle shifts in your mood.
• Menopause is the permanent end of menstrual cycles and fertility caused by the decline in ovary function and rapid decrease in sex hormones. It is diagnosed after one full year without a period, meaning that women have to tune into their bodies regularly to know the signs.

What Role Does Estrogen Play?

Estrogen actually refers to a group of sex hormones produced mainly by the ovaries. Dr. Duncan explains that estrogen receptors are located in almost every tissue and organ in the body. That's why when estrogen levels suddenly drop, the effects are widespread throughout the body.

Symptoms include:

• Physical: Hot flashes, joint pain, heart palpitations, frozen shoulder, vaginal dryness and pain during intercourse.

• Neurological: Brain fog, significant sleep disturbances, mood swings, anxiety, depression, irritability, low-confidence and a drop in libido.

"It’s that loss of estrogen that’s playing in with all of that. It’s not just a slow drift... for most women, it’s pretty precipitous. You go from having it to not, and that’s hard on our bodies." — Dr. Duncan

How Can I Get Relief From Symptoms?

While there is no "magic bullet," lifestyle changes are foundational to managing the transition.

1. Strength Training: Starting around age 40, women experience a decline in muscle mass, which dictates metabolic rate. Strength training is crucial for bone health, heart health, and maintaining metabolism.

2. Nutrition: Focusing on clean, unprocessed foods, lean proteins, and complex carbs for symptom relief.

3. Hormones: Talk with your provider about hormone therapy options.

Why Is Everyone Talking About HRT?

One of the biggest hurdles in current menopause care is debunking outdated information regarding Hormone Replacement Therapy (HRT). Dr. Duncan points out that many fears stem from a 2002 study that lacked nuance. Modern hormone therapy uses different regimens than those used decades ago, offering many women relief from symptoms related to estrogen-loss.

While some clinical research shows that hormone therapy now can reduce the risk of breast cancer, those with hormone-receptive breast cancer should discuss the risks and benefits with their provider.

Next Steps:

Menopause is a natural phase of life, but that doesn’t mean you should suffer in silence. If you are not comfortable discussing symptom management or hormone therapy with your current provider, find one who is.

"Be an advocate for your health," Dr. Duncan urges. "This stuff matters for your long-term health and your quality of life."

Talk with your provider about exploring menopause services at the Cone Health Center for Women's Healthcare.