Tag: menopause

A Blood Test for Menopause?



If this is the first time you’re hearing the term “perimenopause” — welcome! We’ve been expecting you. Everyone who gets a period goes through menopause, and perimenopause refers to the time period leading up to the day when you’re officially out of the egg-dropping game — aka no more periods.

During this time, your hormone levels start to decline and many women and people assigned female at birth (AFAB) experience a wide range of menopausal symptoms, including hot flashes, fatigue and night sweats. But some people don’t experience any changes at all. To further complicate things, the amount of time spent in perimenopause land is different for everyone. The average number is four years but perimenopause can go on for as long as 14 years. And studies show that people of color are typically in perimenopause longer compared to white people.

So, how do you know for sure if you’re in perimenopause/menopause? We asked Sabrina Sahni, M.D., MSCP, a menopause and breast medicine physician and member of HealthyWomen’s Women’s Health Advisory Council, for her thoughts on taking a blood test for menopause and if the new at-home menopause test kits can provide any answers.

Take our quiz: True or False: Menopause >>

1. Is there a blood test that can confirm that you’re in perimenopause/menopause?

There is no single blood test that can detect perimenopause. Your hormone levels fluctuate throughout perimenopause, which can make interpretation of any hormone level during this time period tricky. A diagnosis of perimenopause is usually clinical and based on a woman’s age and symptoms such as hot flashes, night sweats, vaginal dryness, sleep issues and irregular [menstrual] cycles.

2. It seems that most healthcare providers don’t recommend getting a blood test to check hormone levels for perimenopause. Why is that?

Obtaining a blood test of a specific hormone level really only gives us a snapshot in time. There’s so much fluctuation of hormones that it really can make it difficult to truly interpret. A proper evaluation of a woman’s clinical symptoms is usually the best way to determine if a woman is in perimenopause.

Read: Menopause Is Complex. Is Your Healthcare Provider up for the Job? >>

3. What about using one of the new at-home menopause tests that measures follicle stimulating hormones (FSH) to see what stage of menopause you may be in?

Urinary FSH may not be a reliable indicator since it may not be able to reflect fluctuations throughout a woman’s cycle or even day to day. A sole FSH — which may be elevated in menopause — must be looked at in the context of other hormones. For example, a high FSH along with a low estradiol level usually indicates that someone is in menopause. Again, tracking clinical symptoms — with or without hormonal testing — may give a woman a clearer picture of where she may stand — and should always be discussed with a healthcare provider.

4. What is your advice for people who think they are in perimenopause but don’t know for sure?

If you think you’re in perimenopause, start by tracking your symptoms, including your cycles, sleep patterns, mood changes, etc. Find a The Menopause Society Certified Practitioner (MSCP) — someone who has had extensive education and training about menopause — to help guide you during this period and address the potential treatment options. Menopause can be really challenging, but you don’t have to navigate it alone.

From Your Site Articles

Related Articles Around the Web



Source link

Vaginal Estrogen Is Safe for People with a History of Breast Cancer



A new study is adding to the evidence that vaginal estrogen therapy is a safe option for people with a history of breast cancer.

The meta-analysis review of more than 5,000 studies found that women with a history of breast cancer who used local vaginal estrogen (tablets or creams) to treat genitourinary syndrome of menopause (GSM) did not increase their risk of recurrence or breast cancer-related death.

Other recent studies have supported the use of vaginal estrogen for GSM in breast cancer survivors, however, many people are unaware that it’s an option even if you’ve had hormone-receptor positive breast cancer. This is because local vaginal estrogen only affects the vaginal area — not your entire body like hormone therapy.

Read: 15 Minutes With: Ashley Winter, M.D., Talks Urology, Sex and All Things Vaginas >>

Vaginal estrogen won’t help with vasomotor symptoms — night sweats and hot flashes — or things like bone loss that happens because of declining estrogen levels during menopause, but it can restore vaginal tissue and help with symptoms of GSM.

We asked menopause and breast medicine physician Sabrina Sahni, M.D., NCMP, a member of HealthyWomen’s Women’s Health Advisory Council, for her thoughts on the recent study and vaginal estrogen therapy.

1. With this new study in mind, is it safe for women with a history of breast cancer to use vaginal estrogen?

This data is very reassuring and something we have certainly suspected for quite some time. It shows that low dose vaginal estrogen does not increase the risk of breast cancer recurrence, breast cancer mortality and overall mortality.

2. Why is it important for people to know about vaginal estrogen therapy?

Vaginal estrogen is truly a game changer for women with GSM. Symptoms like burning, dryness, pain with intercourse and even urinary symptoms are just some of the major symptoms that can affect women and have a profound impact on their overall quality of life and intimacy.

3. If you have a history of breast cancer, what should you do if you’re interested in using vaginal estrogen or have questions about it?

Start the conversation with both your oncologist and your gynecologist/women’s health provider. This study emphasizes that vaginal estrogen is not only an effective option but is considered safe in cancer survivors. A collaborative approach with your whole healthcare team will always ensure you’re getting appropriate care.

From Your Site Articles

Related Articles Around the Web



Source link

The Role of Nurse Practitioners in Women’s Health: Menopause



During this three-part series of WomenTalk, we’re partnering with the National Association of Nurse Practitioners in Women’s Health to explore the role nurse practitioners play in contraceptive, maternal and menopause care.

In the third episode in our Women Talk: “The Role of Nurse Practitioners in Women’s Health” series, we’ll be exploring the role nurse practitioners play in women’s health, particularly in menopause. We’ll discuss options to manage symptoms and simple tips on what you can do to support yourself through the big change.

Watch more WomenTalk episodes

From Your Site Articles

Related Articles Around the Web



Source link

What Is VMS? Hot Flashes and Night Sweats.



What is VMS?

Vasomotor symptoms (VMS) — hot flashes and night sweats — are common during perimenopause and menopause.

For many women, hot flashes and night sweats aren’t just annoying — they’re a serious health problem.

VMS can go on for years

Some women and people assigned female at birth (AFAB) experience VMS for more than a decade.

7 = Average number of years

4.75 = Average number of hot flashes a day

3 = Average number of night sweats per night

Race matters

Women of color:

Are more likely to report symptoms of VMS

Experience VMS for longer compared to white women

VMS and sleep

Night sweats and hot flashes can disrupt sleep and cause:

Poor sleep

Early morning awakenings

Insomnia

Daytime tiredness

Over time, sleep problems can reduce your quality of life and increase the risk for serious health conditions, such as:

DYK?

½ of all postmenopausal women have poor sleep that could benefit from treatment.

VMS increases the risk for many serious health conditions

It’s not just you

As many as 8 out of 10 women in midlife experience VMS …

… But only 1 in 4 get treatment

Know your treatment options

  • Hormone therapy
  • Non-hormonal therapy specifically for VMS
  • Prescription medications (e.g., some antidepressants, gabapentin, oxybutynin)
  • Over-the-counter and alternative medications

When it comes to supplements, should you?

Over-the counter supplements aren’t regulated by the FDA and have not been heavily studied. Be sure to ask your healthcare provider before starting supplements.

Don’t sweat it out

VMS can have serious consequences. Talk to your healthcare provider about treatment options.

This educational resource was created with support from Astellas, a HealthyWomen Corporate Advisory Council member.



Source link

Menopause and Bladder Leakage – HealthyWomen



This educational resource was sponsored by Poise, a brand of Kimberly-Clark. Other Kimberly-Clark brands include Depend and Thinx for All Leaks.

My friends and I knew the hot flashes were coming for us. And we’d heard the chatter about sleep disturbances and mood swings. Women are now more likely to be openly discussing the menopause symptoms previous generations weren’t even whispering about. But there remains one exception to this openness. Lurking in the dark corner of menopause conversations among friends is the symptom few want to discuss: bladder leakage.

But it’s too common to ignore. More than half of postmenopausal women experience some sort of urinary incontinence, the medical term for bladder leakage. If you’re like me, you may be asking: doesn’t menopause take enough, even without the bladder leakage? Menopause has claimed our sleep, our moods, our ability to control our facial sweating. Can’t menopause just let us keep our ability to sneeze, laugh and cough without fear?

We should be so lucky. “We see sharp increases in bladder leakage during the menopause transition and during the menopausal years,” said Lauri Romanzi, M.D., a urogynecologist and member of HealthyWomen’s Women’s Health Advisory Council. “Aside from estrogen deprivation in the bladder and urethra, we don’t truly understand why this spike at and around menopause occurs. And it’s difficult to sort out whether it’s caused by menopause, aging issues or delayed onset impacts of childbearing.”

In the search to narrow down a culprit, estrogen loss from menopause looks reasonably guilty. Estrogen is a hormone that affects far more than the reproductive system, and most types of bladder leakage during menopause have links to estrogen loss.

Estrogen loss can weaken the urethral closure, which causes a type of bladder leakage triggered by pressure on the bladder and urethra. Changes in pelvic floor strength have also been linked to estrogen loss, and this issue is more common among women who have given birth. However, Romanzi said, women who have not given birth aren’t necessarily guaranteed a lifetime of fear-free sneezing, coughing or laughing.

Another type of bladder leakage, overactive bladder (OAB), causes urinary urgency, which is when you don’t have much warning before you have to pee. It can also trigger urinary frequency and nighttime urination, with or without a sense of urgency. The loss of estrogen receptors in the bladder because of menopause can cause overactive bladder, Romanzi said.

Bladder leakage may be common, but you can manage the symptoms

While bladder leakage from menopause is common, it should not be accepted as a “new normal.” Possible solutions depend on the type of bladder leakage you’re experiencing and how bad it is, but they all should begin with a conversation with your healthcare provider (HCP).

“Be your own advocate,” Romanzi said. “Start by speaking with your primary care physician or gynecologist. Ask for a referral to a urogynecologist or urologist specializing in women’s bladder problems.”

Your healthcare provider might also suggest lifestyle changes or seeing a physical therapist that specializes in pelvic floor therapy. A pelvic floor physical therapist can help you strengthen your pelvic floor muscles through physical exercises, such as the Kegel technique. They might also help you retrain your bladder using biofeedback and electrical stimulation techniques. Many women perform Kegel exercises incorrectly, so it can be a good idea to talk to a professional to make sure you’re doing them correctly.

Using bladder leakage pads, like Poise pads, or underwear designed for bladder leakage, like Depend or Thinx for All Leaks, can be helpful in offering you protection and peace of mind. Bladder leakage pads are designed to control odor and wetness from urine unlike sanitary pads made for periods.

Avoiding certain foods can help improve bladder leakage symptoms for some women. Some foods to avoid are:

  • Caffeinated drinks (such as coffee, tea and some energy drinks)
  • Carbonated drinks (such as soda and sparkling juice)
  • Citrus juices and fruits
  • Tomatoes
  • Chocolate
  • Alcohol
  • Spicy foods

What irritates your bladder might not irritate someone else’s, so it’s a good idea to try to figure out what you personally can and cannot eat and drink by keeping a journal of what you’ve eaten and drunk. If you have overweight or obesity, your healthcare provider might suggest weight loss to reduce pressure on the bladder and pelvic muscles.

If these changes don’t work, medicine might be an option. If menopause is causing your bladder leakage, topical estrogen that goes inside the vagina can be helpful. It comes as a cream, tablet or vaginal ring.

There are also FDA-approved medications to treat urinary incontinence. Some of these medicines can cause side effects such as dry mouth, which can actually make things worse by making you drink more. Although it may seem odd, drastically limiting fluid intake to control bladder leakage is not recommended. In fact, staying well hydrated (but not overly hydrated) and emptying the bladder regularly may help retrain and strengthen the muscles around the urethra and bladder.

If these treatments don’t work well enough, there are other treatments available, but they’re considered more invasive. These include Botox injections to the bladder, or a weekly treatment called percutaneous tibial nerve stimulation (PTNS). PTNS delivers electrical stimulation through a needle inserted into a nerve in the ankle.

According to Romanzi, a device that resembles a pacemaker can be implanted in women with severe OAB or urge incontinence that doesn’t respond to other treatments. These devices are inserted in the lower back and deliver electrical pulses. Weakened urethras can be surgically strengthened with a urethral sling. Urethral bulking is a similar surgical procedure that strengthens the urethra by injecting it with silicon.

Data show that only 1 in 3 people experiencing bladder leakage try to get treatment. But shame, fear or embarrassment should not silence you into needless suffering.

To get treatment, let your healthcare provider know you’re having this common menopause symptom. You may feel like you’re the only one having bladder leakage, but you’re definitely not alone. And your HCP can help you find solutions.

Resources

National Association for Continence

Poise Incontinence Pads

This educational resource was sponsored by Poise, a brand of Kimberly-Clark. Other Kimberly-Clark brands include Depend and Thinx for All Leaks.

Poise and Depend are registered trademarks of Kimberly-Clark. Thinx for All Leaks is a trademark of Kimberly-Clark.

From Your Site Articles

Related Articles Around the Web



Source link

Prolapse Changed My Life – HealthyWomen



As told to Jacquelyne Froeber

June is Pelvic Organ Prolapse Awareness Month

Sitting in a waiting room with mostly 80-year-old men, I wondered how I got here.

I was 50. Active. In good health. But apparently my bladder thought I was twice my age. The urge to pee was taking over my life. No matter where I was or what I was doing, I had to pee at least once an hour — more than 30 times a day on a good day. And the more I thought about it, the worse it got.

My full and happy life was already changing when this bladder bully showed up in early 2023. Over the past few years, my family and I had moved to a new neighborhood, my daughter moved away for college and my teenage son was getting ready to leave too. I started to feel insecure and unsure of my next purpose in life. My inner critic was always firing major bullets my way, telling me I wasn’t good enough. What was going to happen when my job as a hands-on mom was being downsized? I was scared to find out.

The ongoing conflict inside my brain was causing a lot of overall tension in my mind and body. Even if I could relax enough to sleep, I’d still have to get up throughout the night to pee. I was desperately trying to keep it all together, but the pressure in my pelvis was pushing me to a breaking point.

I was frank about this with the urologist during that office visit. “This is unbearable,” I said. He was the latest healthcare provider to listen to my symptoms. Six weeks earlier I was treated for a UTI, but three rounds of antibiotics didn’t really help. Now the pressure was so intense, it felt like a boulder sitting on my pelvis. It would roll to the side when I went to the bathroom, but it always returned a few minutes later.

The urologist diagnosed me with an overactive bladder. But that didn’t add up to me. Why did it come on so suddenly? He didn’t have any answers except that I was menopausal and these things happen with age.

My doubts lingered. I told my friend that I didn’t feel like the doctor was listening to me and she suggested I go to a urogynecologist who specializes in bladder issues. When I called the office, the receptionist said they were only seeing patients with severe pelvic floor issues or prolapse. I asked her to repeat the word. I’d never heard of prolapse before — maybe this was what was happening to me? I went straight to the internet. I learned pelvic organ prolapse (POP) is when your pelvic organs can drop and bulge into your vagina. This was, of course, scary to think about, but overall I was disappointed. I had some symptoms of POP, like the feeling of fullness in my lower stomach, but it didn’t sound like this was what was happening to me.

The very next night I was in the bathroom — per usual — when I felt an odd sensation like a tampon coming out of me. It didn’t hurt, but something was not right. I screamed downstairs for my husband. “My insides are falling out!” It felt like a bulging in my vagina. Wait, where had I heard that before? All at once it dawned on me that I was experiencing prolapse. I knew from the research I’d done the day before that I wasn’t dying and I didn’t have to go to the emergency room. (But I could call that urogynecologist now.)

And something miraculous happened. For the first time in weeks, the pelvic pressure was gone. Poof. I was cautiously excited — surely it would return any second. But hours passed and no pressure. I was beyond ecstatic. I’m sure this is not the response most women have when they experience prolapse, but I felt free for the first time in a long time.

My pressure-free high was taken down a few notches after I got in to see the urogynecologist. He said the only solution was surgery with a chance that the frequent urination would come back and the prolapse could happen again.

I wanted to avoid the pressure and constant peeing at all costs. I asked him about seeing a pelvic physical therapist, which I had read about online. He said the same thing that all my other healthcare providers would say: You can try pelvic floor therapy, but we will be here when it doesn’t help.

Thankfully, I didn’t let them discourage me. I had rehabbed major back, neck and shoulder issues with movement therapy years before, so I knew the power of the body to heal and regenerate. What did I have to lose?

I had to wait more than a month to get an appointment, so I binge-watched pelvic floor workouts and tutorials on prolapse. I learned that prolapse can be caused by a hypertonic pelvic floor, which means it’s in a constant state of contraction and stops the muscles from relaxing. Then I learned one of the symptoms of a hypertonic pelvic floor is frequent urination. I realized this was probably the reason for my prolapse. My muscles had been so tight for weeks — they just gave out. Just like a pressure cooker that burst.

With the help of my pelvic physical therapist and a lot of online resources, I slowly educated myself on how to rewire my body and nervous system to relax my pelvic floor. I learned how to breathe fully and I worked on softening and relaxing my entire body — letting it melt into the floor. Then I built up my strength and learned how to really listen to my body.

But the body work only got me so far. My mind was the real driver of my symptoms, so I had to work on calming down my inner critic. I learned to shed layers of protection and shame and allow myself to gain strength from within. I learned how to regulate my nervous system so that it felt safe. I began to believe in myself and trust my body, soul and mind.

Turns out, stress can have a negative impact on the pelvic floor and urinary frequency, although none of my healthcare providers made that connection. No one asked me how I was sleeping or if I was dealing with any life changes. They looked at my chart, saw my age and wrote me off. Yes, two vaginal births and entering menopause probably contributed to my prolapse, but it was so much more than that.

I’m not sure what my next season of life will look like, but I’m approaching it with curiosity and confidence instead of fear. I now know my pelvic floor is where I store my stress, frustration and deepest feelings. I do my best every day to honor my body, mind and my spirit.

I haven’t had any prolapse symptoms in several months and I’m back to doing my regular activities. Urinary frequency is still a problem when I’m stressed and tense, but I’m OK with that. It’s my barometer telling me to relax, take a deep breath and remind myself, “You’re good, Lisa.”

*Last name withheld for privacy.

Have a Real Women, Real Stories of your own you want to share? Let us know.

Our Real Women, Real Stories are the authentic experiences of real-life women. The views, opinions and experiences shared in these stories are not endorsed by HealthyWomen and do not necessarily reflect the official policy or position of HealthyWomen.

From Your Site Articles

Related Articles Around the Web



Source link