Dealing with hot flashes and other menopausal symptoms

Menopause is a natural, normal part of a woman's life. But when you're going through menopause, it can feel like your world has been flipped upside down. The changes in your menstrual period, hot flashes, brain fog, and other menopausal symptoms can impact your daily routine in ways you never expected. It may feel overwhelming, but there are ways to manage symptoms and make a healthy transition into this new phase of life.

What are the stages of menopause?

Menopause is the time in life when your period permanently stops. You officially have stopped menstruating 12 months after your last period. But the term "menopause" is often used to talk about the entire transition that starts four to eight years before your period stops for good. This transition is called perimenopause. There is also a transition phase after menopause, known as postmenopause, that lasts about five to seven years.

The average age of menopause is 51. Perimenopause usually starts when women are in their 40s but can start in their 30s.

Certain health conditions, such as polycystic ovary syndrome, can cause women to experience menopause later than usual. However, certain thyroid disorders, as well as medical treatments such as chemotherapy and ovary-removal surgery, may cause premature menopause in women under 40. Talk with your provider if you think you may have signs of or be at risk for premature menopause.

What are the symptoms of menopause and what can I do about them?

Signs and symptoms of perimenopause can vary between women. Some may have mild symptoms they barely notice, while others may have severe symptoms they can't ignore.

Hot flashes are the most common symptom of perimenopause and affect 75% of women. Night sweats are hot flashes that happen at night, particularly during sleep.

Hot flashes and night sweats usually last between 30 seconds and 10 minutes. They might happen once or twice a week, several times a day, or even multiple times per hour. Many women experience night sweats that are strong enough to wake them up. Black and Latina women often experience hot flashes for more years than Asian or white women.

During a hot flash or night sweat you may experience:

• A sudden feeling of heat that impacts the whole body or just the upper part of the body
• Cold chills or shivering right after
• Excessive sweating
• Racing heartbeat or palpitations
• Redness, red blotches, or flushing on the face, neck, chest, back, or arms

To help deal with hot flashes and night sweats:

• Carry a portable fan.
• Dress in layers that you can remove during a hot flash.
• Keep a cold pack in your freezer to grab when needed.
• Keep your bedroom cool at night.
• Layer your bedding.
• Take a few deep breaths.

Other common symptoms may include:

• An irregular menstrual cycle: missed periods, shorter time between periods, periods that last more than a week, and having a heavier-than-usual flow
• Bladder leakage, also known as or urinary incontinence
• Brain fog, difficulty concentrating, or memory loss
• Insomnia or other sleep problems
• Mood changes, depression, or anxiety
• Vaginal dryness

Many of the symptoms of perimenopause go away or improve during postmenopause. But postmenopause also increases the risk of osteoporosis, stroke, and heart disease.

Making lifestyle changes can help

There are many lifestyle changes you can make to help manage hot flashes, other menopausal symptoms, and to maintain your health during postmenopause, including:

• Avoiding alcohol, spicy foods, and caffeine
• Doing things that challenge your brain, like word puzzles or learning a new skill
• Eating a healthy diet
• Exercising regularly
• Not smoking or quitting smoking
• Practicing mindfulness exercises like meditation or deep breathing.
• Maintaining a healthy weight
• Sticking to a regular bedtime schedule

What are the best hormonal treatments and other medications for menopause?

Many women benefit from taking non-hormonal medications that treat the symptoms of menopause, including:

• Selective serotonin reuptake inhibitors (SSRIs) and selective serotonin-norepinephrine reuptake inhibitors (SNRIs) are common treatments for hot flashes and night sweats, as well as symptoms of depression and anxiety. Vaginal dryness may be treated with over-the-counter vaginal moisturizers or non-hormonal prescription medications like ospemifene and prasterone.

Many menopausal symptoms come from having lower levels of estrogen and progesterone in the body. These hormones are made naturally in the ovaries, but the production stops during menopause. Hormone replacement therapy (HRT) addresses the symptoms of menopause by increasing the levels of estrogen and progesterone.

There are multiple types of HRT and they can come in different forms that can include pills, creams, skin patches, or pellets placed under the skin. Which type of HRT is best for you depends on your medical history, lifestyle factors, and the type of menopause symptoms you have.

HRT may be a good option for many, but it's not for everyone. HRT may increase the risk of strokes, heart attacks, blood clots, and breast cancer. Some women are not able to use HRT due to other medical conditions. Your provider can help you figure out if it's right for you.

Talk with your provider before taking hormones that are not approved by the Food and Drug Administration (FDA), herbal supplements, or dietary supplements. And many non-FDA-approved hormones and supplements have not been tested for safety or effectiveness. They may have harmful side effects or may interact with medications you are taking.

If you're struggling with the symptoms of menopause or have questions about which treatments are right for you, request an appointment with a Reid Health OB/GYN provider.