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By: Dr. Austin Kooba, M.D., Ob/Gyn at Calexico Wellness Center.
There seems to be a lot of misinformation about medical definitions and options for medications regarding menopause, so I will create this series of blogs to clarify it. This first blog will be about the definition, diagnosis, accompanying symptoms, and facts of menopause. The next blog will review diagnosis and treatment options.
Let’s start with the facts. Before menopause there is perimenopause, also known as menopausal transition: the period of time starting a few years before the last menstrual period, and ending 12 months after it. Menopausal transition can last 2-8 years. The sign of this is irregularity in your cycle and not having a menses for 3 to 11 months.
Menopause starts 12 months after the last menstrual period and occurs because the ovaries discontinue their normal activity and significantly decrease or stop their hormone production. The age range of when this occurs is approximately 48-55, with the median age being 51. Perimenopause is not influenced by one’s age when they started menstruation (menarche), and can occur earlier in women who smoke cigarettes and/or are undernourished. Race, number of pregnancies, use of birth control pills, socioeconomic status, and age of one’s mother at menopause, have little influence on when one starts menopause themselves.
Because the hormone levels (FSH, LH, Estrogen, Progesterone) fluctuate during normal menstruation and perimenopause, there is little value in checking them to determine if/when perimenopause is occurring; a single window in time (one random blood test) do not help with any additional information. For those women with symptoms of menopause, we take a detailed medical history and physical exam and have a discussion about next steps to make an accurate assessment and diagnosis.
The symptoms vary for everyone; some women transition from perimenopause through menopause noticing minimal side effects while others can experience hot flushes and sweats (vasomotor symptoms), vaginal symptoms (irritation, dryness, itching, discharge, odor, bleeding), pain with sex (dyspareunia), decreased libido, increased urinary tract infections, psychological symptoms (anxiety, increased tension, mood depression and irritability), and/or changes in sleep patterns. Osteoporosis (thinning of the bone and the increased risk of a fracture) and cardiovascular disease (increased risk of a heart attack or stroke) are the 2 main health problems that result from the decrease in estrogen during menopause. I will discuss why these occur in the next blog on this series.
Certainly this is not meant to be an all inclusive list, and is an overview of the most common symptoms that the majority of women experience. Everyone’s journey may be different, and we will take the time to listen and discuss your symptoms and concerns and make an accurate diagnosis so we can make shared decisions about how to help you through this life transition.
Up Next: The physiology of menopause and the changes. What is actually occurring in your body that may result in symptoms.
Dr. Austin Kooba, Ob/Gyn, brings nearly 30 years of experience providing compassionate, evidence-based care. Inspired by his mother’s battle with terminal breast cancer, he treats every patient as family—listening, educating, and guiding them through shared decisions. His philosophy focuses on individualized care that addresses body, mind, and spirit.