Saint Agnes Medical Center

SPR 2018

Spirit of Women magazine is a national publication presented to women by hospitals and their physicians. The magazine provides up-to-date, evidence-based healthcare information and promotes our hospitals as leaders in women's health excellence.

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M enopause—missing your period consecutively for a year at around the age of 51 (although the age range can vary between 45-55 years) because the ovaries stop producing most of their estrogen—can be a challenging phase of life. Menopause is a normal part of a woman's life, and does not always need to be treated. The telltale symptoms can impact both your productivity at work and your quality of life. Menopause can also increase your risk of bone-weakening osteoporosis and heart disease. "Menopause symptoms can be debilitating, and no one should have to suffer," says board-certified obstetrician and gynecologist Marci L. Dabbs, MD, of Saint Agnes Medical Center. Here's what you can do in menopause and beyond to get relief and maintain your long-term health. Seek hormone help. To say goodnight to persistent hot flashes, consider hormone therapy taken by pill, patch, spray, gel or vaginal ring, which delivers hormones throughout your body. When estrogen gets into the blood, your brain gets tricked into thinking the ovaries are making estrogen, so you're less likely to experience hot flashes and disrupted shut-eye. You may want to think about hormone therapy even if you don't have menopause symptoms yet, says some researchers. Preventing osteoporosis, the risk of which increases after menopause, could be reason enough for some women to try hormones. "Hormone therapy has been shown to prevent bone loss and prevent fractures," Dr. Dabbs says. If you're concerned about hormone therapy based on the Women's Health Initiative study, sponsored by the National Heart, Lung, and Blood Institute (NHLBI), that suggested it could increase a woman's risk of breast cancer and heart disease, consider the mounting new evidence about the health benefits of hormone therapy. "There continues to be confusion and fear for both women and their healthcare providers about the use of hormone therapy for menopausal women," Dr. Dabbs says. To spell out the latest evidence-based risks and benefits of hormone therapy at menopause, NAMS recently released its 2017 Hormone Therapy Position Statement. A new spin-off of the WHI study published in the Journal of the American Medical Association, for example, found that women taking hormone therapy for five to seven years weren't at any increased risk of death long-term, compared with those who didn't take hormones. "Hormone therapy is the gold standard for hot flashes, is safer than you think, and may have benefits for you beyond just helping your hot flashes – including preventing bone loss," Dr. Dabbs says. But timing is important. Hormone therapy is considered safe and effective for women under age 60 and within 10 years of menopause. Taking estrogen alone (or estrogen plus progesterone, to reduce the risk of uterine cancer in women who haven't had a hysterectomy) between ages 50 and 59 or within 10 years of beginning menopause may not only reduce annoying symptoms, but it may also lower your risk of breast cancer, osteoporosis and heart disease by helping to keep arteries clear. "In the absence of estrogen, the heart arteries build up plaque at a faster rate," Dr. Dabbs says. Hormone therapy can also help reduce the risk of type 2 diabetes and help keep your skin more youthful looking. Still, hormone therapy isn't right for everyone, so it's important to talk with your doctor. "In general, there's more risk than benefit for women who start hormone therapy at older ages, such as over age 60, or if they're more than 10 years from menopause," Dr. Dabbs says. If you're prescribed hormone therapy, be sure to check back with your physician regularly to make sure you still need it. "There's no hard stop date and the decision to stop or continue depends on your age and situation," Dr. Dabbs says. Dr. Dabbs adds that women with a current or past history of breast cancer, coronary heart disease, previous breast cancer, heart attack, stroke, or those at a high risk for those conditions should avoid hormone replacement therapy. Consider hormone alternatives. If you can't or don't want to do hormone therapy, non-hormonal remedies are available that may ease menopause symptoms. "Many physicians prescribe non-addictive sleep aids, and the over-the-counter sleep-aid supplement, Melatonin, has been shown to provide some benefit as well, " Dr. Dabbs says. Black cohosh, an herb in the buttercup family, but not an herbal form of estrogen, may also help reduce hot flashes. NAMS recommends buying black cohosh from a reputable company and using it for a short time to see if it alleviates your menopause systems. If it's not effective, don't keep using it. The most common side effects include stomach upset and headache. Take good care of yourself. Be sure to exercise regularly, don't smoke, sleep well, eat a balanced diet and find fun ways to relax to reduce stress. "If you want to stay younger as you get older, you're going to have to invest the effort to live a healthy lifestyle, with or without hormone therapy," Dr. Dabbs says. Ob/Gyn Marci L. Dabbs, MD, is currently accepting patients at Saint Agnes Care Obstetrics & Gynecology, 6121 N. Thesta, Suite #303, in Fresno. To schedule an appointment, call (559) 450-2300, or request an appointment online at agnes-care. Hot flashes. Memory loss. Sleeplessness. Vaginal changes. Mood swings. 7 w w w . s a m c . c o m S P R I N G 2 0 1 8 H E A LT H Y S P I R I T

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