Menopause is something every woman will experience, yet many say they feel unprepared for the symptoms and changes that come with it. Ozarks at Large's Fallon Frank spoke with two local health care providers about what women should know before, during and after menopause.
For many women, menopause is thought of as a single moment in time. But health care providers say the transition often begins years before a woman's final period.
"Menopause is something that we define as your last period," said Anne Montgomery, a primary care internist at Washington Regional. "And the hard thing is you don't know that it's happened until 12 months after. So we say women have reached menopause once they are 12 months from their last period."
Alexis White, an OB-GYN, says the years leading up to that point are known as perimenopause, a stage that can bring significant physical and emotional changes.
"Menopause is the time in our life when our ovaries have run out of eggs," White said. "Women are born with all of the eggs that they're ever going to have. A decade leading up to that time is called perimenopause, and that's when we're starting to notice that our quality of eggs, our number of eggs, is going down."
While the average age of menopause is around 51 or 52, symptoms can begin much earlier. Some are well known, while others may be unexpected.
"Hot flashes, night sweats, and those can be mild or they can be severe," Montgomery said. (speaker unclear from here through the next paragraph — verify against audio) "Poor sleep, I think, is one where you may not even notice that those temperature fluctuations are happening, but maybe you perceive it as, I just am waking up a lot more overnight than I used to."
Poor sleep can affect nearly every aspect of daily life.
"A lot of women describe brain fog. And I think there's probably some of it that's driven directly by the hormone changes, and then some of it that's driven by just less restful sleep."
White says there are symptoms many women never realize could be connected to menopause.
"I think what people are surprised to find out is that sometimes they can experience shoulder pain," White said. "A lot of menopausal women will get something called frozen shoulder, and that's not due to inactivity or an injury. It's just due to their hormone changes."
Other women may notice joint stiffness, anxiety, mood changes or changes in their menstrual cycle. Both providers say one of the most important things women can do is pay attention to their bodies and speak up when something feels different.
"When you are thinking to yourself something's not right, it's not right. And not ignoring that fact and bringing that to the attention of your health care provider."
That conversation can be especially important when symptoms interfere with sleep, work or everyday activities.
"We want to make sure that we're living our best lives, our happiest lives, and suffering in silence is not helping you achieve that goal."
Menopause is also an important time to stay on top of other preventative care. Providers recommend continuing routine screenings, including mammograms, cervical cancer screenings and colon cancer screenings, while also monitoring blood pressure, cholesterol and blood sugar levels. Lifestyle habits can also play a major role in long-term health.
"Exercise isn't just good for our weight, but it's good for our mental health," White said. "It's good for our cardiovascular health as well. And we also want to make sure that we're taking in good amounts of protein and calcium. That's going to help keep our bones strong as we go through that change in our life."
White says many women focus primarily on cardio exercise, but strength training becomes increasingly important with age.
"I feel like a lot of women in my generation and older were told that it's just cardio, we just have to do cardio, and that's not the case," she said. "We really also have to do strength training exercises."
Montgomery says for women struggling with symptoms, treatment options are available.
"I think it's okay to ask about what's most effective because it has been studied," she said. "And I would say that menopausal hormone therapy is the most effective treatment that we have for the vasomotor symptoms of menopause."
But hormone therapy isn't the right choice for everyone.
"For women who have a strong family history of breast cancer, have a personal history of breast cancer, who have high clotting risk — they've had blood clots in the past, or they have a clotting disorder — or who just don't want hormone therapy, that is okay to not want hormone therapy," Montgomery said.
Montgomery says the most important thing is having an open discussion with a health care provider about individual risks, concerns and goals. She also encourages women to discuss topics that are often left out of the conversation.
"I wish women knew that it's okay to talk to their providers," she said. "The other aspect of menopause that we haven't really addressed in this conversation is just sexual health. Loss of estrogen has an impact on vaginal dryness, libido, all of these things, and I think a lot of women are reluctant to talk about that in the doctor's office."
White agrees and says no topic should be considered off-limits.
"It is always okay to talk to your health care provider about your body," White said. "That's what they're there for. That's their job. And they are not uncomfortable. So we want you to not feel uncomfortable."
While menopause can bring challenges, Montgomery says it should never come at the expense of a woman's overall health.
"And so finding time for yourself and finding time for your health can be really hard," she said. "But this is when it is important."
As we've learned over the last few weeks, preventative care is not always a priority for women. The idea of only going to the doctor when something is wrong can lead to unforeseen issues. It's about catching things early before they become serious. From cancer screenings to the inevitability of perimenopause and everything in between, health care providers reiterate the importance of staying on top of your care. For Ozarks at Large, I'm Fallon Frank.
Ozarks at Large transcripts are created on a rush deadline and edited for length and clarity. Copy editors utilize AI tools to review work. KUAF does not publish content created by AI. Please reach out to kuafinfo@uark.edu to report an issue. The audio version is the authoritative record of KUAF programming.
