Manage Menopause with Direct Access Primary Care
The symptoms of menopause go well beyond the commonly portrayed experience of hot flashes, night sweats, and mood swings. Estrogen plays a role in most systems of the body, and it’s loss can be felt in them all.
About 70% of women will experience the musculoskeletal syndrome of menopause, which presents as body pain - muscles, joints, generalized stiffness. Also common is sleep disturbance, and not just from night sweats. Women in menopause often have trouble falling asleep and staying asleep. The lack of estrogen in brain tissue leaves menopausal women with a sense of brain fog, forgetfulness, and/or word finding difficulties. And unsurprisingly, low estrogen levels affect the genitourinary system, resulting in vaginal pain, pain with sex, frequent urinary tract infections and so on.
Often the direct effects of loss of estrogen in one area are made worse by indirect effects from loss of estrogen in other areas. For example, as mentioned above, low estrogen levels affect women’s memory and sense of mental sharpness, plus their ability to get a good night’s sleep. Having poor sleep further effects memory and sense of mental sharpness, creating a negative feed back loop.
The best approach to treating the symptoms of menopause is hormone replacement therapy, to raise the levels of declining estrogen which seems to be at the heart of menopausal misery. Many studies show the benefit of hormone replacement therapy on treating hot flashes and vaginal dryness/pain. More research is also starting to show that estrogen replacement can help address the other menopausal symptoms, like joint pain or brain fog.
While hormone therapy does carry some risk and might not be for all women, it is generally safe and preferred for women under the age of 60 suffering from menopausal symptoms. The first step is discussing symptoms with your doctor. For recent decades, women have generally suffered the symptoms of menopause in silence, believing them to be inevitable and the treatment too risky. Lately however, following a NY Times article in 2023 (titled Women Have Been Mislead About Menopause, definitely worth a read!), renewed public interest has encouraged women to seek out relief from what are often intrusive and overwhelming symptoms.
Sometimes women’s menopausal concerns are brushed aside by their doctors, either because of time constraints or lack of education about menopause or mislead beliefs about risks of treatment. With direct access primary care, I have more time and opportunity to work with women suffering the effects of menopause. From avoiding misleading over the counter products, reviewing certain lifestyle adjustments to avoid triggers, implementing a strength training program to limit effects of weight gain, muscle wasting, and fat redistribution, to talking through the risks, benefits and various formulations of hormone therapy, I am here for the menopausal journey!
