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Menopause

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A healthy approach to menopause includes:

  • Making informed choices.
  • Acknowledging, discussing and reassuring each other that, “No, it is not just you who thinks it is hot in here.”
  • Focusing on the positive aspects, accomplishments and successes of your life,
  • Understanding that every woman is her own woman and each experience with menopause is unique.
  • Embracing a healthy approach
  • Visiting your healthcare provider.
  • Speaking to supportive family and friends.

You are not alone. Approximately 5.5 million Canadian women are going through the same thing!

Everything you wanted to know…

  • Menopause is a point in time that is reached when a woman has not had a period for 12 months.
  • The average age of women experiencing perimenopause is 45, but it can happen anytime between the ages of 39 and 51.
  • Perimenopause can last anywhere from two to eight years.
  • A woman’s body starts to decrease hormone production.
  • Periods may become lighter or heavier, or farther apart or closer together, or may even be missed.
  • This change means that every month will be different.

When you just don’t feel like yourself…

  • Signs and Symptoms
  • Fatigue.
  • Irritability.
  • Changes in mood.
  • Changes in concentration and memory.
  • Hot flashes.
  • Night sweats.
  • Sleep disturbances.
  • Nausea.
  • Dizziness.
  • Palpitations.
  • Anxiety attacks.
  • Vaginal dryness and discomfort.
  • Urinary frequency and urgency.
  • These signs and symptoms may not affect every woman. These symptoms may be present during perimenopause, but will fade with time.
  • 85% of women experience hot flashes; temporary episodes of skin flushing and sweating, with anxiety and heart palpitations.
  • These hot flashes can disrupt your healthy sleep-rest pattern, which, in turn, can lead to your increased emotional symptoms.
  • Skin can become drier and thinner as a result of decreased collagen and elastin (what causes wrinkles).
  • Menstrual cycle changes can be present for two to eight years.

Vaginal discomfort

Vaginal dryness and associated discomfort, urinary frequency and urgency are very common in postmenopausal women. Incontinence (leakage) increases with age (12-15% at age 50). (International Menopause Society, 2007)

Vaginal symptoms, including dryness, irritation, itching and painful intercourse, are progressive and unlikely to go away on their own.

Treatment of moderate to severe vaginal discomforts is low-dose estrogen therapy either locally (vaginally) or systemically (oral or through the skin i.e. patch). Local (vaginal) treatment of either rings, tablets or creams are favourable because they produce fewer side effects. Choice of treatment should be guided by the woman’s preferences and the health care professional. (North American Menopause Society, 2007)

Treatment of vaginal discomfort greatly improves sexual health, and overall quality of life for both the woman and her partner. (International Menopause Society, 2007)

There are two forms of hormone therapy:
Systemic hormone therapy (pill, gel or patch) restores estrogen levels throughout the body.
Local hormone therapy (vaginal estrogen cream, tablet or ring) restores estrogen in the vaginal area. Women tend to prefer the oestradiol releasing ring for ease of use and comfort. (Suckling et al., 2007)

Hormone therapy

SOGC 2006 Menopause Consensus Report
Hormone therapy is a safe and effective option for short-term use (up to five years) for the treatment of moderate to severe menopausal symptoms, including hot flashes, night sweats, mood swings, insomnia, difficulty concentrating and vaginal dryness.

The dose should be as low as possible and the time should be as short as possible. Ongoing evaluation is essential to maintaining safe treatment.

It is very important to talk with your health care provider about any concerns, changes or wishes to stop treatment.

The increased risk for breast cancer after five years of combined estrogen-progestin therapy is similar in magnitude to other lifestyle variables, such as fewer pregnancies and reduced breast-feeding, postmenopausal obesity, excessive alcohol or cigarette use, and lack of regular exercise.

Another therapy option is a lifestyle change! If you and your health care provider decide hormone therapy is not for you, choices are still available!

Another great reference for the management of menopause is Leslie Beck’s book, Managing Menopause with diet, vitamins and herbs. (Prentice Hall Canada, 2000). Available at the Health Unit.

Healthy lifestyle changes

Stop smoking
Smoking has been shown to increase the onset of menopause by one to two years.
For more information, visit Smokers’ Helpline online:

Healthy Eating
For more information, visit Canada’s Food Guide online:

Exercise
Weight-bearing and resistance exercise and aerobics are all effective ways to increase the bone mineral density of your spine.
Walking increases range of motion and overall health!
Lifestyle change is something you can control. It improves hot flashes and mood.
For more information, visit Canada’s Physical Activity Guide online:

Great Information for women

Many women are now searching independently for resources online. This is a great way to gather information, but rather than replacing professional health care advice, these resources should be used to help you understand and ask questions.

Online resources:

Books: Recommended from the North American Menopause Society

Understanding Menopause
Janine O’Leary Cobb. Toronto, ON, Canada: Key Porter Books; 2005.

A Woman’s Guide to Menopause & Perimenopause
Mary Jane Minkin, MD, and Carol V. Wright, PhD, New Haven, CT: Yale University Press; 2005.

Chicken Soup for the Soul in Menopause: Living and Laughing through Hot Flashes and Hormones.
Deerfield Beach, FL: Health Communications, 2007. Available through Norfolk County Public Library.

Is it hot in here? Or is it me? The Complete Guide to Menopause
Barbara Kantrowitz and Pat Wingert Kelly New York, NY: Workman Publishing; 2006. Available at the Health Unit.

Mind Over Menopause: The Complete Mind/Body Approach to Coping with Menopause
Leslee Kagan, MS, NP; Bruce Kessel, MD; and Herbert Benson, MD, New York, NY: Free Press Simon & Schuster; 2004. Available at the Health Unit.

The Sexy Years: Discover the Hormone Connection
Suzanne Somers New York, NY: Crown Publishers; 2004. Available at the Health Unit.

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