How is menopause diagnosed and treated?

How is menopause diagnosed?

The signs and symptoms present leading up to menopause and during it are usually enough to inform the majority of women and doctors that it has begun or taken place. However, if you have any concerns regarding any symptoms such as hot flushes or irregular periods, then it is best that you speak with your doctor. Some cases may require further evaluation. 

Tests are not normally needed in order for menopause to be diagnosed. However, in certain situations, your doctor is likely to suggest that you have blood tests done in order to check your levels of:

• Oestrogen (oestradiol) and follicle-stimulating hormone (FSH) – When menopause occurs your oestradiol levels decrease and your follicle-stimulating hormone levels will increase. Your FSH is a hormone that stimulates the growth of the ovarian follicles of your ovary before it releases an egg from one of the follicles during ovulation. This will also increase the production of oestradiol. Follicle-stimulating hormone is produced by your pituitary gland. Basically, the hormone helps in controlling your menstrual cycles and the egg production of the ovaries.
• Thyroid-stimulating hormone (TSH) – Having an underactive thyroid, known as hypothyroidism, can cause similar symptoms to menopause such as weight gain.

How is menopause treated?

There is no specific medical treatment for menopause. The treatments instead focus on the relief of your symptoms and try to aid in the prevention and management of chronic conditions that often occur with natural ageing.

Other treatments can include:

• Hormone therapy – Oestrogen therapy is the most effective form of treatment to relieve the main symptom of menopause, hot flushes. Your doctor may recommend that you take the lowest dose needed in order to provide some relief. You will also need to take progestin if your uterus is still intact (has not been removed through surgery). Oestrogen therapy will also help in preventing bone loss. If you start hormone therapy within a five-year period from your last menstrual cycle, then it may also have some benefits for your cardiovascular health (heart disease).

• Low-dose antidepressants – There are certain antidepressants that are related to a class of drugs known as SSRIs (selective serotonin reuptake inhibitors). These have been known to help decrease hot flushes associated with menopause. This form of treatment is often helpful for women who are unable to undergo hormone therapy for specific health reasons or need antidepressants for a certain mood disorder.
• Gabapentin (Neurontin) – This is a drug that has been approved for the treatment of seizures, however, it has also been useful in reducing the symptoms of hot flushes. It is also helpful for women who cannot use oestrogen therapy and those who suffer from migraines.
• Vaginal oestrogen – Oestrogen can be used to relieve the symptom of vaginal dryness when it is administered directly to your vagina in the form of a tablet, ring or cream. This form of treatment will release a small dosage of oestrogen and the vaginal tissues will then absorb this.  
• Medications to treat or prevent osteoporosis – Your doctor may suggest that you treat or prevent osteoporosis, this is dependent on your individual condition. There are a number of medications that are available to help in reducing potential fractures and bone loss.

Before you decide on any form or method of treatment, it is best that you speak to your doctor or gynaecologist about what your risks, benefits and options are. It is also advised that your treatment is reviewed annually as with ongoing medical advances, treatment options are often changing.

What lifestyle and home remedies are there for menopause?

There are a number of symptoms and signs that are associated with menopause that are often temporary. There are some steps you can take in order to help prevent or reduce the effects of menopause:

• Cool down your hot flushes – It is best if you dress in layers so that you can take off a layer of two when you get a hot flush. If you are having a hot flush, then it often helps if you drink a cold glass of water or fan yourself. Some triggers for hot flushes are:
  • Hot beverages
  • Spicy foods
  • Stress
  • Caffeine
  • Hot weather
• Reduce your vaginal discomfort – You can use OTC (over-the-counter) and water-based lubricants such as K-Y jelly or Astroglide, this will help ease any sexual discomfort during intercourse. Being sexually active can help increase blood flow to the vagina. **Remember not to choose products with glycerine as this may cause an itching or burning sensation in some women.
• Make sure you get enough sleep – You may want to avoid any products with caffeine in them, as well as alcohol as these can often interrupt your sleep. It also helps to exercise during the day and not late at night. If you find that hot flushes are disturbing your sleep, then try sleeping in cooler sleep attire and with a fan in your room.
• Try to practice some relaxation techniques – There are a number of breathing and relaxation techniques available that can help ease your symptoms of menopause.
  
  Some of these include:
  
  
  • Guided imagery
  • Deep breathing
  • Meditation
  • Massage
  • Progressive muscle relaxation
• Do your Kegels – Try to keep your pelvic floor muscles strong through performing Kegels. This will also help in urinary incontinence.
  
  How to do Kegels:
  
  
  • You can do these by finding the muscles you use when you want to stop urinating.
  • Once you have found these muscles, squeeze them and hold for three seconds.
  • Repeat this move 10 to 15 times and do this once a day.
  • Try to increase your reps every week.
• Stick to a healthy and balanced diet – Sticking to a balanced meal plan that consists of vegetables, fruit, whole grains and protein will help in easing your symptoms. It is advised that you limit your intake of sugars, saturated fats and oils. Speak to your doctor or pharmacist about any calcium or multivitamin supplements you should be taking with this diet.
• Do not smoke – If you smoke your risk of stroke, heart disease, cancer, osteoporosis, as well as a variety of other health issues is greatly increased. Smoking can also increase your hot flushes and lead to early menopause.
• Stick to a regular exercise regime – By getting regular exercise at least three times a week, your risk of diabetes, heart disease, osteoporosis and other health issues is lowered. Your symptoms of menopause may also be reduced.