The clinical definition of menopause is going 12 months without a menstrual cycle, but women who’ve experienced it know that it’s far more than that.
“Menopause is a very unique experience for each woman,” said Gretchen McCreless, M.D., a gynecologist at UAB St. Vincent’s Women’s Health. “Women can experience symptoms like hot flashes, trouble sleeping, skipping periods, and weight gain for months or years before they are officially in menopause.”
Dr. McCreless holds a Certified Menopause Practitioner certification through The Menopause Society. She was inspired to get certified after being disappointed by the care her mother was receiving for menopause.
“I just felt that we can do better, so I started researching and came upon The Menopause Society,” Dr. McCreless said. “I knew there was a need for better understanding of this clinical phenomenon that every woman in her 40s or 50s is experiencing, so it was important to me to do everything I could to learn more and be better able to help women.”
Irregular menstrual cycles
For many women, the journey to menopause starts in their 40s with what is called perimenopause. This period may include menstrual cycles that were once normal beginning to become more irregular. Women may begin to experience hot flashes, night sweats, trouble with sleeping, dysregulated mood, and generally not feeling like themselves.
Dr. McCreless says there is no treatment for perimenopause. Rather, it is often a time when women really take notice of the changes their bodies are starting to experience and talk with a provider about them. She says you shouldn’t wait until symptoms begin disrupting everyday activities.
“I have a lot of patients in their 40s who opt to go back on birth control after not taking it for years, just because it helps stabilize their hormones during that transition period,” Dr. McCreless said. “I have other patients who are adamant about not wanting to take birth control but are willing to take hormones, so we are able to do a cyclic patterning of estrogen and progesterone to help stabilize their hormones.”
Any changes in menstrual cycles are worth a conversation with a provider. Dr. McCreless says women in perimenopause who have missed periods should see a doctor to confirm that they are not being caused by another hormonal issue.
“I have seen a big increase in women in their 40s coming to see me as they start to realize that their body is changing, and I think that’s the perfect time for us to meet and start to discuss their health history,” she said.
Hormone replacement therapy
Hormone replacement therapy (HRT) is a great option once a woman is determined to be in menopause, Dr. McCreless says.
“Historically, hormone replacement therapy has gotten a bad rap, but when you look at the historical studies, you realize that the data were tracking an older patient population,” Dr. McCreless said. “In fact, women in the earlier years of menopause were not having the same complications and were actually seeing tremendous benefits.”
Recently, there’s been a cultural shift in understanding the data on HRT. In 2022, The Menopause Society released guidelines suggesting that HRT should be considered for the first 10 years of menopause, as it improves the bone health, heart health, and general well-being of women experiencing menopausal symptoms.
The future of menopause medications
In addition to HRT, Dr. McCreless suggests that women explore other types of treatment, including over-the-counter remedies and prescription medications. She says a new medication hitting the market targets the area of the brain responsible for hot flashes, and she’s hopeful that the future is bright for better understanding and treatment of menopause.
“For so long, the culture has been to think that hormones are bad or that women need to just tough this part out, but that’s certainly not the case,” Dr. McCreless said. “One of the more rewarding things I hear is how hormone treatment has literally changed a patient’s life. The common theme I hear is, ‘I finally feel like myself again.’”
Personalized care at every age
The health care needs of women are unique. The doctors at UAB St. Vincent’s Women’s Health provide care for life, including menopause and gynecologic care and screenings that are right for your age and health history. Talk to a doctor today by calling 205-939-7800.