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Menopause
Patient Education

Patient Guide

Menopause - Patient Education Overview

Menopause occurs gradually, and physicians typically classify its progression in three stages.

Stages	Age	Description
Perimenopause	Begins anywhere from late 30s or early 50s	It is the process of change that leads up to menopause, can lasts from 2 to 8 years. Irregular periods and other related symptoms can appear.
Menopause	Varies from mid 40s to early 50s	Menopause is the point in a woman's life when she has not had a menstrual period for 1 year.
Postmenopause	Depends on the menopause age	A woman is considered to be postmenopausal when she has not had her period for an entire year, with FSH (Follicle Stimulating Hormone).

Types

An atypical occurrence of menopause can happen in some women. Generally, there are two types of atypical menopause.

Stages	Age	Description
remature Menopause	Before the age of 40	Early loss of estrogen brings increased risk for colon and ovarian cancer, periodontal (gum) disease, tooth loss, and cataract formation.
Surgical Menopause	At any age, performed in case of ovarian cancer, uterine fibroids, endometriosis, or infections.	Ovaries and uterus are surgically removed in a procedure called a bilateral oophorectomy or total hysterectomy. This causes an abrupt menopause.

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The Team

Menopause is such a natural occurrence that most primary care physicians and gynecologists will treat the patient and her symptoms. While there is no distinct medial specialty for menopause doctors can be certified by the North American Menopause Society (NAMS) as a menopause doctor. These doctors are listed below in our patient education guide.

Endocrinologist - An internist who concentrates on disorders of the internal (endocrine) glands such as the thyroid and adrenal glands. This specialist also deals with disorders such as diabetes, metabolic and nutritional disorders, pituitary diseases, and menstrual and sexual problems. A patient may see an endocrinologist to be sure that symptoms, like hot flashes, are being caused by menopause and not a different condition (e.g. can be hypothyroidism).

Psychotherapist - A therapist who deals with mental and emotional disorders. Menopausal patients may seek a psychotherapist to deal with mood changes, depression and dealing with lifestyle adjustments.

Holistic Practitioner - A specialist who views the body as a whole, considering physical, mental and spiritual components. Herbs and nutritional supplements are considered to eradicate menopausal symptoms, in addition to meditation, cleansing, diet and exercise programs.

Compounding Pharmacist - This particular pharmacist prepares a very specific medication, prescribed by a physician, for a patient's individual needs. Often used when a patient wants bioidentical hormones.

How to Prepare

It is very natural in menopause that we face lots of anxiety and queries, so there are several actions that need to be taken in order to maximize benefit of the visit which are listed in this patient education guide:

Write down any symptoms you're experiencing, including any that may seem unrelated to the reason for which you scheduled the appointment.
Write down key personal information, daily lifestyle including any major stresses or recent life changes.
Write down your maternal family history of menopause related disorders. Note if any major illnesses began specifically after menopause.
Make a list of all medications, as well as any vitamins or supplements that you're taking and the dosage.
Keep all of your records. It is very common that we tend to take menopause lightly. Though it is normal change of the body, it is important to have records of your diagnosis and treatment. Organize your records in a binder or folder that you can take to your appointments.
Consider taking a family member or friend along. As sometimes information provided by physician could be overwhelming

Questions to Ask - Patient Education

It is very important to understand various facts of menopause, as it is a permanent change in a woman's life.

Question About My Diagnosis

How long will menopause last?
What kind of tests might I need to determine if my symptoms are due to menopause or other disorder?
What could be expected complications with these changes in hormones?
What are the common disorders caused after menopause?
Can high blood pressure/cholesterol/diabetes affect menopause?

Questions About My Treatment

What treatments are available to minimize my symptoms? What are the side effects?
Do I have to see a psychologist to help with my mood swings?
How often do I have to visit my gynecologist after menopause occurs?
Will naturopathic medication like meditation help to reduce menopause symptoms?

Questions About My Lifestyle & Family

What steps can I take to maintain my health?
Is there any modification required in my routine life?
Should my diet change now that I am experiencing menopause?
Being a working woman, will menopause mood swings affect my work?
Can my post-menopausal disorders be passed to my daughter?

What to Expect - Patient Education Guide

The signs and symptoms of menopause are enough to tell most women they have begun going through the menopausal transition. If you have concerns about irregular periods or hot flashes, talk with your doctor.

In some cases further evaluation may be recommended. Learn more in this patient education guide.

Test	Why Test?	What Happens?	What is Normal/Abnormal?
Blood Test	Tests the level of FSH (Follicle Stimulating Hormone) which helps to evaluate an irregular vs. missing menstrual period.	Blood is drawn from vein of forearm or arm.	Past menopause level � 14 to 52 IU/L
Pelvic Exam	Risk of cancer increases with age, so regular pelvic exam is necessary.	Performed by gynecologists and regular physical check up is done for ovary, fallopian tube, uterus, cervix	Any abnormalities, like tumors or tenderness, can be detected and further tests can be ordered by doctor.
Bone Mineral Density Test (Bone Densitometry)	There is a direct relationship between the lack of estrogen after menopause and osteoporosis.	Usually the lumbar spine (lower back) and hips are examined using a low-dose X-ray machine called a dual-energy x-ray absorptiometry (DEXA) scan.	The density of bone is observed and compared with soft tissues, and also helps to predict risk of fracture.
Breast Self Exam and Mammogram	Risk of breast cancer increases with age.	Mammogram is performed by placing the breast between two clear plates to take an image.	Mammograms detect cysts and breast tumors. A self exam can help diagnose any early changes in the breast.

Common Treatments - Patient Education

There are several common medications available to help women cope with the effects of menopause.

Below is a chart of the most common treatments used.

Treatment Type	How it Works
Hormone Therapy	Relieves menopausal hot flashes
Low-Dose Antidepressants	Relieves menopausal hot flashes
Hot Flash Treatments	This drug is approved to treat seizures, but has been shown to significantly reduce hot flashes.
Non-Hormonal Medications	Prevents or treats osteoporosis These medications effectively reduce both bone loss and your risk of fractures.
Selective Estrogen Receptor Modulators (SERMs)	Beneficial effects on bone density in postmenopausal women, without some of the risks associated with estrogen
	Estrogen can be administered locally using a vaginal tablet, ring or cream. Relieves vaginal dryness and discomfort with intercourse and some urinary symptoms

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Menopause
Patient Education

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