What we know about menopause is changing: It can start years earlier

What we know about menopause is changing
Modern science helping women through menopause

Menopause: You could call it a "sensitive" subject. After all, it seems that unlike the proverbial “birds & bees” chat, our mothers didn’t talk much about this milestone in our lives.

Ohio State University Wexner Medical Center obstetrician/gynecologist Cynthia Evans told me there’s good reason for that.

“I think part of that is because they don’t know anything about it,” she said.

The bottom line on menopause is that we are simply outliving our natural lifespan.

In other words, we live past those years and on into our 90's and with those additional years, some things change. Beverly Justice knows all about it.

Here’s what she had to say about having hot flashes when she was 37 years old: “It just feels like you have an internal fire inside of you and it's trying to break out.” Anxiety, mood swings and depression followed.

The married mother said her doctor prescribed hormone therapy which didn’t work. Justice called the experience horrifying.

“I had leg cramps and they would wake me up at night in screaming pain."

While health care providers used to turn to hormone therapy as a first resort most now personalize treatment for their patients and recognize that hormone therapy isn’t for all.

Dr. Michelle Birkenholz of OhioHealth Grant Medical Center said hormones can be safe with the right indications.

"The goal with hormone replacement therapy is to put you on the lowest dose for the least amount of time," she said.

There are nonhormonal options that Dr. Birkenholz recommends to her patients with the caveat that natural doesn’t necessarily mean safe.

Beverly Justice chose the what is called natural hormone pellet therapy which is available at Restorative Health in Central Ohio.

Dr. Vernon Reynolds who is the Medical Director at the Dublin Center described them as like what the body produces.

“We have an extraction process though the pharmacies that obtain this through Chinese yams and different sources that are more natural for you," he said.

Justice said the pellets, which are implanted in her hip, have raised her energy level and eliminated her hot flashes.

One other option is to get a referral to a compounding pharmacist who will essentially customize treatments for patients targeting hormones for which they are deficient.

The American College of Obstetricians and Gynecologists described compounded bioidentical hormones as made by a compounding pharmacist from a health care provider’s prescription and available in various routes of administration, including oral, sublingual, as implants, injectables, and suppositories.

Bob Wood the Registered Pharmacist who runs Integrative Hormone Consulting, said the mood change and other symptoms in perimenopause are real.

“I’d rather go the route of fixing the hormones and get those balanced because that’s going to do a cascade of good when you get those balanced," he said.

More information about menopause from the North American Menopause Society.