What role can endocrinologists play in the medical care women need as they approach and experience menopause?
They help patients address conditions associated with glands, which are responsible for producing estrogen (among other hormones). And during menopause, there is marked decrease in the production of estrogen, the female sex hormone responsible for the development and regulation of the female reproductive system. For some women, it can set off a series of symptoms that need attention.
Beverly Tchang, M.D., assistant professor of clinical medicine in the Division of Endocrinology, Diabetes, and Metabolism at NewYork Presbyterian / Weill Cornell Medicine, shares five things women need to know about the menopause-endocrine connection.
Though all women will undergo the loss of estrogen and menstrual changes, the symptoms of menopause vary. Some women might have all of the “typical” symptoms--hot flashes, difficulty sleeping, memory problems, mood disturbances, vaginal dryness, and weight gain. Some women might not.
Weill Cornell Medicine physicians understand that a tailored, comprehensive approach to helping women in menopause often means engaging a team of specialists--obstetrics/gynecology, endocrinology, psychiatry, cardiology, etc.--to address medical needs. That strategy requires more coordination and more thought--and leads to better outcomes.
Menopause is natural and normal, but it does not need to be uncomfortable. We encourage patients to discuss symptoms with us, particularly if they are disruptive to your routine. (And we can help determine whether symptoms are, in fact, due to menopause or something else.)
Women experiencing menopausal symptoms prior to age 40 might be experiencing early menopause, which needs to be evaluated by a physician.
Sometimes we recommend lifestyle changes, like reducing stress and incorporating more exercise, to alleviate menopausal symptoms. But we understand that we are often not in full control of our day-to-day activities or time.
Medication can help. Hormone replacement therapy, for example, can be an effective option that addresses many of these symptoms. And vaginal estrogen creams are available to treat vaginal dryness, which can contribute to painful sex or urinary tract infections.
Studies on weight change in menopause vary, and often conclude that weight does not change pre- and post-menopause. But many women disagree.
We understand that, over time, we tend to lose lean muscle mass and gain fat, which can accumulate in the central abdominal area, so the end result is no change in weight. But: Abdominal fat or a waist circumference greater than 35 inches is associated with an increased risk of conditions such as type 2 diabetes and cardiovascular disease. We suspect that one of the culprits of the change in body composition is due to the general reduction in activity as we age.
When it comes to nutrition, no specific diet has been proven to "balance hormones" in menopause. Women may find that certain foods or beverages, like spicy foods or red wine, can worsen some menopausal symptoms, such as hot flashes. We do advise women in menopause to be mindful of their dietary calcium and vitamin D intake, because the loss of estrogen causes bones to weaken and increase the risk of fracture.
I recommend physical activity of any level to everyone--man or woman, pre-, peri-, or post-menopause--because of its multiple benefits, including reducing stress and improving mood. Walking 30 minutes a day for five days a week can help prevent weight gain. Even shorter bouts of activity, like seven-minute workouts or walking for two minutes every hour, has been associated with health benefits.
October is World Menopause Month and we here at Weill Cornell Medicine deliver the highest level of care at every stage of life, from adolescence to childbearing, to menopause and the post-menopausal years. Our team of North American Menopause Society Certified Menopause Practitioners focus on preventative care and patient education, empowering you to achieve your optimum level of health. Schedule your appointment today.