Current and Future Trends of Menopause Therapy: An Expert Interview With Dr. Ivy Alexander

Ivy Alexander, PhD, ANP-BC

Medscape: What are the specific symptoms related to menopausal changes?

Dr. Alexander: There are many, and they vary for the individual woman. Most women will experience changes in their menses with irregular bleeding, either longer or shorter periods or longer or shorter lengths of time in between getting a period. Many women also have changes in flow and experience heavier or lighter periods.

Other really common symptoms include hot flashes, vaginal dryness, difficulty with sleep, irritability, and mood swings, although these last two are probably related to sleep disturbances. In addition, perimenopausal and postmenopausal women often complain of difficulty with their memory — cognition — and that is also usually related to sleep disturbances.^[1-3]

Additional symptoms related to menopause include things like acne, changes in skin tone, wrinkles and dryness, hair changes with dry or thinning hair, or changes in the character of the hair. For example, if the person’s hair was curly, it might be less so. Some women have difficulty with headaches, nervousness, anxiety, irregular heartbeats or palpitations, and urinary changes. Lastly, the vaginal dryness that is associated with menopause comes from vaginal atrophy and can cause pain and discomfort with sexual intercourse or sexual activity.

Medscape: Are these symptoms directly related to menopause or do comorbidities, such as diabetes or heart conditions, affect the types of symptoms perimenopausal and postmenopausal women experience?

Dr. Alexander: Several of the symptoms that occur in menopause are directly related to changes in the hormone levels in the woman’s body. These changes occur because the hormone receptors throughout the body are no longer bound with the hormone and, thus, cause symptoms.

Because some of these symptoms can also mimic other health problems, such as diabetes with blood sugar shifts, untreated high blood pressure, and thyroid disease or, in the case of mood disorders and sleep problems, depression, it can be difficult to determine whether it is menopause or some other health problem that is affecting a woman at midlife. Occasionally, the symptoms are related to menopause and also complicated with another condition. Once the diagnosis is made, treating and managing the other condition may significantly reduce the symptoms related to menopause, but they likely will remain to some degree. More info from this article

Decisions about surgery depend on many factors.

“This is just a roadblock on your way to successful living. You sort of have to figure out how you’re going to get around or get over that roadblock. Our goal with the surgery is to try to maximize the ability of the patient to function. We want to get them back to living. ”

Thomas Frazier M.D.

More info

This seems to be an on going problem for several patients. If the test results could change the course of you life, it would be a “kind” compassionate thing for your doctor to be able to get them to you timely.
How to accomplish is the trick. You can ask before you get the test done, how and when they will be notifying you. Also ask if there is anything you need to do to expedite this process, to reduce your stress.
Your Patient Advocate can also help you with this if they have a HIPPA release to act on your behalf.
CNN did an interesting article on this subject.
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Just finished an Interview with a New York TV, and magazine writer. She was doing an article on How to Choose Your Doctor. This discussion brought to my mind many interesting thoughts.
What are your ideas on how to choose a doctor?

My frustration is extremely high tonight with the health care system.  One of my patients just needed his PET scan results, to know if the cancer had returned.  His doctor’s office could not be bothered with calling him with the results… but left him to “wonderment”  over the weekend.  They just do not get it!  The patient’s stress and consternation could all have been eliminated with at 5 second phone call to say from his doctor’s office saying… you are fine.  He probably will not die of the cancer, but of  health care system induced stress!  My patient”s comment was ” I guess they are just not compassionate”.  I will be having a chat with the doctor’s office staff about this issue.  Hopefully  it will not happen again.

Always have a clipboard or a notebook, that you date each page.  That way you can go back to your previous visit notes and see what happened at the visit