Many women have hot flashes, which can last for many years after menopause, according to the National Institute of Aging. In fact, up to 80 percent of women will experience hot flashes associated with menopause. These are known as vasomotor symptoms (VMS), which are characterized as sudden and intense sensations of heat throughout your body. It may be accompanied by sweating, reddening of the skin, chills, and rapid heartbeat. Hot flashes can also be mild or strong enough to wake you up (called night sweats). Most hot flashes last between 30 seconds and 10 minutes and can happen several times an hour, a few times a day, or just once or twice a week.
Despite the prevalence of hot flashes, and the number of people who undergo menopause (an estimated 1.3 million women in the U.S. alone enter menopause every year), there’s still a negative stigma associated with it. As a result, women aren’t receiving the proper care or attention to address the symptoms associated with menopause, which also include vaginal dryness, mood changes, sleep problems, weight gain, and slowed metabolism to name a few. So, why is there a stigma surrounding it? The short answer is that menopause makes women feel old, undesirable, and invisible, says Dr. Tara Allmen, Board Certified Gynecologist in NYC and Author of Menopause Confidential. And that’s why there’s a level of shame associated with it and its symptoms.
The impact of menopause
In addition to the stigma associated with menopause, VMS can also impact many aspects of women’s lives, including sleep, the ability to focus, and personal relationships. “The most common symptom in menopause that 80% of women will endure are hot flashes and night sweats,” says Dr. Allmen. “This will lead to poor sleep and therefore increase fatigue, foggy brain, and affect their mood while diminishing their interest in sex. Vaginal health will be affected. Their vaginas will become drier so sex will become painful. Their interest in making good lifestyle choices will also decrease, which will impact their weight.”
There are a lot of myths surrounding menopause, one being that life (and your sex life) is over, which is simply not true. “One of the greatest misconceptions surrounding menopause is that life is over or that you’ll never have great sex again,” says Dr. Allmen. There’s also the idea that you’ll never be able to lose weight, that you’re old, or that you’ll never feel like yourself again. It’s understandable that you’ll be going through an array of emotions during this time, but one thing to remember is that being in your 40s or 50s does not make you old. There are an array of women in their 50s who have never looked better and when you think about what comes after menopause such as no periods (this also means no PMS symptoms) and less pelvic pain, it can give you a new outlook on this next life phase.
Another misconception is that yes, hot flashes may be a nuisance, but “that’s okay.” “They’re not just a nuisance,” says Dr. Jane Minkin, a clinical professor in the Department of Obstetrics, Gynecology, and Reproductive Sciences at the Yale University School of Medicine. “There are studies that show that hot flashes can be associated with increased risks of heart disease, bone loss, or all these other things that can go along with menopause and that’s why we don’t want to ignore them.”
A doctor’s role
Another reason there seem to be fewer people talking about menopause and its symptoms is because there are fewer doctors treating it, according to Dr. Minkin. The culprit? In 2002, the Women’s Health Initiative study was released, which showed that hormone replacement therapy had more detrimental than beneficial effects. This essentially led to a mistrust of hormone therapy and estrogen among women.
“A lot of obstetrics and gynecology residency programs in the United States stopped teaching menopause management,” says Dr. Minkin. “If you had anybody who trained in obstetrics and gynecology finishing their residency less than 20 years ago, they weren’t trained in menopause, so they learned nothing about medical management.” She adds, “It’s not their [the student’s] fault, but we have a lot of people suffering because of it.” Dr. Minkin does offer some good news, however. “Hot flashes do tend to get better over the course of time,” she says. “It’s not instantaneous, and the average duration of hot flashes is about 7.4 years, but it does tend to get better—it’s not 7.4 years and misery for most people.”
A changing landscape
There haven’t been a lot of medical breakthroughs for hot flashes in the last 20 years, but Dr. Minkin says that’s about to change. “Estrogen has certainly been the mainstay of therapy and it still works—it’s an excellent remedy for hot flashes,” she says. “There are some herbal/over-the-counter, non-hormonal medications and alternative therapies which can be helpful.” She adds, “There is also a brand new drug coming out. It’s non-estrogenic and works extremely well. We are hoping that will be available this coming year.” A major misconception is that there are no treatments for hot flashes. There may have been a time when it was brushed off by doctors, but “we can come up with concoctions and combinations which can really be quite helpful to women symptomatology-wise,” says Dr. Minkin.
Ending the stigma
In order to end the stigma, we need to encourage and empower women to take charge of the rest of their lives. “Let’s give everyone permission to say aloud, ‘I need help. I don’t feel well,’” says Dr. Allmen. “This is a normal part of life that we need to talk about. If all women had the what to expect when you’re not expecting talk at the age of 40 to help them understand the journey ahead of perimenopause and menopause, they would be less confused, less fearful, less miserable, and know what choices are available, whether lifestyle or medication, to help them have an easier time with the transition and find symptom relief.”
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