MENOPAUSE
DEFINITION
Menopause is the cessation of menses (stopping of menstrual periods) for 12 consecutive months and is generally experienced in women between 45 and 55 years of age; however, some women may be earlier or later:
A.Menopause before the age of 40 is considered premature.
B.Induced menopause is the abrupt cessation of menses related to chemical or surgical interventions.
Perimenopause is the time preceding menopause and may last several years. The average age of onset is usually in a woman’s 40s but may occur earlier. Symptoms may occur during this time period because of fluctuations in hormone levels. Pregnancy may still occur during this time and reliable contraception should be used.
CAUSE
Menopause can be natural or induced. Natural menopause is a normal function of aging. Surgical or chemical intervention can result in induced menopause.
SYMPTOMS
Symptom occurrence and severity vary from very mild to moderate or severe. Symptoms may include the following:
A.Hot flashes.
B.Night sweats.
C.Insomnia.
D.Vaginal dryness.
E.Pain with intercourse.
TREATMENT
A.Plan of care: Your care provider will work with you to develop a plan of treatment that is based on your individual symptom pattern. Inform your care provider if you have:
1.Acute liver disease.
2.Cerebral vascular or coronary artery disease, myocardial infarction (MI), or stroke.
3.History of or active thrombophlebitis or thromboembolic disorders.
4.History of uterine or ovarian cancer.
5.Known or suspected cancer of the breast.
6.Known or suspected estrogen-dependent neoplasm.
7.Pregnancy.
8.Undiagnosed, abnormal vaginal bleeding.
B.Activity:
1.Regular physical exercise can be beneficial for weight reduction and symptom control.
2.Dress in layers to accommodate hot flashes and avoid warm areas.
3.Avoid hot showers and baths.
4.Regular sexual intercourse is encouraged, and you may use vaginal lubricants (K-Y Jelly, Astroglide, Replens) helpful for vaginal dryness.
C.Over-the-counter (OTC) products for vaginal dryness/pain with intercourse:
1.More prolonged foreplay increases natural vaginal lubrication.
2.Use a vaginal lubricant such as Replens, K-Y Jelly, Silk-E, or Astroglide prior to intercourse. Crisco oil is also a hydrogenated vegetable oil that is solid at room temperature and can be used effectively by applying to the posterior vaginal area prior to intercourse to help prevent pain. Place a small amount of Crisco oil in a decorative jar next to the bedside for use.
3.Use a moisturizer gel with lactic acid on a regular basis to decrease vaginal dryness and pain with intercourse. Luvena is a vaginal moisturizer and lubricant that can help to improve symptoms.
4.Do not use Vaseline as a lubricant.
5.Do not use contraceptive creams for lubrication; they often cause dryness (dehydration) and may worsen soreness.
D.Be sure to use a reliable method of birth control to prevent undesired pregnancy if you have had a period within 1 year.
Diet: You need to eat a well-balanced diet (three meals a day). Supplement your diet to achieve calcium 1,200 mg/d and vitamin D 800 IU/d. Avoid alcohol, caffeine, and spicy food as they may trigger hot flashes.
Medication:
You Have Been Prescribed: ___________________________________________________________
You Need to Take: ___________________________________________________________
You Need to Notify the Office If:
A.You experience unexpected vaginal bleeding.
B.Your symptoms worsen.
C.You are on hormone replacement therapy and you experience calf pain, chest pain, or shortness of breath; cough up blood; or have severe headaches, visual disturbances, breast pain, abdominal pain, or yellowing of the skin.
D.Other: ___________________________________________________________
Phone: ____________________________
PATIENT TEACHING GUIDE