While the clinical definition of menopause is the point where a woman has gone 12 months without a menstrual cycle, those who have experienced it know that it's far more than that.
“Menopause is a very unique experience for each woman,” said Gretchen McCreless, MD, gynecologist at Ascension St. Vincent’s Women’s Health. “Women can experience symptoms like hot flashes, trouble sleeping, skipping periods and weight gain for months or years before they are officially in menopause.”
Dr. McCreless is the only doctor in Birmingham, Alabama to hold a Certified Menopause Practitioner certification through The Menopause Society. She was inspired to get this menopausal certification after experiencing disappointment with the care her mother was receiving for menopause.“I just felt that we can do better, so I started researching and came upon The Menopause Society,” said Dr. McCreless. “I knew there was a need for better understanding of this clinical phenomenon that every woman in her 40s and 50s is experiencing, so it was important to me to do everything I could to learn more and be better able to help women.”
Irregular menstrual cycles can be a symptom of perimenopause
Dr. McCreless explains that the journey to menopause starts, for many women, in their 40s with what is called perimenopause. This time can be marked by menstrual cycles that were once normal that begin to become more irregular. It is a time when women begin to experience hot flashes, night sweats, trouble with sleeping, dysregulated mood, and generally not feeling like themselves. While Dr. McCreless says there is no actual treatment for perimenopause, it is often a time for women to really take notice of the changes their bodies are starting to experience, having a conversation with a provider about them, and not waiting until symptoms begin to disrupt everyday activities.
“I have a lot of patients in their 40s who opt to go back on birth control, who haven’t taken it in years, just because that helps to stabilize their hormones during that transition period,” said Dr. McCreless. “I have other patients who are adamant about not waiting to take birth control, but they’re willing to take hormones, so we are able to do a cyclic patterning of estrogen and progesterone to help, again, to stabilize their hormones.”
Dr. McCreless says that any changes in menstrual cycles are worth a conversation with a provider. She cautions women in perimenopause to be aware of skipping cycles and urges those who have to see a doctor to confirm that there is not another hormonal issue causing the missed periods.
“I have seen a big increase in women in their 40s coming to see me as they start to realize their body is changing, and I think that’s the perfect time for us to meet and start to discuss their health history,” said Dr. McCreless.
Treating menopause with hormone replacement therapy
Once a woman is diagnosed with menopause, Dr. McCreless believes hormone replacement therapy (HRT) is a great treatment.
“Historically, hormone replacement therapy has gotten a bad wrap, but when you look at the historical studies, you realize that the data was tracking an older patient population,” said Dr. McCreless. “But in fact women in the earlier years of menopause were not having the same complications and were actually seeing tremendous benefit.”
McCreless says there has been a cultural shift recently in understanding the data on HRT, and that in 2022, the Menopause Society released guidelines that state that for women in the first 10 years of menopause, HRT should be considered because it improves bone health, heart health, and general wellbeing of patients experiencing menopausal symptoms.
The future of menopause medication
In addition to HRT, Dr. McCreless suggests women explore other types of treatment, including over-the-counter remedies, as well as a variety of prescription medications. She shares that there is new medication hitting the market that targets the area of the brain that is responsible for hot flashes that has her excited about the future of menopause medicine and understanding.
“I think for so long the culture has been to think that hormones are bad or that women need to just tough this part out, but that’s certainly not the case,” said Dr. McCreless. “One of the more rewarding things I hear is how hormone treatment has literally changed a patient’s life. The common theme I hear from patients is ‘I finally feel like myself again.’”
Personalized menopause care for women
The healthcare needs of women are unique. Your doctor at Ascension St. Vincent’s Women’s Health provides care for life, including screenings right for your age and health history, care for menopause symptoms and gynecologic concerns. Talk to a doctor today about menopause care and management for symptoms by calling 205-939-7800.