Menopause

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UT Southwestern’s team can assist women in navigating the changes of menopause. Depending on a woman’s age, symptoms, and medical needs, experts in reproductive endocrinology, menopausal hormone therapy, and vulvar and bladder health are available for consultation.

What Is Menopause?

Menopause is a natural biological process that marks the end of a woman’s menstrual cycles and reproductive years, defined as 12 consecutive months without a period. In the United States, the average age of menopause is 51, but menopause can also occur much earlier, either by natural causes or by surgical removal of the ovaries.

Premature menopause is diagnosed in women under the age of 45 and premature ovarian insufficiency (POI) is diagnosed in women under age 40. Both of these conditions should prompt medical management.

Women over the age of 45 who are experiencing menopausal symptoms may also benefit from treatments that can range from hormonal therapy to lifestyle modifications.

At UT Southwestern, we believe menopause offers a unique time when physicians and patients can discuss and initiate preventive, life-enhancing health care strategies to emphasize graceful aging. Wellness during this transition period begins with a positive attitude and healthy behaviors, including a balanced diet and regular exercise.

What Are Menopausal Symptoms?

The months or sometimes years leading up to menopause are called perimenopause. Symptoms may include:

Irregular periods
Hot flashes
Night sweats
Sleep problems
Mood changes
Weight gain
Thinning hair and dry skin
Vaginal dryness and painful sex
Anxiety/palpitations
Joint pain

What Services Are Available for Menopausal Women at UT Southwestern?

Our multidisciplinary approach to helping women with menopause can include:

Consultations to accurately diagnose and treat menopause and menopause-related conditions
Pelvic examinations and cervical cancer screening as indicated
Screening for breast cancer
Bone density and ultrasound testing
Hormone therapy as well as nonhormonal options
Advanced reproductive technologies for women who desire pregnancy but have low ovarian reserve or ovarian insufficiency
Evaluation and minimally invasive surgery for postmenopausal uterine bleeding

What Is Hormone Therapy?

More than 10 million women in the United States use some form of hormone therapy.

Systemic or “whole body” estrogen therapy is FDA approved to treat vasomotor symptoms such as hot flashes and night sweats, as well as to prevent osteoporosis. Women who start estrogen therapy within 10 years of the onset of menopause may experience other benefits. However, there can also be some risks depending on the type of estrogen prescribed and the addition of other hormones, such as progestogens.

Vaginal estrogen therapy involves very low doses, has a proven safety record, and is effective in treating menopausal vaginal and bladder symptoms. It does not treat vasomotor symptoms or provide bone protection.

How Does Menopause Affect Bone Density?

The hallmark of menopause is the loss of ovarian estrogen production. Estrogen helps prevent bone resorption, or breakdown, but does not build bone. Women can lose up to 10% of bone mass within five years of menopause. Brittle bones can have a big impact on health and quality of life as a woman ages and can lead to frailty fractures.

A bone density (DXA) scan is a quick, easy way to assess skeletal health and fracture risk. We recommend that women get a baseline DXA scan around the time of menopause and monitor every few years depending on results and risk factors.

Adequate calcium intake (1,200 mg per day from all sources, including diet and supplements) plus 2,000 international units (IU) of vitamin D3 daily helps to build bone. So does weight-bearing exercise, such as walking, jogging, yoga, Pilates, weight lifting, and resistance bands. Getting adequate protein in a diet to maintain muscle mass, which diminishes during menopause, is also important.