Menopausal symptoms are not pleasant. Women often suffer through the hot flashes, the mood swings, the loss of libido and the vaginal dryness, not realizing that there may relief! And some symptoms, like increased headaches, gastrointestinal distress or depression, may not be obviously menopausal signs but can be directly related to a change in hormone levels.

Note these symptoms:

• Hot flashes, flushes, night sweats and/or cold flashes, clammy feeling
• Irregular heart beat
• Irritability
• Mood swings, sudden tears
• Trouble sleeping through the night (with or without night sweats)
• Loss of libido
• Dry vagina
• Pain during sex
• Crashing fatigue
• Anxiety, feeling ill at ease
• Feelings of dread, apprehension, doom
• Difficulty concentrating, disorientation, mental confusion
• Disturbing memory lapses
• Incontinence, especially upon sneezing or laughing; urge incontinence
• Itchy, crawly skin
• Aching, sore joints, muscles and tendons
• Increased tension in muscles
• Breast tenderness
• Headache change: increase or decrease
• Gastrointestinal distress, indigestion, flatulence, gas pain, nausea
• Sudden bouts of bloating
• Depression
• Worsening of existing conditions
• Increase in allergies
• Weight gain
• Hair loss or thinning on head, in pubic area, or over whole body; increase in facial hair
• Dizziness, light-headedness, episodes of loss of balance
• Changes in body odor
• Electric shock sensation under the skin and in the head
• Tingling in the extremities
• Gum problems, increased bleeding
• Burning tongue, burning roof of mouth, bad taste in mouth, change in breath odor
• Osteoporosis
• Changes in fingernails: softer, crack or break more easily
• Tinnitus: ringing in ears, bells, 'whooshing,' buzzing, etc.

Write it down and talk to your doctor

If you are experiencing any of these symptoms listed above, you are encouraged to keep a journal, writing down your symptoms and their intensity. Then, after journaling, make an appointment with your doctor. These health issues are all worthy of a discussion with your personal doctor!

Many women wonder which of their doctors will be the hormone doctor. This could be your GYN, your family doctor or an endocrinologist. Through appointments and discussions with your doctors, you will find the doctor who is interested in working with you, through multiple appointments if needed, to find the best hormone therapy and dosage for your needs.

Tweaking your hormone therapy

It's important to note that if you try one hormone therapy and find it doesn't seem to work, it isn't necessarily the kind of hormone that may be the problem. Instead it may be the dosage that needs tweaking. And it's also important to note that HysterSisters have found that it's important to try a hormone therapy for a month or so before changing to another kind or dosage.

Why? Our body's hormone levels fluctuate quite a bit, especially during the first few months post-op hysterectomy as our body systems are trying to find new balance.

Keep a hormone diary noting symptoms and level of intensity of suffering.

And given some time, as the symptoms become more consistent, this hormone diary should help your doctor work with you in altering your hormone therapy. Having patience through the process can be difficult, but the right HRT is worth the effort.

Hang in there! You do not need to suffer!

Whether you're experiencing menopause as a result of having your ovaries removed, or just entering natural menopause, your menopause journey will likely include some treatment choices. If you're choosing to use estrogen therapy for the first time, or thinking about trying a new option, there are questions you and your doctor will want to consider: How severe are your symptoms? Are you interested in an oral pill or a transdermal patch? Which option best fits with your active lifestyle? Do you prefer your estrogen from an animal or a plant source?

One of the major differences between pills and transdermal patches is how they deliver estrogen to your body. In short, a transdermal patch uses less estrogen than a pill does to manage your symptoms. Here's the science: When taken orally, estrogen has to pass through the stomach and then be metabolized by the liver before reaching estrogen-receptive tissue. During this process, a lot of estrogen is broken down and destroyed. So in order for your body to receive enough estrogen to relieve your symptoms, the dose in a pill has to be higher than the dose used in a transdermal patch.*

By passing estrogen directly through your skin into your bloodstream, avoiding your digestive tract and liver metabolism, a patch may begin controlling your menopause symptoms within 4 hours, with smaller total doses than pills.*

Talk to your doctor about your menopause treatment options.

If you have decided that you can't or you won't take hormone replacement therapy after menopause there is some work for you to manage your menopause symptoms. It is not just a matter of doing without HRT. You will need a battle plan to negotiate through your menopause symptoms of hot flashes, vaginal dryness and fatigue for your external symptoms. And don't forget the things going on that you may not be aware of until it is too late: protecting your bones and your heart.

Stay cool through hot flashes

Minimize hot flashes and night sweats using black cohosh which has estrogenic effects. Dress with layered, lighter clothing that can be adjusted through a hot flash. A "chillow" can be a helpful way to keep your bed a cool zone for those "night sweats". Keep a fan handy or a damp cloth to cool down your face and neck.

V Zone dryness

Vitamin E (in oil or cream) can be substituted for estrogen cream to treat vaginal dryness. There are also over the counter choices such as lubricants (Astroglide) or moisturizers (Very Private, Replens) available for vaginal dryness symptoms.

As you find ways to manage the obvious symptons of menopause, there are some other health concerns for women in menopause. Even if there is no apparent risk, one in two American women is at risk of breaking a bone after menopause due to osteoporosis. And one in three women after the age of 65 develops heart disease.

Protect your bones

Take a calcium supplement along with a supplement of vitamin D. Vitamin D is essential for calcium absorption. Check with your doctor or pharmacist when selecting a calcium supplement. Calcium citrate is a good choice as it is more easily absorbed.

Exercise regularly with a weightbearing exercise: walking, weight lifting with small weights or bands, bicycling. Swimming is not weightbearing.

Avoid drinking alcohol, caffeine and carbonated sodas as they increase bone loss.

Eat plenty of whole grains, fruits and vegatables.

Discuss with your doctor taking a bone strengthening medication which prevents or slows osteoporosis.

Protect your heart

Here we are again: Exercise regularly!

Eat a low-fat diet and avoid saturated fats.

Make sure you are eating foods high in omega 3 fatty acids (salmon, tuna, mackerel, herring) or take omega 3 supplements.

Keep your blood pressure and cholesterol at healthy levels.

Stop smoking!

Menopause can be negotiated without hormone replacement therapy but there are some difficulties and and challenges involved. Be sure and discuss your concerns and medical needs with your doctor. Stay cool! Stay healthy!

Besides the traditional estrogen therapy available, another option is available only at compounding pharmacies. Compounding pharmacies differ from other pharmacies. Although they dispense the same products that are prepared by pharmaceutical companies and sold at regular pharmacies, they also make customized prescription medications for patients.

Compounding pharmacists can prepare hormones for replacement therapy based on your needs, particularly if you have trouble swallowing pills. Working with your doctor based on symptoms you have (and in some cases, also based on hormone testing), the pharmacist can make your hormones not only in the strength and dose you need but also can make them in various forms. Common forms are creams, pills, troches (lozenges) and sublingual drops. This makes compounded prescriptions versatile and a good choice for women whose needs aren’t met by products available from conventional pharmacies. The raw hormones (estradiol, estrone, progesterone and testosterone) used in compounding are FDA-approved ingredients.

If you are interested in finding a compounding pharmacy near you, use the locator service from this link: http://www.iacprx.org. If there isn’t a compounding pharmacy close by, it is still possible to benefit from their services as many offer mail order delivery. A compounding pharmacist can guide your doctor on how to write the prescriptions. If your doctor isn’t willing to prescribe compounded hormones, referrals can be made for doctors who use the pharmacy’s services.

Noteworthy information: Patches and pills are certainly the easiest hormone therapy to try first, before compounding - especially those products deemed as "bio-identical." Compounded hormone therapy is an option if you have trouble with standard HRT. Be aware: most insurance companies do not cover compounded prescriptions.

I am 41 years old. My doctor suggested to start HRT right after the surgery, because of my age. I said no HRT for me! I felt good until last week, when the roller coster sucked me in! I have not been sleeping for a week, because the hotflushes at night.Of course my mood swings are up to the sky. I am exhausted all day of course and I am up and down. So I changed my mind; my doc gave me three samples.

Join the Discussion

More Discussions to join about hormones and menopause:

Should I refuse HRT? (Endometriosis)

I can't keep my estrogen where it needs to be....

3 1/2 months post-op and LOST in the jungle!

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