Women, Hormones and Aging
Say the word “menopause” and some women might cringe at the thought of how their bodies will respond to their changing hormones, in those years leading up to their final monthly period. Hot flashes, trouble sleeping, migraines, loss of libido, vaginal dryness, weight gain, mood swings: It’s not a pretty picture. But each person’s experience is different—some women may not feel much change at all, while for others the discomforts are so severe they seek treatment as they go through this natural hormonal change of life…which brings us to Deana Sferra who lives in Warren, Ohio with her husband and lots of pets.
Sferra is a blonde ala Marilyn Monroe and she looks fresh and peppy, even at 5 o’clock after a full day of work at the local police station.
She lives in a roomy house with a wooded backyard, full of deer, chipmunks, and even a fox family that she feeds.
SFERRA: And then I have a little garden and a lot of flowers, so I sit on my deck at night and watch all the little critters roam, and it’s kind of nice.
But life hasn’t always been so calm for Sferra and those around her. When she hit her 50s, she noticed changes to her body:
SFERRA: Getting old is not for the weak: it’s a pain, it’s itchy, it’s grouchy, it’s dry skin, it’s gaining weight, it’s being tired.
For Sferra, getting older also brought on more pressing health concerns.
She was laid up with severe migraines, and as anyone who has experienced one can attest:
SFERRA: They’re so brutal.
In addition to the migraines, Sferra found she was losing her cheerful self:
SFERRA: And I’m not a depressed person--I get the blues, everybody does, but after a while they go away, but this was a depression that it seemed like I couldn’t get out of.
It got so bad that she finally realized:
SFERRA: This isn’t me, and there’s got to be help out here.
Sferra turned to her doctors at Cleveland Clinic’s Center for Specialized Women’s Health, and what she learned is that changing hormone levels could be the root of her problems.
VOLKAR: In the years approaching menopause, we have a lot of hormonal fluctuations
Dr. Judith Volkar, one of Sferra’s physicians at Cleveland Clinic
VOLKAR: The hormones that come from our pituitary gland change from day to day and sometimes from hour to hour.
Most women hit menopause—defined as the phase of life when there is no menstrual period for at least a year—around their early 50s. The ovaries wind down as we age, and the body’s reproductive hormones—including estrogen—diminish.
These hormonal fluctuations can cause a range of symptoms—everything from the serious to the seriously annoying. Dr. Volkar:
VOLKAR: The classic symptom of menopause is the vasomotor symptom which is known as the hot flash or the night sweats.
A hot flash is a sensation of warmth that starts from the waist and works its way up the body. Blood vessels enlarge, causing redness in the face and sometimes sweating. It’s an exceptionally uncomfortable feeling, says Volkar, and having several hot flashes a day can really interfere with a woman’s life.
When women come to Dr. Volkar with symptoms such as frequent hot flashes, night sweats, heart palpitations, and more severe concerns like Sferra’s migraines and mental health, she doesn’t hesitate to explore the possibility of using hormonal replacement therapy.
VOLKAR: I have no issue giving out hormone replacement therapy; I myself am on hormone replacement therapy and I think that the safety and efficacy has been looked at in detail.
It used to be common to relieve menopausal symptoms with hormone therapy, but
that practice came into question when the National Institutes of Health published a study from their Women’s Health Initiative. The study connected the therapy with an increased risk of heart disease and breast cancer. Women became, understandably, fearful of the medication.
However—a point that’s gotten a little lost--the therapy is still deemed appropriate for certain women, especially those in their 40s and 50s who are dealing with severe symptoms in the years leading up to menopause.
Cleveland Clinic gynecologist Judith Volkar says that often patients are concerned about starting on hormonal therapy:
VOLKAR: They have been lead to believe that hormone replacement therapy is dangerous so I think I need to allay their fears with good evidence-based medicine.
Deana Sferra is a prime example of a good fit for hormone therapy—she was experiencing severe symptoms and didn’t have other risk factors.
SFERRA: We started out slow and I’ve felt great ever since.
But going on hormones during menopause doesn’t make sense—and isn’t necessary—for all women. Many manage “the change” with alternative approaches that run the gamut from herbal teas, to plant based creams, yoga, lifestyle changes or anti-depressants.
One final note - Hormones, like estrogen, have profound influence on the body, and we feel it when they change, on both a mental and physical level. But menopause isn’t a disease, it’s not an excuse, it’s not a label—it’s simply a date in time that marks a woman’s natural aging process.