Annual Checkups After Menopause – A Change of Focus

with Sandra Gottwald, M.D., obstetrician/gynecologist with Advanced Healthcare.

Last Updated: May 1, 2003

Referred to in the heated moments associated with a hot flash as “the change,” menopause can mean a major adjustment and life change for some. For others, it is a uniquely liberating proposition, one where a woman feels free to explore a new side of life.

Menopause, or “mid-life,” is the time when a woman experiences her last period. Technically, that means that her ovaries have stopped releasing eggs. Just prior to menopause, hormones may fluctuate wildly, and a myriad of symptoms like hot flashes, decreased vaginal lubrication, sweating, headaches, achy joints, mood swings and insomnia can become an unpredictable part of life.

It’s estimated that 10% to 15% of American women experience no symptoms of menopause while another 10% to 15% have a much more extreme experience. Regardless, the symptoms associated with menopause can be daunting and uncomfortable. While most women have begun to experience cycle changes as early as age 35, once menopause is fully underway, a gynecologist can provide a number of options and suggestions during an annual exam.

Annual exams important
Dr. Sandra Gottwald, an obstetrician/gynecologist with Advanced Healthcare, said that the average age for menopause is 52, plus or minus two years. If a patient is experiencing symptoms of menopause, Gottwald typically explains the physical aspect and the changes in the body that are prompting the symptoms to occur. She explains the risks during and after menopause as well as options for therapy, like hormone replacement. “Hopefully, I can help my patients make that ever-elusive, informed choice,” she said.

Annual exams for a menopausal woman include yearly mammograms, a cholesterol profile, blood pressure monitoring and colonoscopy (once every ten years). Gottwald said that colon cancer has moved into second place behind lung cancer and in front of breast cancer as the cancer with the highest death rate. “We are seeing a higher incidence of breast cancer, but also, the death rate (from breast cancer) has gone way down,” she said.

For women who wish to use herbal remedies for menopause, Gottwald said most are not approved by the Federal Drug Administration and could interact with other medications and have side effects. There are, however, a few non-hormonal products, like vitamin E, that are recommended for things like hot flashes.

“Most herbal or homeopathic remedies are plant based,” she said. “People think they are safer because they’re not a hormone, but many aren’t. Many are phytoestrogens, which means they are metabolically converted to estrogen in the body and can have the same effects.

“As we age, women should be aware of a number of health risks and healthy living routines,” Gottwald added. The risk of osteoporosis becomes greater during menopause and increases with age. While hormone replacement can help, non-hormonal therapies, like Fosamax (a bisphosphanate) and weight-bearing exercise, are good also. Gottwald recommends a pneumonia vaccine at age 65 (good for ten years) along with an active lifestyle. When woman reach their 70s and 80s, Gottwald encourages both physical and mental activity. She recommends reading and doing crossword puzzles along with taking vitamins for memory loss.

If you feel you are approaching menopause, the best thing to do is to discuss your symptoms with your OB/GYN during an annual exam. Together, you can create a plan to help the transition to mid-life be as smooth as possible.

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