Dallas' Advanced Women's
Climacteric and Menopausal Care
at Cohen Center
The period in life beginning with the onset of hormonal, psychological, emotional and physical changes and ending at the menopause (last menses), called the climacteric period, is a normal biological change in the life of a woman. During this time symptoms of hot flashes, irritability, insomnia, mood changes, vaginal dryness, pain during intercourse, loss of libido and general inertia may affect the quality of life and productivity of many women. These symptoms may range from mild to moderate or severe with a major loss of productivity and quality of life of the individual.
Over the past fifty years there have been many studies related to the diagnosis and management of these mid-life disorders.
At least two-thirds of women have significant problems during this change in their lifetime. Many may be helped by individualized assessment and tailored treatment designed to alleviate their personal symptoms.
An individualized assessment includes a lifestyle review, medical and family history, and particular evaluation of conditions such as elevated blood pressure, cholesterol and lipids, prior thrombosis or thromboembolism, and previous breast cancer. A family history of osteoporosis is also an important consideration. The patient is checked, counseled and advised of the cost-risk benefit of hormonal therapy and alternate agents to help the individual make her own personal informed choice.
An individualized treatment plan is intended to assist in removing the causes of the patient¡¯s symptoms and ensuring an adequate change in lifestyle and restoration of her quality of life together with preparation and prevention of many disorders which would occur in later years.
T he menopause is a good time for personal re-evaluation of the above and the institution of a modified positive lifestyle together with medical treatment to ensure the best quality of life in future years.
Women under the age of fifty have different needs to those under the age of sixty. In women over seventy, particular caution must be exercised in consideration of commencing any form of hormonal replacement therapy, which has more risks and is rarely necessary at this age.
Treatment options include assessment, exclusion of medical contraindications and the initiation of hormonal replacement therapy when indicated. The main objective is to use natural estradiol and progesterone as frequently as possible in a normal rhythmic manner. Hormonal treatment with estrogens and male hormones (testosterone given orally and/or topically as a vaginal cream) and the use of allondronate, to strengthen bones, which may be given weekly monthly or as an intravenous infusion, are backed by adequate intake of calcium, vitamin D and vitamins. The use of folic acid, vitamin B-6 and vitamin B-12 for general cardiovascular and mental health and advice regarding dietary, lifestyle and exercise modifications should help facilitate a long and healthy life.