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Why Women Do Not Discuss Perimenopause / Menopause With Their Healthcare Providers
Of the many women who experience menopause/early menopause in the U.S., only two-thirds of them talk about their symptoms and other health-related issues to their general providers. Nearly one-third of women in the U.S. over the age of 45 do not discuss their health problems or other more personal issues with their doctors. Many women do not seek treatments or medications to help alleviate their menopausal symptoms.
Why Do So Many Women Refuse to Talk to Their Doctors About Their Perimenopause / Menopause Symptoms?
When menopause occurs, women go through a series of bodily changes: weight gain, skin problems, issues regarding sexual intercourse. With these changes, women often feel too embarrassed to speak to their general providers about how best to go about resolving these issues.
In a survey of 3,197 adult women, participants were asked to assess their experiences and attitudes concerning menopause. The survey found that nearly three-quarters of the participants experienced the following six symptoms during perimenopause/menopause: hot flashes, issues sleeping, mood swings/general irritability, decreased mental clarity, night sweats, and weight gain. Of the women who took this survey, one-third of them reported they had good sexual health. Another one-third of the participants reported that they never discuss their menopause-related health issues (primarily sexual health issues) with their doctors.
With this lack of communication between patients and general care providers, it can be difficult for women to understand what they can do to combat menopausal symptoms and achieve relief. In order to diminish the embarrassment associated with menopausal health, it is vital to understand the most common experiences the female body goes through across the board.
Sexual Discomfort
Sexual discomfort encompasses a variety of issues like decreased libido, vaginal dryness, and pain during sexual intercourse. The underlying cause of these symptoms stems from a drastic change in hormones.
As women reach menopause, there is a natural drop in estrogen levels, making it more difficult to become sexually aroused. This decrease of estrogen, in turn, lowers the supply of blood flow to the vagina and causes the vagina's natural lubricant to lessen. This phenomenon is called vaginal dryness.
When vaginal dryness occurs, it can be challenging for women to engage in sexual activity, particularly penetrative sex. The natural lubricants that help coat the vagina decrease, making the friction of sexual penetration highly irritable. Without this lubrication, the lining of the vagina becomes extremely sensitive, and sex becomes painful.
Of the many sexual related issues that come with menopause, the most significantly reported issue is a decrease in libido. Women who once had regular, active sex lives find themselves withdrawing from engaging in sexual activities. This decrease in libido is often described as a form of fatigue when preparing to engage in sexual intercourse. This withdrawal can lead to tension between partners and can often strain relationships.
Hormonal Issues: Weight Gain
Imbalances in hormonal levels affect more than just sexual arousal. The decrease in estrogen also affects female metabolism. A form of estrogen, estradiol, is responsible for regulating metabolism and overall body weight. As estradiol decreases, the body's ability to burn through fat cells decreases, even with regular exercise. As a result, weight loss during menopause becomes challenging.
Introducing new diets and exercise regimens can help maintain muscle, joint, and cardiovascular health. However, if weight loss is the overall goal, then treatments meant to help balance hormones are the best solution to achieving that goal.
Hormonal Issues: Mood Swings
Estrogen's effect on the body impacts more than weight and arousal; it also affects mood. Mood swings among menopausal women are one of the most commonly researched and reported symptoms. Nearly 70 percent of women report experiencing irritability during perimenopause. These women state that they find themselves being easily irritated by things that they would otherwise ignore. Their patience becomes lessened, and their interpersonal relationships suffer from it.
Women experience more than irritability as they go through menopause. Some women experience depression, anxiety, unexpected crying, and some experience extreme insomnia. Similar to irritability, these conditions all stem from drastic decreases in estrogen.
One in five women cites having depressive episodes during perimenopause and a few years into their menopausal transition. Many women experience hyper-anxiety during menopause and panic attacks under stressful situations. Between forty and fifty percent of women experience insomnia during menopause. Without proper estrogen regulation, these mood swings can become more intense.
What to do?
Given this information, what can women do to help alleviate the discomfort they feel when talking to their general care providers about their health problems during menopause?
1) Identify your symptoms
Half of the battle resides in understanding what symptoms are present. Start with the most common symptoms: mood swings, hot flashes, fatigue. Then move on to the more specific symptoms: vaginal dryness, fluctuating weight, or extreme weight gain in a short period. Once you've identified these symptoms, consult a doctor.
2) Learn how to describe your symptoms
As women go through menopause, sometimes they experience these symptoms at varying degrees, making it difficult to pinpoint whether or not they are genuinely experiencing these symptoms. Additionally, some women may experience specific symptoms more than others or have preexisting conditions that exacerbate menopausal symptoms. The key to maintaining the best health is to identify and describe symptoms. With this knowledge, it will be easier to talk to a doctor about these issues.
3) Don't be afraid to ask questions
When uncertain about the possible symptoms that could arise, ask a general care provider about what can be expected during menopause. What symptoms are likely to be present? How severe can perimenopause symptoms be? How do pre existing conditions affect menopause? What are the forms of treatment that are best for menopause? What are some possible side effects of those treatments?
4) Confidentiality is key
Remember that nothing leaves the doctor's office. Discussing sensitive, often embarrassing topics is part of a general care provider's job. Vaginal dryness is not the strangest health-related issue a general care provider has helped treat. Personal health is of utmost importance. A general care provider will help treat any menopausal issue without making their patients feel ashamed or embarrassed.
5) Do some research
Menopausal experiences are different for every woman. Research can be a helpful tool for understanding menopausal symptoms, causes, treatments, and medications. There is a multitude of academic research available to women going through menopause. These studies have been conducted to adequately explain how menopause affects the body and how current treatments can be improved to provide the most relief.
Understanding how the body changes throughout the different stages of menopause may help guide lifestyle changes, future treatment options, and provide some ease of mind before discussing it with a general care provider. For information on some of these symptoms during menopause, the following studies can lend some insight into how estrogen affects the body and how its decrease can change overall mood.
- A new, female-specific irritability rating scale
A research study meant to help measure irritability during all stages of menopause.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2440789/
- Postmenopausal syndrome
A study with a focus on mood swing management and treatments that can aid with menopausal depression.
