Experts say menopause can put women at increased risk for a condition that can lead to pain during sexual intercourse. Mayo Clinic's Dr. Juliana Kling explains why and says there are safe and effective treatments.

Watch: The Mayo Clinic Minute

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Vaginal dryness

As reproductive years come to an end, estrogen levels drop. That can lead to one of the most common symptoms of menopause, vaginal dryness. "Postmenopausal women are at risk for developing something called the genitourinary syndrome (GSM), where there are changes to the vagina and the vulva that cause dryness. This can increase your risk of urinary urgency, as well as a risk of urinary tract infections.

Vaginal dryness can also lead to pain with intercourse. "I can't tell you how many women I see that just think pain with intercourse is a normal part of aging. I'm here to tell you that is not the case," says Dr. Kling. "You should not have pain with intercourse."

Treatments

The good news is there are safe and effective treatments for vaginal dryness. "The low-dose vaginal estrogens can be used if you're just having vaginal symptoms, like dryness and urgency. Those are safe and won't increase your risk of heart attack, stroke, blood clot or breast cancer," says Dr. Kling. "So even older women can consider starting those and really using those indefinitely." Other treatments include oral medications like ospemifene and over the counter vaginal moisturizers.

Dr. Kling recommends checking with your clinician to help determine which treatment is right for you.

Related posts:

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• Mayo Clinic study puts price tag on cost of menopause symptoms for women in the workplace
• Mayo Clinic Minute: Menopause and the heart connection

The post Mayo Clinic Minute: Menopause and sexual health appeared first on Mayo Clinic News Network.

SCOTTSDALE, Arizona — Menopause, the end of menstrual cycles, can produce symptoms such as hot flashes, night sweats, insomnia and mood changes. Women do not need to suffer in silence: Many treatment options are available. Jewel Kling, M.D.,  chair of the Division of Women’s Health at Mayo Clinic in Scottsdale, Arizona, describes hormonal and nonhormonal therapies.

"We sometimes hear the question, 'Do I need to treat hot flashes or night sweats?' and the answer for many may be, 'Yes,'" Dr. Kling says. "Because hot flashes and night sweats affect quality of life and productivity at work and at home for women.”

Hormone replacement therapy is an estrogen medication; for women with a uterus, hormone therapy typically includes estrogen plus progestogen medication to prevent endometrial cancer. For women younger than 60 or within 10 years after their final period, the benefit of hormone therapy outweighs the risk in healthy women with postmenopausal symptoms, according to recent guidelines from the North American Menopause Society.  

“Many factors affect a woman’s decision whether to use hormones and if she uses them, which particular regimen is best to relieve her symptoms,” Dr. Kling says. “Common factors  considered include age, underlying health, symptom severity, preferences, available treatment options, and of course, cost considerations. One important consideration is whether the potential benefits outweigh the potential risks.”

Among benefits:

• Many studies have shown that systemic hormone therapy such as a pill, patch, gel or spray, helps with hot flashes, night sweats, and vulva vaginal symptoms, Dr. Kling says.

There’s also strong evidence that long-term treatment with estrogen therapy or estrogen plus progestogen therapy reduce the risk of fractures after menopause.

“Along with these benefits often comes improvement with menopause-related symptoms, including those most likely bothersome, including disturbed sleep, mood problems, and diminished sexual satisfaction,” Dr. Kling says. “Addressing these symptoms can lead to a better quality of life.”

Among risks:

• With oral systemic estrogen therapy or estrogen plus progestogen therapy, risks include blood clots in the legs and lungs, and stroke.

“Stroke is dependent on the age at which a woman starts hormone therapy. Specifically, the risks are low for women younger than 60 or within 10 years after their last period,” Dr. Kling says. “There do not appear to be the same risks associated with transdermal estrogen products such as patches, particularly when we use lower doses.”

• Use of estrogen alone by women who have a uterus carries a risk of uterine cancer; that risk can be lowered by including progestogen or an estrogen selective estrogen receptor modulator, also known as the SERM (selective estrogen receptor modulator) combination.

• Breast cancer risks should also be considered, and appear slightly higher, particularly in women with a uterus who use estrogen plus a progestogen.

“However, overall, the risk of serious events with hormone therapy are rare,” Dr. Kling says. “For women with only vaginal symptoms, low-dose vaginal estrogen can be used. Low-dose vaginal estrogen does not have the same risks as systemic therapy because the body absorbs very little.”

Hormone therapy generally isn’t an option for women with breast cancer, other hormonally mediated cancers or blood clot issues, and other women may simply wish to avoid hormone therapy, Dr. Kling says. There are many nonhormonal therapies ranging from mind-body techniques to medication that can bring relief with few or no side effects:

• There is some evidence that losing weight may reduce hot flashes and night sweats.
• Among medications, low-dose paroxetine has been shown to help some women with symptoms such as hot flashes. At low doses, it doesn't appear to cause weight gain or have adverse sexual effects.
• In some cases, antidepressants may be appropriate, and the health care practitioner and patient will weigh benefits and risks, Dr. Kling says.
• Mind-body techniques include cognitive behavioral therapy and clinical hypnosis, both of which depend on expert guidance for success, Dr. Kling says. Some patients have found relief from acupuncture, yoga and meditation.

"There are many ways to help women deal with the discomfort and diminished quality of life associated with menopause," Dr. Kling says. "Women don't need to simply tough it out. They can get help."

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About Mayo Clinic
Mayo Clinic is a nonprofit organization committed to innovation in clinical practice, education and research, and providing compassion, expertise and answers to everyone who needs healing. Visit the Mayo Clinic News Network for additional Mayo Clinic news.

Media contact:

• Sharon Theimer, Mayo Clinic Communications, newsbureau@mayo.edu

The post Menopause symptoms: Mayo Clinic expert outlines hormone and nonhormonal therapies appeared first on Mayo Clinic News Network.

Listen: Mayo Clinic Radio 12/28/19

On an encore Mayo Clinic Radio podcast, Dr. Shanda Blackmon, a Mayo Clinic thoracic surgeon, explains how advances in surgical techniques are improving outcomes for patients. Also on the podcast, Dr. Eric Moore, a Mayo Clinic otolaryngologic head and neck surgeon, shares treatment options for head and neck cancers. And Dr. Jewel Kling, a women's health expert, shares nonhormonal treatment options for menopause symptoms.

The post #MayoClinicRadio podcast: 12/28/19 appeared first on Mayo Clinic News Network.

Chest surgery, also known as thoracic surgery, formerly involved "cracking open the chest," which requires a large incision, cutting through muscles, and a crank to spread apart the ribs in order to access the organs. But advances in techniques, including minimally invasive procedures and the use of 3D models, are improving the way chest surgery is performed. Minimally invasive surgery can be performed through small incisions. This approach to surgery has many benefits for patients, including less damage to the muscles, less pain, fewer complications and a shorter hospital stay than with open surgery. 

On an encore presentation of Mayo Clinic Radio, Dr. Shanda Blackmon, a Mayo Clinic thoracic surgeon, will explain how advances in surgical techniques are improving outcomes for patients. Also on the program, Dr. Eric Moore, a Mayo Clinic otolaryngologic head and neck surgeon, will share treatment options for head and neck cancers. And Dr. Jewel Kling, a women's health expert, will share nonhormonal treatment options for menopause symptoms.

To hear the program, find an affiliate in your area.

Use the hashtag #MayoClinicRadio, and tweet your questions.

Mayo Clinic Radio is on iHeartRadio.

Access archived shows or subscribe to the podcast.

Mayo Clinic Radio produces a weekly one-hour radio program highlighting health and medical information from Mayo Clinic.

The post Innovations in surgery improve outcomes for patients appeared first on Mayo Clinic News Network.

On an encore presentation of Mayo Clinic Radio, Dr. Shanda Blackmon, a Mayo Clinic thoracic surgeon, will explain how advances in surgical techniques are improving outcomes for patients. Also on the program, Dr. Eric Moore, a Mayo Clinic otolaryngologic head and neck surgeon, will share treatment options for head and neck cancers. And Dr. Jewel Kling, a women's health expert, will share nonhormonal treatment options for menopause symptoms.

To hear the program, find an affiliate in your area.

Miss the show? Here's your Mayo Clinic Radio podcast.

Use the hashtag #MayoClinicRadio, and tweet your questions.

Mayo Clinic Radio is on iHeartRadio.

Access archived shows or subscribe to the podcast.

Mayo Clinic Radio produces a weekly one-hour radio program highlighting health and medical information from Mayo Clinic.

The post Mayo Clinic Radio: Innovation in surgery / head and neck cancer / nonhormonal treatments for menopause appeared first on Mayo Clinic News Network.

On the next Mayo Clinic Radio program, Dr. Shanda Blackmon, a Mayo Clinic thoracic surgeon, will explain how advances in surgical techniques are improving outcomes for patients. Also on the program, Dr. Eric Moore, a Mayo Clinic otolaryngologic head and neck surgeon, will share treatment options for head and neck cancers. And Dr. Jewel Kling, a women's health expert, will share nonhormonal treatment options for menopause symptoms.

To hear the program, find an affiliate in your area.

Miss the show? Here's your Mayo Clinic Radio podcast.

Use the hashtag #MayoClinicRadio, and tweet your questions.

Mayo Clinic Radio is on iHeartRadio.

Access archived shows or subscribe to the podcast.

Mayo Clinic Radio produces a weekly one-hour radio program highlighting health and medical information from Mayo Clinic.

The post Mayo Clinic Radio: Innovation in surgery / head and neck cancer / nonhormonal treatments for menopause appeared first on Mayo Clinic News Network.