Search this site
Article Listings
Active Living
Full Listing with story descriptions
A Healthy Balance
Ankle Sprains
Active Kids, Healthy Kids
Active Kids in Winter
Athletic Skin Infections
Children, Nutrition and Exercise
Beat the Heat!
Cold Comfort
Cold Weather Workouts
Concussion in Sport
Core Stability
Cross Country Skiing
Exercise and Disabilities
Exercise and Menstrual Irregularities
Exercise in the Heat
Exercise is Medicine
Exercise Options
Exercising in Pregnancy
Exercising in Pregnancy
Female Athletes
FITT Prescription
Footwear for Running
From Surviving to Thriving
Gadgets and Gizmos
Get Moving!
Get Motivated
Golf Exercises
Golf Injury Prevention
Head Injuries
High Intensity Interval Training (HIIT)
Hockey Injuries
Home Gyms
Jump Start Weight Loss
Knee Cap Pain
Knee Ligament Injuries
Live Actively
Low Back Pain
Osteoporosis and Exercise
Osteoarthritis of the Knee
Plantar Fasciitis
Prehistoric Workout
Recreational Safety Equipment
Safe Snow Shovelling
Shin Splints
Ski Conditioning
Sore Elbow
Sore Shoulder
Spinal Cord Injuries
Staying Active
Staying Fit in the Cold
Sports Nutrition and Supplements
Strength Training
Swimming Injuries
Teen Sports Injuries
Water and Exercise
Weight Training
7 Wonders of Walking
Adolescent Health
Full Listing with story descriptions
Adolescent Behaviour Problems
Adolescent Growth and Development
Body Image
Body Piercing
Chronic Diseases in Teens
Communications Skills
Concussion in Sport
Cosmetics and Skincare
Dangers of Artificial Tanning
Depression - Causes
Drug Use
Female Physical Exam
First Period
Internet Safety
Junior High
Mentoring to Quit Smoking
Parent-Teen Communication
Parent -Teen Interaction Patterns
Personal Care
Psychological Assessment
School Problems
Self Esteem
Self Esteem and Body Image
Sexually Transmitted Diseases
Talking About Sex
Taking Chances
Teaching Respect
Teens and Smoking
Teenage Blues
Teen Bedwetting
Teen Drivers
Teen Girls
Teen Health
Teen Immunization
Teen Independence
Teen Rebellion
Teens and Divorce
Teenagers and Sexual Issues
Teens and Exercise
Water and Exercise
A Woman's Physical
Your First Job
Youth Violence
Ask the Doctor
Aspirin Every Day?
Cost of Doctor's Visit
Does My Sore Knee Require an MRI?
Do I Need a Bone Density Test?
Do I Need an Annual Physical?
My Doctor Says I Need a Test
My Doctor Diagnosed Osteoarthritis
Restore Your Core
Should I Exercise During pregnancy?
Vaccination Controversies
Full Listing with story descriptions
Advice from the Maternity Clinic
Advice from the Maternity Clinic (Part 2)
Alcohol in Pregnancy
Building a Better Baby
Birthing Etiquette
Birth Plans
Birthing Procedure Trends
Bleeding in Pregnancy
Blood Pressure
Breastfeeding Benefits
Caesarean Section by Request
Care for the New Mother
Cord Blood Banking
Delaying Motherhood
Blue after Baby or Postpartum Depression
Diabetes in Pregnancy
Eating Well for Pregnancy
Evolving Ideas about Pregnancy and Birth
Exercise in Pregnancy
Is it Safe to Exercise During Pregnancy
Fetal Alcohol
Flying During Pregnancy
Folic Acid in Pregnancy
High Blood Pressure in Pregnancy
Getting a latch on breastfeeding
Group B Streptococcus
Induction of Labour
Infections During Pregnancy
Intrauterine Growth Restriction (IUGR)
In-Vitro Fertilization
Low Birth Weight Babies
Maternity and parental leave
Medication and Pregnancy
Managing Your Own Labour
Monitoring Your Labour
Nausea and Vomiting in Pregnancy
Pain Relief in Labour
Prenatal Classes
Preterm Labour
Planning a Pregnancy
Prenatal Care Providers
Postpartum Repetitive Strain Injuries
RH Disease
Rupture of Membranes Before Labour
Sex During Pregnancy
Skin Changes in Pregnancy
Smoking and Pregnancy
Support During Labour
Travelling While Pregnant
Ultrasound for Fun and Photos
Natural Remedies in Pregnancy
Pregnancy Weight Gain
Vaccinations During Pregnancy
Vacuum and Forceps for Delivery
Vaginal Birth After Caesarean
When Baby Comes Home
Full Listing with story descriptions
Asthma in Children
Attention Deficit Disorder
Bedtime Battles
Bed Wetting
Childcare Options
Children's Headaches
Childhood Obesity
Choosing A Babysitter
Colds and Flu
Common Childhood Skin Infections
Developmental Milestones
Diaper Rash
Daytime Wetting
Developmental Co-ordination Disorder
Feeding Your Baby
Feeding Your Toddler
Head Lice
How Children Grow
Hearing Loss
Hearing Issues in Newborns
Heart Murmers
Hip Clicks
Is it an Emergency?
Children and Sports Injuries
Lazy Eye (Amblyopia)
Learning Disabilities
Leg Problems
Preparing for Lab Tests
Red Rashes
RSV-Childhood Respiratory Virus
Safe Summer Fun
Sick Toddler
Sleep Struggles
Sniffles, Fevers, Rashes and Coughs
Introducing Solid Foods
Sore Throats
Speech Problems
Strep Throat
Toddler Safety
Tooth Injuries
Travelling with Children
Urinary Tract Infections
Vaccination and Autism
When to go to the Doctor
Whooping Cough
Worried Sick
Yeast Infections in Children
Chronic Pain
Full Listing with story descriptions
Managing Your Pain
Movement Matters
Moving Forward
Pain Medications
Returning to Work
Understanding and Goal Setting
When Pain Doesn't End
Dental Health
Full Listing with story descriptions
Antibiotics and Dental Surgery
Baby Bottle Tooth Decay
Baby Teeth
Bad Breath (Halitosis)
Children's Dental Injuries
Choosing a Dentist
Cosmetic Dentistry
Mouth Guards
Dental Exam
Dental Care Devices
Dental Caries
Dental Implants
Dental X-Rays
Dentures and Healthy Jaw
Esthetic Dentistry
Fluoride Findings
First Dental Visit
A Healthy Mouth
Healthy Mouth, Healthy Body
Jaw Joint and Muscle Problems
Keeping it Clean
Laser Use in Dentistry
Oral Cancer Screening
Oral health and long term care
Oral Health Care Products
Orthodontist First Visit
Painless Dentistry
Periodontal Disease
Removable Dentures
Root Canal
Seniors Oral Care
Sensitive Teeth
Sore Mouth, Aching Jaw
Snoring and Sleep Apnea
Teeth for Life
Temporomandibular Disorders (TMD)
Tobacco Risks to Oral Health
Tongue Piercing
Tooth Whitening
Travel Dentistry
Water Fluoridation
Wisdom Teeth
Your Healthy Smile
Full Listing with story descriptions
10,000 Steps
A1C Test
A Diabetes Success Story
ABCs of Diabetes Management
Alternate Site Testing
Artery Health
ASA Therapy
Benefits of Insulin
Benefits of Breakfast
Blood Glucose Medications
Blood Glucose Myths
Blood Glucose Testing
Blood Sugar Lows
Blood Glucose Monitors
C-Peptide Testing
Canada Food Guide Revisited
Carbohydrate Counting
Catastrophic Drug Plan
CDA Guidelines for Diabetes
Celiac Disease and Diabetes
Celebrating Health
Childhood Diagnosis of Diabetes
Children and Type 2 Diabetes
Cholesterol-lowering Medications
Colds and Diabetes
Continuous Blood Glucose Monitoring
Cutting Edge
Dangers of Uncontrolled High Blood Pressure
Driving and Diabetes
Diabetes and Menopause
Diabetes Care Team
Diabetes and Depression
Diabetes Distress
Diabetes Eating on a Shoestring Budget
Diabetes Etiquette
Diabetes and Oral Health
Diabetes and Thyroid Disease
Diabetes and Your Mouth
Diabetes and Your Eyes
Diabetes in Cats
Diabetes in Dogs
Diabetes Management ABCs
Diabetes Meter Technicians
Diabetes Myths
Diabetic Ketoacidosis
Diabetic Retinopathy
Diet Tips for South Asians
Dining Out with Diabetes
Drinking and Diabetes
Eating Disorders
Easing the Strain of Stress
Eating Mindfully
Eating to Protect Your Kidneys
Eating Well During Shift Work
Eggs in a Diabetic Diet
Emotional Eating
Emotions of Diabetes Diagnosis
Erectile Dysfunction
Exercise Excuses
Why Fad Diets Fail
Fill Your Day with Energy
Diabetic Retinopathy
Food Temptation
Foot Care
Foot Health
Footwear and Foot Health
Fruits and Veggies
Gestational Diabetes
Get Active
Get Physical
Gift Ideas
Glucose Meters
Glycemic Index and Glycemic Loads
The Glycemic Index
Going Green in the Kitchen
Going Home from the Hospital
Grocery Shopping Tips
Holiday Party Survival Guide
Health Information on the 'Net
Healthy Happy Holidays
Healthy Beverage Choices
Health Benefits of Soy
Healthy Restaurant Meals
High Blood Pressure and Diabetes
High Blood Pressure
HbA1c Test
Healthy Eating for Active People
High Blood Lipids
Home from the Hospital
Home Alone and Sick
Hypoglycemic Unawareness
Impaired Glucose Tolerance
Immunization and Diabetes
Incretins-a Hormone Treatment
Injecting Insulin
Insulin Discovery-The Story
Insulin Handling
Insulin - the Key to Energy Management
Insulin Pumps
Insulin Pen Needles
Insulin Pump Infusion Sets
Insulin Pump Therapy
Immunization and Diabetes
Internet Health Sites
Islet Cell Transplantation
Kidney Disease - Reducing the Risk
Living Powerfully with Diabetes
Low Blood Glucose
Managing Diabetes
Managing Blood Glucose
Mental Health and Diabetes
Nutrition Food Labels
Meal Planning
Your Medication Expert
Medication Research Studies
Metabolic Syndrome
New Diabetes Technologies
Natural Medicines and Diabetes
No Need for Insulin?
Not Snoozing
Oral Health and Diabetes
Osteoporosis and Diabetes
Diabetes and OTC Medications
Pedicure Precautions
Pain of Walking - Peripheral Arterial Disease
Pet Diabetes
Planning for Pregnancy
Prebiotics and Probiotics
Preparing for Activity
Putting off Insulin
Reducing Stress of Surgery
Safe and Successful Travel
Schizophrenia and Diabetes
Setting Health Goals
Setting Goals for Physical Activity
Sharps Disposal
Shorter Insulin Needles
Sleep - a Missing Link
Smart Snacking
Smart Summer Nutrition
Snack Bars
Snacking with Diabetes
Social Media and Diabetes
Stress and Diabetes
Success in School
Supporting Spouse with Diabetes
Sugar, Carbs and Blood Glucose Control
Think Positive with Diabetes
Tiny Bites Equal Big Calories
Travelling with Diabetes
Tips for a Better You
Tobacco Use and Diabetes
Top 10 Reasons to Exercise
Treating Low Blood Glucose
Treating Hypoglycemia - Role of Glucagon
Tune up Your Diet
Type 1.5 Diabetes
Type 2 Diabetes
Understanding Diabetes
Understanding Diabetes Medications
Urinary Incontinence
Vacationing with Diabetes
Vegetarian Eating for Diabetes
Vitamin D
Wonderful Water
World Diabetes Day
Working Toward a Cure
Your Medicine Cupboard
Zimbabwe Hand Jive
Family Medicine
Full Listing with story descriptions
ADHD in Children
Allergic Rhinitis
Antibiotic Use
Aspirin Every Day?
Back Pain
Back Pain Myths
Back Pain - Lower
Birth Control
Bladder Problems
Blood Transfusions
Breaast and Prostate Cancer Screening
Carpal Tunnel Syndrome
Colon Cancer Screening
Contact Lenses
Diabetes Management
Diagnostic Tests
Doctor Visit
Driving Vision
Dealing with Dry Eyes
Electronic Medical Records
Eye Exam
Family Doctor
Floaters and Flashes
Food Poisoning
5 Ways to Stay Healthy
Get Active!
Healthcare Teams
Heart Health
Hepatitis C
Human Papilloma Virus
High Blood Pressure
How to Talk to Your Doctor
Irritable Bowel Syndrome
Joint Replacement Surgery
Kidney Disease
Lazy Eye Blindness (Amblyopia)
Medical Digital Technology
Multiple Sclerosis
Multiple Myeloma
Opioid Myths
Primary Healthcare Reform
Prostate Problems
Quitting Smoking
Red Eyes
Respiratory Tract Infections
Screening Tests
Special Diagnostic Tests
Sports Eye Injuries
Stopping Stroke
Urine Tests
Win by Losing
Urinary Incontinence
Urinary Tract Infections
Vision Flickers
First Aid
Full Listing with story descriptions
Bites and Stings
Cuts and Scrapes
Emergency Care Guidelines
Eye Injuries
Fainting and Convulsions
First Aid Travel Kit
Hypothermia and Frostbite
Poisoning - Household
Growing Older
Full Listing with story descriptions
Advance Care Plans
Age-Related Macular Degeneration
Alzheimer Disease
Avoiding Memory Loss
Building Strength
Caring for the Caregiver
Can I see Well Enough to Drive?
Congestive Heart Failure
Coping with Dementia
Controlling Medications
Diagnosing Dementia
Dementia and Agitation
Dizziness (Vertigo)
Eating Well
Elder Abuse
Exercise Benefits
Erectile Dysfunction
Eye Care
Eyesight and Driving
Fungal Nail Infections
Get Active!
Have Health, Will Travel
Health Tips for Seniors
Joint Replacement
Lab Tests
Living Longer With Diabetes
Macular Degeneration
Male Menopause (Andropause)
Maintaining Quality of Life as You Age
Memory Loss
New Corneal Treatments
Nutrition for Seniors
Parkinson Disease
Problem Gambling
Prostate Health
Seniors and Medications
Senior Sexuality
Sexually Transmitted Infections
Screening Tests
Seniors and Driving
Skin Structure
Skin Protection
Skin Over 50
Solving Sleep Issues
Staying Healthy
Stroke Prevention
Travel Tips for Snowbirds
Wills and Personal Directives
Modern Living
Full Listing with story descriptions
Adult ADHD
Aging and Memory
Alcohol and Your Health
Anger Management
Barbecue Basics
Bathtub Safety
Binge Drinking
Bisphenol A
Canada's New Blood System
Caring for a Loved One Dying at Home
Carpal Tunnel Syndrome
Computer Stress
Coping With Change
Cosmetic Surgery
Cosmetic Pesticides
Diabetes Epidemic
Diseases from Pets
Dying at Home
Erectile Dysfunction New Treatments
Exotic Travel
Fertility Issues
Fetal Alcohol Spectrum Disorder
Foodborne Illness
Flu Pandemic
Healing Through Music
Healthy Computing
Ice Safety
Indoor Air Quality
Mature Student
Melamine in Food
Middle Age Health
Mind-Body Connection
Mom Time
Money Matters
Outdoor Workers and Sun Safety
Patient Safety in the Hospital
Pets and Health Benefits
Pet Therapy
Physiotherapy Visit
Planning for End of LIfe
Reproductive Freedom
Safe Drinking Water
Smokeless Tobacco
Sexually Transmitted Diseases
Stigma of Mental Illness
Street Drugs
Stressed or Depressed?
Stress in the Workplace
Stress Leave
Swim to Survive
Time Management
Travel Health Protection
Travel Comfort Tips
Travel Immunization
Understanding Change
Wind Chill Index
Workplace Drug Testing
Workplace Health
Full Listing with story descriptions
5 Myths about Nutrition and Diabetes
5 Tips to Manage Weight
10 Ways to Cut Down on Fat
Battle the Bulge
Boost Your Bone Strength
Body Image
Breakfast is Important
Bowel Health
Building Your Bones
Celiac Disease
Challenging the Milk Myth
Diet Reality Check
Drink Up!
Eating Smarter and Cheaper
Energy Drinks
Food Allergies
Food for Active Kids
Fast Food
Food Labels
Giving Up Gluten
Healthy Diet, Healthy Smile
Healthy Eating for Boomers and Zoomers
Healthy Eating for Seniors
Healthy Eating on Business Travel
Healthy Ethnic Meals
Fad Diets
Fruits and Veggies - 5-10 a Day
Fat Phobias
Fats and Cholesterol
Feeding Your Kids
Food Chemistry 101
Food and Mood
Getting Kids to MOVE
Healthy Eating for Teens
Healthy Habits
Herbal Medicine and Nutrition
New Ingredients for Your Shopping Cart
Kid's Food
Liquid Candy
Meal Planning with Planned Overs
Meal Planning for Busy Families
Mercury Levels in Fish
Night Snacking
Night Shift Eating
Nutrition on the Net
Nutrition Myths Busted
Nutrition Questions Top 5
Nutrition for Menopause
Essential Omega-3
Preventing Cancer Through Nutrition
Picky Eaters
Power of Fruits and Veggies
Portion Control
Power Lunch
PMS and Nutrition
Preparing for Surgery
Reducing High Blood Pressure
Replacement Meals
Sensible Snacking
Sodium and Blood Pressure
Sports-Minded Nutrition
Sugar Substitutes
Survive and Thrive
Teen Nutrition
Tips for a SuperDiet
Understanding Food Biotechnology
Vacation Eating
Vitamins D
Vitamins and Minerals
Vegetarian Diet
Weight Loss Wisdom
Weight Loss
Weight Wise Tips
Pharmacy Care
Full Listing with story descriptions
After a Heart Attack
Adverse Drug Reactions
Adult Vaccinations
Allergy Attack
Antibiotic Overuse
New Anticoagulant Medications
Inhaled Asthma medications
Arthritis Medications
Biological Response Modifiers
Blood Pressure Monitoring
Blood Thinners
Calcium and Iron Supplements
Changing Role of the Pharmacist
Children's Cold Remedies
Child's Fever
Choosing Sunscreens
Cold Relief
Cold Sores
Constipation and Haemorrhoids
Diuretics and Potassium Supplements
Drug Recalls and Withdrawals
Drug Interactions
Emergency Contraception
Erectile Dysfunction
Expanding Role of Pharmacies
Eye Protection - Sunglasses
Feminine Hygiene
Generic or Name Brand?
Heart Health
Kids and Cold Medications
Medication Questions?
Metabolic Syndrome
Natural Medicines
New Blood Thinners
Non-Steroidal Anti-Inflammatory Drugs
Obesity Medication
Over-the-Counter Drugs
Over-the-Counter Pain Relievers
Over-the-Counter Drugs and Pregnancy
OTC Pain Relief
Packing Medications for Travel
Pharmaceutical Studies
Preventing Summer Hazards
Research Studies
Quit Smoking
Skin and Cosmeceuticals
Sports and Nutrition Supplements
Taking Medication
Take as Directed
Using Antibiotics Wisely
Vitamin D
Yeast Infections
Your Best Shot
Your Medicine Cupboard
Full Listing with story descriptions
Accident Prevention
Antibiotic Resistance
Backpack Pain
Bacteria Fight Back
Disaster Planning
Diseases from Pets
Cell Phones and Driving
Childhood Obesity
Cancer Prevention Tips
Chronic Disease Prevention
Cold and Flu Season
Disaster Planning
Diseases from Pets
Distracted Driving
Farm Safety for City Kids
Foodborne Illness
Flu Pandemic
The Flu and You
Heading Home for a Visit
Health Tips for Snowbirds
Hearing Loss and Music Players
H1N1 Virus - Plan Ahead
Household Mould
Infection Control
Injury Prevention
Live Actively!
Insect Repellant
Keys to Preventing Cancer
Kids' Mental Health
Live Actively!
Low Birth Weight
Are Pesticides Safe?
Preventing Burns and Scalds
Preventing Cancer through Nutrition
Quit Smoking 101
Respiratory Infections
Seniors and STIs
Should You Immunize?
Sun Safety
Surviving Disaster
Sushi Preparation
Teens, Drugs and Driving
Travel Health Considerations
Travel Medicine 101
Travel Tips
Type 2 Diabetes Prevention
Water Smarts
Vision Damage
Water Wisdom
West Nile Disease
Whooping Cough
Workplace Alcohol Abuse
Women's Health
Full Listing with story descriptions
15 Great Reasons to Breastfeed
Approaching Menopause
Birth Control
Breast Cancer Screening
Breast Cancer - Genetic Risks
Breast Cancer Self-Exam
Breast Cancer Screening Guidelines Changes
Breast Health
Breastfeeding Myths
Cervical Cancer Screening
Contraception for Mature Women
Cosmetic Procedures
Estrogen's Effect on the Brain
Fear of Fracture
Heart Attack
Hirsutism - Unwanted Hair
Hormone Replacement Therapy
Menopause - What Men Should Know
Menopause and Your Moods
Menstrual Bleeding - Abnormal
Menstrual Bleeding - Heavy
Menstruation Myths
Menstrual Pain
Third Generation Birth Control Pills
Ovarian Cancer
Ovarian Cysts
Oral Contraction (The Pill)
Pap Test
Premenstrual Syndrome
Sexually Transmitted Infections
Urinary Incontinence
Varicose Veins
Viagra for Women
Yeast Infections
Your Pelvic Floor
[an error occurred while processing this directive]
spacer   spacer pharmacy image pharmacy
Family Health Magazine - WOMEN'S HEALTH

What men should know

Men whose partners are at or beyond the time of menopause may want to support and understand their partner as she experiences this natural process commonly called “the change of life”. It is not a disease and for the most women the transition to the end of reproductive life is fairly smooth. This article will explain the process of menopause so women and their male partners can understand and discuss the physical changes and other problems that may occur. Knowledge and good communication between partners will help men provide the support needed during this time.

What is menopause?

Menopause literally means the end of menstruation. This occurs when the supply of eggs that the women is born with runs out. At the same time, there is a decreased level of hormones that had been released as the eggs matured. This process begins several years before the final menstrual period.

As sex hormones decrease, fertility declines. Periods become less predictable and the short term effects such as hot flashes can be a nuisance. The possible long term problems involve bones, the heart and other organs of the body.

What problems with periods occur before menopause?

Few women just stop having periods. More that 80 percent begin to have irregular periods as the ovaries produce fewer sex hormones. Some women fear these are a sign of some disease, particularly cancer. A family doctor or gynaecologist can usually put these fears to rest and no treatment is needed.

For a few women, bleeding may be heavy enough to cause anemia and undermine their health. The bleeding can also be embarrassing if, for example, they bleed through their clothing. The problem generally goes away as menopause approaches but it can make life difficult. In the past, hysterectomy was the solution but now new methods can be used. One way is to destroy the lining of the uterus by balloon therapy. That and other simple day surgery procedures can end the problem or reduce the bleeding to tolerable levels. Hormone medications are effective treatment for abnormal bleeding but some women do not want to take the medication for a long time. A quick surgical “fix” is often seen as the answer.

What hormone replacement and other drugs are used in menopause?

The most effective way to control the problems of menopause is through estrogen. Most studies show that hormone replacement therapy (estrogen together with progesterone for those women who have a uterus) gives women a better quality of life. The chances of heart disease and osteoporosis at an early age are reduced. Hormone replacement also appears to decrease the risk of colon cancer.

For some women, use of hormone replacement is not advised because of a family history of breast cancer. For others, fears and uncertainties about the hormones make them hesitant to use them. Many women prefer to put up with the hot flashes rather than risk the perceived dangers of treatment. In Western Canada, only about 15 per cent of women take estrogen and the average length of treatment is about two years. This is too short to gain any long term benefit.

The reasons behind this reluctance are complex. For some women, breast cancer is a major concern. For others, taking hormone replacement is seen as not natural. There may be some unpleasant side effects and often the return of periods.

Women do not find it easy to make a decision about long term hormone replacement and the decision need not be hurried. For many women the process is not a weighing of risks and benefits, it is a balance of hopes and fears. The woman's decision should be made consciously and not by default. Not knowing or understanding the benefits and risks of medications remain major problems.

To provide reassurance, a doctor can monitor health and other worries that the woman may have. Medications can be adapted to her needs (not the other way around). The range of pills, patches, gels and creams means there should be something for everyone. Some non-estrogen drugs (Dixarit™, Provera™, Megace™ and Aldomet™) can reduce the frequency of hot flashes but often cause side effects.

Doctors know about prescription medications but not necessarily about health food store remedies. These remedies vary in quality. They may have unknown ingredients and often little information is known about their effects or their dangers. This lack of data often makes their use difficult to support. When doctors do not recommend such a treatment it is usually because they do not see enough evidence that it works. When shown to be effective, some herbal remedies may be recommended.

What are hot flashes and related changes?

More than 85 per cent of women have hot flashes and night sweats around menopause. These can begin before the final period and often continue for up to two years after menopause. One quarter of women have hot flashes for five years or more.

When the hot flashes occur at night, sleep is disturbed. Even without hot flashes, changing hormone levels interfere with a woman's sleep. The restlessness of a sweaty, sleepless partner can interfere with the man's ability to sleep. This in turn can make both partners irritable and insensitive. By knowing this, they can both try to be more understanding when tensions arise.

Hot flashes are a natural event over which a woman has little control. However, there are a few things she can do to ease them. They are made worse by hot environments, alcohol, spicy food, hot drinks and anxiety. A woman who knows this can try to avoid these situations.

Plant extracts that contain substances called isoflavones, soy for example, can reduce hot flashes. The difficulty is that their use requires a major change in eating patterns and less is known about potential side effects.
Plant estrogens are usually called "phytoestrogens" and their use is increasing. A common misconception is that if the substance is natural it is safe. Most of the knowledge about soy, ginseng and other substances that contain estrogen is not scientific. Increased research will help determine their safety and effectiveness, and set quality controls. If you want to take them it would be prudent to discuss their use with your family doctor or pharmacist.

What sexual difficulties may develop?

There is no reason why sex should not continue many years beyond menopause. This includes both vaginal intercourse and other sexual activity. A common cause of change in intercourse in a relationship is the male partner's loss of interest or his ability to obtain and maintain an erection. The recent success of Viagra™, used to improve erections, provides clear evidence about the high frequency of male sexual dysfunction.

This does not mean women don't have difficulties. When the ovaries stop producing hormones, the lining of the vagina becomes dry. It is more likely to be injured during intercourse, causing pain. Lubrication in response to sexual stimulation is slower and less certain than in younger women. Just when men have an erection that may not last long, their wives need more time to respond. Vaginal dryness is a common problem that can usually be solved by a partner's patience and use of lubricants such as Replens™. Hormone replacement, including locally in the vagina, can help.

Even when sex has been a healthy part of the relationship, a woman's sexual enjoyment depends on many factors. If physical pleasure has decreased or intercourse is painful, it is not surprising that her enthusiasm for sex and ability to have an orgasm begin to fade. Hormones have less effect on sex drive in women than in men but if the small amount of male hormone in her body falls too low, she may lose interest in sex. Treatment with testosterone can improve a woman's desire and her sense of general well being also.

What about mood changes?

An unkind portrait of women at menopause shows them with mood swings out of control. They go from angry to happy to sad without obvious reason. Lack of estrogen, hot flashes and difficulty sleeping all have some effect on mood but there are other factors.

The loss of reproductive function is a major life change. For some women, this is a symbol of the end of a useful life as wife and mother. For some it seems to herald the inevitable decline into old age. Other factors that can influence mood include children leaving home, aging parents making demands, or a spouse's attitude. Often middle-age men can be grumpy because they are losing their own dreams for success or have physical failings. The physical and emotional stresses of this time may well be reflected in a change in mood.

Hormones help to some degree but practical and emotional support help much more. If the problem is a long standing psychiatric one, hormones probably will not help much and other treatment is indicated. In these cases, the male partner can be a great source of support as a woman seeks appropriate care.

Can bladder control be a problem?

Bladder control in women is less reliable than in men. In women, bladder control often depends on the balance of pressures inside and outside the belly cavity. Muscles and supports that control the bladder may have been stretched and damaged during pregnancy giving problems even before menopause. Decreased sex hormone levels make matters worse. The supports can stretch further thus causing major problems with bladder control.
The nature of the bladder problem must be determined before treatment is attempted. It is clear from surveys that many, perhaps most, women with these problems do not discuss them with their doctors.

What are the long-term consequences of menopause?

Low levels of sex hormones after menopause are linked with an increased risk of heart disease, osteoporosis and perhaps Alzheimer's Disease. For women who do not use estrogen replacement, other drugs are now available to decrease some of the risks.

Didrocal™ and Fosamax™ act on bones to prevent osteoporosis and reverse bone loss. Evista™ is a new drug that prevents osteoporosis. It does not help with hot flashes or vaginal health. Perhaps the most interesting feature of Evista™ is its ability to reduce the risk of breast and uterine cancer.

What is the risk of breast cancer?

The most frequently voiced concern that women have as they grow older is breast cancer. About one woman in nine will develop breast cancer and one woman in 25 will die from the disease. Heart disease causes 10 times more deaths than breast cancer but women don't fear it as they fear breast cancer.

Many women believe surgical disfigurement, medical and radiation treatments and a painful death are inevitable consequences of this cancer. A quick heart attack death seems merciful by comparison. Neither picture is totally accurate but it does make it easier to understand some of the concerns of women about menopause.

Although breast cancer increases in frequency as women age it is not caused by menopause. Long term estrogen replacement therapy may have a small effect on the frequency of diagnosis of breast cancer. The decision to take or not take hormone replacement therapy is very much an individual one and one which most women do not take lightly.

A man can encourage his partner to express her fears and confusion but finally the decision to take or not take estrogen for its longterm benefits is the woman's alone. A woman will need respect and support for her decision; it is not an easy one.

How can men help?

Where do male partners fit in this great debate? They may have their own fears of health problems, of growing older and less effective, and of difficulties with sexual performance. Sometimes they may be too preoccupied to be supportive. Also they may feel they lack the knowledge to be helpful. Knowledge and communication are the keys. An understanding of the mutual needs of each partner at this time should return matters closer to normal.

A man who learns as much as he can about the changes of menopause will be more effective in understanding, supporting and empathizing with his partner's experience. If he knows about medication choices he can act as a sounding board for a woman making a decision about their use. An understanding man can help his partner overcome the embarrassment of loss of bladder control and seek help.

Open discussions are not easy about subjects where men have traditionally not been invited to be involved. Social conventions have meant that men and women often find the topic of menstrual periods embarrassing to discuss even within a stable relationship. Men should not dismiss the situation as "women's troubles." They should seek to become involved and encourage their partners to become active participants as they review the evidence as partners in problem solving. They can support by listening to their partners and helping them think through the best decision. However, most women need to be free to make their own decisions about easing symptoms and choosing medications.

A woman has control over what happens to her body. The decision is her own and a man should respect this. He should support her decision, even if it changes over time. A man will hopefully share much of the final third of a woman's life - that portion beyond menopause. If both partners can discuss and have a positive approach to health, this time together can be more fulfilling.

FAMILY HEALTH is written with the assistance of
Alberta College of Family Physicians
FAMILY HEALTH is written with the assistance of
Alberta College of Family Physicians
While effort is made to reflect accepted medical knowledge and practice, articles in Family Health Online should not be relied upon for the treatment or management of any specified medical problem or concern and Family Health accepts no liability for reliance on the articles. For proper diagnosis and care, you should always consult your family physician promptly. © Copyright 2019, Family Health Magazine, a special publication of the Edmonton Journal, a division of Postmedia Network Inc., 10006 - 101 Street, Edmonton, AB T5J 0S1    [WH_FH]
Safeway Med Advisor / Safeway Pharmacy logos
Safeway Med Advisor / Safeway Pharmacy logos