Navigating Midlife

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The hot flash is the quintessential symptom of the “change of life,” or menopause, for women. But how do you know if your hot flash is from menopause? Or, are you in perimenopause? And, how long will it last?

Menopause, by definition, is 12 months of no menstrual activity. Perimenopause is the transitional period before menopause when there is a gradual decrease in menstrual bleeding and fluctuation of hormone levels. The average age women go through menopause is 51 years old, while perimenopause occurs, on average, four years prior.

Hot flashes are the most common symptom, while others include mood changes, sleep disturbances, irregular menstruation, difficulty concentrating and remembering things, headaches or dizziness, change in sexual desire and comfort, vaginal dryness, skin dryness and thinning hair. Christy Chan, MD, from Overlake Clinics Primary Care – Kirkland, adds, “Changes in lipids and bone loss also occur, both of which have implications for long-term health. So it’s important for women to know their risk factors for heart disease and osteoporosis.”

Studies have shown menopausal symptoms are undertreated. To encourage more women to address these symptoms, Annapoorna Murthy, MD, of Overlake Clinics Primary Care – Kirkland, suggests downloading an app. “MenoPro is a free app recommended by the North American Menopause Society that women can use to check if the symptoms they are experiencing qualify for hormone replacement. It is based on current guidelines and asks a series of questions about age, symptoms, medical and family histories,” says Dr. Murthy. Consult with your healthcare provider about any results you may receive.

Some women can manage their symptoms by watching their weight with diet and exercise, staying away from tobacco and making simple lifestyle changes. When symptoms become unnerving, hormone therapy (HT) can provide significant relief for some women. For those looking for alternatives to HT, certain antidepressants and medications used to treat seizures and high blood pressure may be effective. Alternative treatments, such as soy, phytoestrogens and herbs, have also been helpful.

Once a woman has experienced menopause, she is at an increased risk for cardiovascular disease that is equal to a man’s risk. Christine Ngoc-Han Nguyen, DO, with Overlake Clinics Primary Care – Kirkland, advises to review your health status with your primary care provider as you age in order to evaluate and modify your total risk.

There are a number of treatments available for the symptoms of menopause. The key is to work with a healthcare provider who can help you navigate the latest information and create a plan that’s right for you based on your priorities, current health status and family medical history.

Tips for Discussing Menopause with Your Healthcare Provider

  1. Medical History: Provide a clear and concise medical history, including surgeries, gynecologic history and current lifestyle. Be honest and thorough.
  2. Family History: Understand how your family history may play a role in your treatment decisions. Are you more at risk for osteoporosis than heart disease? Does breast cancer run in your family?
  3. Symptoms: Explain your symptoms and your priorities for treating them. Which symptoms are uncomfortable or bothersome?
  4. Treatment Options: Decide your comfort level with various treatments. Do you want to try simple lifestyle changes first?

To learn more about women’s services at Overlake, visit

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