FAQs

Top 10 Questions About Menopause

  1. I have read a lot about the use of natural products to treat menopausal symptoms. Do they work?
  2. How long can I use hormone therapy and how will I know when to stop?
  3. I seem to be gaining weight more easily as I head toward menopause.  What can I do about it?
  4. Does my risk for breast cancer go up if I take hormone therapy?
  5. My sex drive seems to have disappeared. Is this normal?
  6. What are some of the early signs of osteoporosis?
  7. I have trouble controlling my urination from time to time. What can I do about it?
  8. Are my overall risks of cancer higher if I am on hormone therapy?
  9. Since I am having trouble with vaginal dryness and have some pain with intercourse, is having sex a good idea for me as I age?
  10. Are urinary tract infections more common during perimenopause and menopause?

I have read a lot about the use of natural products to treat menopausal symptoms. Do they work?

A range of non-hormonal therapies (some that require prescriptions, others that do not) are available in the marketplace, and research continues in the search for additional menopause therapies that will give women more choices.  For example, complementary and alternative medicines, including black cohosh and red clover, are often suggested as a way to ease hot flashes and night sweats.

Unfortunately, there is very little scientific data about the long term effectiveness and safety of these products and therapies so it is a good idea to talk to a health care professional you trust to get some advice before you try them. 
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How long can I use hormone therapy and how will I know when to stop?

Health care professionals in Canada, armed with new research, can help women decide whether some type of hormone therapy (HT) would help them manage their menopause symptoms.  The kind of HT, and the length of time you take HT, are both things you need to talk over with your doctor. They will also have information about alternative therapies, and the impact of lifestyle issues such as diet, exercise, alcohol, smoking and caffeine, and what course of treatment will work best for you.

The Society of Obstetricians and Gynaecologists of Canada (SOGC) supports the recommendations of the 2006 Menopause Consensus Report, that hormone therapy be prescribed for the duration necessary to address menopause-related problems.
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I seem to be gaining weight more easily as I head toward menopause.  What can I do about it?

Weight gain is not necessarily a symptom of menopause.  Even though the rate at which our bodies burn energy, and subsequently fat, declines as we age, a healthy diet and a moderate exercise program can usually keep those extra kilos at bay.  And a modest weight gain is not necessarily a bad thing, as long as your weight remains in a healthy range. The most important thing is not your weight, but that you are eating healthfully, and exercising regularly.  Still, if you are struggling with weight issues as you are nearing, or have reached, menopause, consult a health professional who is familiar with your health status and history.
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Does my risk for breast cancer go up if I take hormone therapy? 

There is an increased risk of breast cancer for women who have used combined HT for more than five years.  This increase is of a similar magnitude to other common risk factors for breast cancer, such as your age of puberty, being older than age 30 when you have your first child, or being overweight.  The good news is that the absolute risk for any one person is small, and the risk returns to normal soon after stopping HT.

Risk Factors for Breast Cancer


Risk Factors for Breast Cancer
Factor Baseline breast cancers* per 1,000 women Additional cancers per 1,000 women Total cancers per 1,000 women
No HT use (baseline) 45 0 45
5 years of HT use 45 2 47
10 years of HT use 45 6 51
15 years of HT use 45 12 57
Alcohol consumption
(2 drinks per day)
45 27 72
Lack of regular exercise
(<4 hours/week)
45 27 72
Late menopause
(10-year delay)
45 13 58
Body mass index
(10 kg/m2 increase)
45 14 59
Weight gain after menopause
(>=20 kg)
45 45 90

*Baseline or basic risk applies to all women and is due to factors that cannot be controlled (e.g., aging, gender)


And since all women face an increased risk of breast cancer as they age, you should participate in regular breast cancer screening programs to enhance your chances for early detection.

And finally, quit smoking!  Women who smoke increase their risk of all types of cancer, including breast cancer.
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My sex drive seems to have disappeared. Is this normal?

Many women experience ups and downs in terms of sexual interest over the years as pregnancies, child care responsibilities and fatigue take their toll. So it is not unusual for women to report a decreased sex drive after menopause, or to feel sadness and a sense of loss. And yet others experience a greater sense of sexual freedom once concerns about pregnancy are gone. And for some, their partner may have health concerns, or the changes in sex drive are not a concern. The good news is that all of these feelings are normal and even though the sex drive may be less strong, for the most part, women do report that they are able to respond to their partner and have pleasurable experiences.
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What are some of the early signs of osteoporosis?

By the time a bone fracture occurs, even after a small fall, osteoporosis may have already done its damage.  Understanding the risk factors previously mentioned, is the best way to determine if you are at risk for osteoporosis.

Osteoporosis Canada recommends that all postmenopausal women, men over 50, and all individuals over the age of 65, be assessed to see if they are at risk for osteoporosis. Tests known as Bone Mineral Density (BMD) which are safe and painless, much like an X-ray, can accurately measure the density of your bones. A BMD test can tell you whether or not you have osteoporosis and how likely you are to develop it in the future, and can help you to make decisions now that may prevent fractures or further bone loss.
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I have trouble controlling my urination from time to time. What can I do about it?

As they age, many women have trouble with urinary incontinence, the medical term for when your body accidentally leaks urine. There are a number of reasons why incontinence occurs and thankfully many treatments exist, including a wide range of non-surgical approaches. You can make lifestyle adjustments, find out about non-surgical support devices, do pelvic exercises, and investigate operations that might provide a more permanent solution.

Physicians and other health professionals can help you work out what will work best for you. Take the first step and let them know you need help.
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Are my overall risks of cancer higher if I am on hormone therapy?

A number of recent studies that followed women through their menopause years have shed new light on the topic of cancer risk and hormone therapy (HT).  These studies provide new evidence that the risk of cancer for HT users is of no greater magnitude than for other predictors such as age at puberty or age at childbirth, or family history.

There is an incraeased risk of breast cancer for women who have used combined HT for more than five years.  This increase is of a similar magnitude to other common risk factors for breast cancer, such as your age of puberty, being older than age 30 when you have your first child, or being overweight.  The good news is that the absolute risk for any one person is small, and the risk returns to normal soon after stopping HT.
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Since I am having trouble with vaginal dryness and have some pain with intercourse, is having sex a good idea for me as I age?

In fact, research shows that sex increases the blood flow to the genital area, something that is good for the long term health of the sexual organs, especially the vagina. Issues such as reduced vaginal lubrication can be addressed with over-the-counter lubricants and/or a vaginal estrogen cream. For more information, visit thebigow.ca
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Are urinary tract infections more common during perimenopause and menopause?

A urinary tract infection (UTI) is a sign that something is out of balance and needs to be treated. As hormone levels decline at this time of life, there can often be a direct impact on the tissues, muscles, glands and functions of the vagina and urinary tract.

Chronic UTIs are cause for some concern and a health professional should always be consulted since this type of infection can cause more serious problems (e.g. bladder infections). It is not necessarily true that UTIs are more common during perimenopause and menopause, but they may be related to other physical changes to the vagina and urinary tract that occur as women age.
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