A thorough assessment of the menopausal woman should culminate in a management and/or treatment plan, outlining to the woman her options so that she may decide on choices to improve or maintain her quality of life, at the same time developing an empathic, communicating and ongoing relationship for the woman with her doctor.
In every case the woman should be advised about improving her lifestyle by having a healthy eating plan, maintaining consistent and individually appropriate physical activity and managing stress.
Smoking is particularly associated with postmenopausal morbidity and mortality.
Alongside lifestyle improvements, a therapeutic regimen may be developed which may include non-prescriptive or complementary therapies as well as prescriptive medicines.
Management plans may include:
1. Therapy for symptom relief, either hormonal or non-hormonal
2. Contraceptive advice
3. Preventative therapy eg for osteoporosis, including lifestyle, calcium, hormone therapy, vitamin D
4. Therapy for osteopenia or osteoporosis, either hormonal or non-hormonal, such as the bisphosphanates, SERMS
5. Therapy for present cardiovascular risk eg. hypercholesterolaemia
6. Referral for surgery for either pelvic or breast pathology
7. Counselling, either psychosexual or psychotherapeutic
8. Assessment of Incontinence, referral to pelvic floor rehabilitation physiotherapist.
9. Lifestyle, nutition, exercise advice as well as giving information or providing educational resources.
Regular follow-up, with two visits in the initial six months after commencing a treatment plan, provides an opportunity for both the woman and her practitioner to discuss her progress, side effects to medication or difficulties in management and treatment.
Yearly assessments should then occur. If therapy is necessary long term, annual review should occur to re-examine risks and benefits and to discuss any new options.
There are many ways to manage this time in your life, both in physical and psychological terms. Decisions about therapies depend on your:
- Current symptoms and their severity
- Current health status
- Long-term health risks
- Personal life expectations
Take some time to review your daily nutrition and physical activity to assist in managing any symptoms you may experience.
- Have plenty of fresh vegetables, fruits, cereals and wholegrains
- Drink six to eight glasses of water daily
- Decrease intake of caffeine (coffee, tea, cola, chocolate)
- Limit alcohol to one to two standard drinks, or less, per day
- Eat high-calcium, low-fat dairy foods
- Include lean meat, fish or chicken in your diet
- Phytoestrogens (plant oestrogens) replace some natural oestrogens lost during menopause, and may reduce symptoms, cholesterol and blood pressure – good sources include soy and linseed bread, soy beans, tofu, wholegrains and legumes
For more information see Nutrition
Regular physical activity
Aim for 30 minutes of moderate physical activity on most days of the week to maintain general health, control weight and help keep bones healthy.
For more information see Physical Activity
Need help quitting smoking?
Look after your emotional health
During menopause, you may experience mood changes such as mild depression and irritability, which are often related to physical changes like hot flushes, night sweats and interrupted sleep. Talk to a health practitioner about controlling the physical symptoms to help improve your general wellbeing.
For more information see Emotional Health
Have regular Pap tests and breast checks
See your health practitioner for a Pap test every two years and regularly check your breasts.
Mammograms are free if you are over 40 years of age – phone BreastScreen on 13 20 50.
What therapies can help you manage symptoms?
Hormone Therapy (HT) (also known as Hormone Replacement Therapy – HRT)
Hormone therapy (HT) can help relieve the symptoms of menopause, but no treatment is without side effects. Any decision about HT is an individual one, so talk to your health practitioner about risks, benefits, concerns and other alternatives.
It is important that all women using HT be reviewed once a year by their health practitioner.
Other (complementary) therapies
Various other therapies such as complementary therapies can be of benefit to some women. It is important to remember that herb and plant medications can have unpleasant side effects in some women, as can prescribed western medications. For long-term guidance and balance through the menopausal years it is important to see a registered naturopath.
Other therapies can often be taken in conjunction with hormone therapy; however it is important to let both your doctor and naturopath know exactly what each has prescribed.
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