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Q: My last period was 3/01-however, I recently went through PMS again and had a period in July of this year. I am 54 yrs old and have been having hot flashes for the past 5 years. The hot flashes have been less frequent in the last 2 months. I had my last gyn check-up and pap smear in April. Does this mean it will take another year before I end menopause? Also, my prior periods were coming every 3 months.

A: It used to be thought that menopause was sudden: you had regular periods, then perhaps fewer and then one day they stopped. It was also thought that all symptoms related to menopause would go away in a year or so. If they didn't, they were blamed on psychological problems.

We now know none of this is true. The ovaries do not turn off suddenly. Rather they slow down over several years. Even after periods stop, many women's ovaries continue to make estrogen. This is why some women have fewer symptoms -- their ovaries are still functioning after their periods stop.
During perimenopause, estrogen levels may fluctuate widely and bring mood swings and other discomforts. Estrogen replacement usually helps this dramatically but of course many women are understandably worried about using estrogen. Oral contraceptives are another approach in women under 50 or 52 who are nonsmokers and do not have other OC risk factors.

It is hard to predict how long symptoms related to menopause will last. Other treatments can be tried for hot flashes including soy milk or tofu and black cohosh. Antidepressants are claimed to sometimes help.

These are important but difficult decisions so there is no one right way for all women. Best is to inform yourself, then discuss with a knowledgeable physician.

Hope this is helpful.


Geoffrey Redmond, MD

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