Every woman goes through menopause, but there are some common misconceptions about "The Change."
Savard tackles the most intimate questions women have about the female reproductive system in her new book, "Ask Dr. Marie: Straight Talk and Reassuring Answers to Your Most Private Questions."
Note: Some questions have been slightly edited for clarity and to ensure anonymity for the submitter.
Joni asked: I'm 52 and have already gone through menopause. I have been through it about a year and a half. Is there anything that can help with hot flashes/night sweats. I know that caffeine and alcohol are to be avoided or restricted. It doesn't seem to matter what I do, the hot flashes/night sweats just don't stop. I am hesitant taking HRT. Are the hot flashes/night sweats going to be with me forever?
Savard answered: You are not alone. About 80 percent of women will experience hot flashes to some degree at menopause and unfortunately for some women they can last years. I have a few patients who took small amounts of estrogen for their lifetime just to dampen their hot flashes. But for most women they will eventually disappear. Unfortunately the other effects of low estrogen such as bone loss and urinary and vaginal dryness will get worse with time. There are ways to minimize the symptoms, but studies have shown that there is nothing better than estrogen to relieve hot flashes and night sweats. A large analysis of alternative therapies found that nothing else worked -- except perhaps for soy foods and the herb black cohash (which can effect the liver and is only advised for up to 6 months of use). Unfortunately the decision to start estrogen is a big one -- but well worth a consideration if you are losing sleep and the hot flashes are impacting your life. Most experts now agree that for women in the throws of menopause, taking estrogen in the smallest dose to relieve symptoms is safe and quite effective. I take a small dose of an estrogen patch which minimizes any bad effects of estrogen pills and helps yet is enough to help me with sleep and dry vaginal tissues. If you have a uterus, you would need to add progesterone each month as well to balance out the estrogen. I take a natural progesterone capsule that comes as a prescription. I would recommend however that you work with your practitioner to make this decision. Women with a history of breast cancer and blood clots are generally not advised to take estrogen. If living a healthy lifestyle, which it sounds like you are trying to do, is not enough then perhaps just a short period of a year or so of estrogen may make all the difference. You can stop estrogen at any time.
Lana asked: For many women, menopause begins long before we become grandmothers. Could you please explain a bit about peri-menopause? When does it begin, at what age, and what are the signs and symptoms to look for?