Dr. Nese Yuksel
Professor & Vice-Dean, Faculty of Pharmacy and Pharmaceutical Sciences,
University of Alberta & President, Canadian Menopause Society
Mediaplanet spoke with Dr. Nese Yuksel, Professor and Vice-Dean at the University of Alberta’s Faculty of Pharmacy and Pharmaceutical Sciences and President of the Canadian Menopause Society, to shed light on the phases of menopause, offer tips for effective conversations with health care providers, and highlight the importance of self-advocacy for women navigating this stage of life.
Could you explain the different phases of menopause —perimenopause, menopause, and postmenopause— and what women might expect in each phase?
Menopause simply means cessation of one’s period, but we diagnose it looking backwards. If somebody hasn’t had a menstrual period for 12 months and occurs naturally, then they’re considered to be in menopause. Anytime after this is considered post-menopause. And perimenopause is the time leading up to menopause (on average it is four years, but for some women it can be eight years or longer).
Perimenopause is a time of major hormone fluctuation. Women can expect to experience symptoms like hot flashes, night sweats, sleep issues, mood swings, vaginal dryness, and brain fog, all of which can persist through the other phases of menopause. During perimenopause is also when women may notice changes in their menstrual periods — they may get more frequent or further apart, and heavier or lighter. Irregular periods are common during perimenopause, although women can experience menopause symptoms even before changes in their periods.
Duration of menopause symptoms overall is typically seven to eight years although this varies. It’s all very individual as far as symptomology goes.
You’re not alone, and you don’t need to suffer through this stage of life.
What are some tips for women to get the most out of a doctor’s appointment focused on menopause?
Menopause is a time to pause and reflect on your overall health — not only on the symptoms you’re experiencing but also long-term health considerations, such as bone health and heart health. It can be a good time to get risk factors, such as obesity or high blood pressure, under control. Prepare for the discussion with your doctor by thinking about all the issues you want to address.
What are some key questions women should ask their doctor to better understand menopause and the health risks associated with it?
Women should start the conversation by sharing the symptoms they’re experiencing and how these may be affecting their quality of life and their daily function. A tool like the Menopause Quick 6 (MQ6) menopause assessment tool/questionnaire, available at mq6.ca, can be helpful here. Are they having night sweats and hot flashes? Are these keeping them awake? Do they feel tired and fatigued during the day? Are they having a hard time concentrating? Is this affecting their ability to function at work? Are there issues within their relationship because of vaginal dryness or low libido? These are important questions to discuss.
Women can ask what options there may be to help with symptoms. Women can inquire if menopausal hormone therapy is an option for them, and whether they have any contraindications. They can also ask about other options for therapy and management, for example non-hormonal medications, lifestyle measures, or complementary therapies to consider that could help them to navigate their symptoms.
It’s also a good idea for women to ask what they should be doing for long-term risk and to understand their individual risk factors. Women may want to inquire about their risk of bone loss and of having an osteoporotic fracture, for example, or about their risk of cardiovascular disease. They can also ask about what kind of health screenings or tests they should consider for their overall health — for example, getting their blood pressure or cholesterol levels checked, undergoing cancer screening through mammograms or Pap tests, or doing a bone density test.
They may also want to ask what lifestyle changes they should consider making, whether that’s exercising more, improving their nutrition, or quitting smoking.
How can women approach sensitive topics, like sexual health and mood changes, with their health care providers to get the support they need?
It can be difficult to share certain things, and there’s unfortunately shame and stigma associated with menopause and aging. But having an open conversation with your health care practitioner is so important. Find a practitioner who takes your concerns seriously.
Women should start the conversation by sharing the symptoms they’re experiencing and how these may be affecting their quality of life and their daily function.
How can women advocate for their health care, and what are some strategies to improve communication and ensure their needs are met?
I encourage women to get support. Tools like the MQ6 questionnaire can be invaluable, and there are many other excellent resources available for women from the Canadian Menopause Society, the Menopause Foundation of Canada, the Society of Obstetricians and Gynaecologists of Canada, and more.
Talk to your primary care provider to discuss your concerns and to learn about the available treatment options or visit canadianmenopausesociety.org to learn more.
This was made possible by the support of Pfizer Canada.
