Barton Glasser, Deseret News
While pregnancy and child-rearing are among the topics most discussed by young mothers, as they grow older the small talk often gravitates to hormones, hot flashes and hysterectomies.
All of those topics and others dealing with women's reproductive health are the subject of Saturday's Deseret News/Intermountain Healthcare Hotline. From 10 a.m. to noon, Dr. Kathryn Walker with Sandy OB/GYN at Alta View Hospital and Lori Eining, assistant nurse manager of the Alta View Hospital Women's Center, will answer questions by phone. Call 1-800-925-8177. You may also e-mail questions to firstname.lastname@example.org from 10 a.m. to 5 p.m. Saturday. Answers will be posted on the paper's web site next Friday.
Walker said hot flashes are the most common complaint she sees among older women. "Even with hormone therapy, sometimes it's not perfectly solved. If they don't want to or can't do hormone therapy, we don't have an anti-hot flash medication.
"We can try some things and make suggestions, but there's no magic bullet for that."
As women age, hormone swings become more common, and while hormone therapy can take care of some associated problems like hot flashes, "there are pros and cons," she said.
For most women, the symptoms calm down and they can get beyond the hot flashes once the onset of menopause has passed.
"Many women have the misnomer that menopause is a year or two and you are done. The fact is (in later life), women are always menopausal but not always symptomatic. The symptoms may change as you age, but menopause is that whole segment of later life when you stop menstruating."
Walker said she also gets a lot of questions about fibroids and perimenopausal bleeding, which can go together. But most often the bleeding occurs "because the ovaries not functioning quite as consistently."
Thickening of the uterine lining creates heavier bleeding and anemia that some women deal with. The condition is very common, she said, and most patients are evaluated and treated in the office after a pelvic exam.
"Sometimes we order an ultrasound, or a biopsy of the uterine lining." But the most common treatment for women in their early 40s or even 50s is low-dose birth control to help regulate their menstrual cycle until they enter menopause, she said.
Once women no longer have a regular cycle, the question usually becomes whether to begin hormone therapy, which is difficult to address in general because the answer has to be so individualized, Walker said.
One thing is certain: The advice women get now is very different than what their older sisters or mothers got 10 or 20 years ago. "The benefits (of hormone therapy) that we thought were there aren't and there are some downsides. We individualize that advice much more than we used to," she said.
Advice involving whether to have a hysterectomy has also changed over the years. "It used to be we routinely told women they should have their ovaries taken out, but now we're more cautious, thinking they may want to keep them as long as they can. We don't automatically take them out at 40 or 45."
As women age, they may have their ovaries removed because of the increased ovarian cancer risk, she said. Even so, her advice to women is seldom prescriptive.
"I usually tend to say here are the pros and cons," and let the women decide themselves, "unless there is something glaring in their history." But if women are healthy with no history of ovarian cancer and no cyst problems, she usually recommends they retain the ovaries to a later age.
"I think women are more attuned to that than they used to be. They have better insight into their own care, so that's a good thing. Our job to make sure they have the right information so they can make a good decision for themselves."
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