You At Your Best

sPOnsOr cOntent The obstetricians and gynecologists at Washington Regional's HerHealth Clinic provide personalized care for women of all ages. Physicians include Dr. Candy Birch, Dr. Laura Collins, Dr. Mary Pat Hardman, Dr. Erin Large, Dr. Alexis McCollum, Dr. Amy Scott, and Dr. Britte Smith. Specialized services: - Gynecological and well woman exams - Prenatal care - Routine and high-risk deliveries - Infertility treatments - Birth control, including oral contraceptive pills, IUDs, subdermal implants and tubal ligation - Menopause support - Treatment for conditions such as abnormal pap smears, irregular or heavy periods and endometriosis - Surgeries include laparoscopy, hysteroscopy, hysterectomy and endometrial ablation - Minimally invasive procedures, including the use of the daVinci System - Ultrasound and laboratory services HerHealth Clinic serves patients at the Washington Regional Women and Infants Center, 3215 N. Northhills Blvd., Ste. B in Fayetteville. To schedule an appointment, call 479-463-5500. For more information, visit www.wregional.com/herhealth. HerHealth Clinic offers comprehensive care for women Hot flashes. Insomnia. Vaginal dryness. Sounds like a list of typical menopause symptoms, right? Precisely speaking, however, those bothersome symptoms are likely due to perimenopause, the years when a woman's body begins to produce less of the hormone estrogen as it transitions out of the childbearing phase. "Perimenopause can last from one to 10 years. Then, once a woman's menstrual periods stop permanently — or she has at least 12 consecutive months without a period — she is in menopause," explains Dr. Alexis McCollum, an OB-GYN at Washington Regional's HerHealth Clinic. "The average age of natural menopause is about 51 years, but the amount of estrogen a woman's ovaries produce can begin to fluctuate 10 years earlier." This is when perimenopause begins — and when estrogen levels swing from high to low. "As the body tries to get accustomed to those fluctuating estrogen levels, that's when you begin to see symptoms," Dr. McCollum says, such as: • Hot flashes - This is a sudden, uncomfortable feeling of heat that rushes to the upper body and face. Hot flashes that happen at night are called night sweats. • Insomnia - Women may have trouble falling asleep or may wake up long before their usual time. Additionally, night sweats can disrupt sleep. • Vaginal and urinary tract changes - The lining of the vagina can become thin, dry and less elastic – causing vaginal infections and pain during sex. The urethra can also become dry, causing frequent urination and urinary tract infections. • Erratic bleeding patterns - Menstrual cycles may become longer or shorter or even skip some months altogether. If a woman has surgical removal of her ovaries before she has gone through menopause, she may immediately begin to experience some of these symptoms. Managing Perimenopausal Symptoms "Many women find that the symptoms of perimenopause can be managed by eating well, staying physically active and making lifestyle changes," Dr. McCollum says. To manage hot flashes, for instance, it may be helpful to dress in layers, sip cool liquids and carry a small fan. Alcohol, caffeine and smoking — which can all trigger hot flashes — should be avoided. Regular exercise has also been shown to aid in body temperature regulation during menopause and perimenopause. "Women with more severe symptoms may want to talk with their OB-GYN about hormone replacement therapy," Dr. McCollum says, referring to a group of medicines approved by the U.S. Food and Drug Administration to help relieve the symptoms of perimenopause. "There are small health risks associated with some forms of hormone replacement therapy, so women should discuss the risks and benefits with their OB-GYN," she says. Options include: • Estrogen Therapy - Women who have had a hysterectomy and no longer have a uterus can take estrogen as a pill, skin patch, vaginal ring, cream or spray. • Combination Therapy - This combines doses of estrogen and progestin, a synthetic version of the hormone progesterone. Women who still have a uterus need combination therapy because progestin helps reduce the risk of cancer of the uterus that occurs when estrogen is used alone. Some non-hormone prescription drugs — including antidepressants, an antiseizure medication and a blood pressure medication — have been found to help with perimenopausal symptoms. Another type of drug, called selective estrogen receptor modulators, has been shown to help relieve hot flashes as well as pain during sex due to vaginal dryness. Vaginal dryness can also be helped with over-the-counter non-hormone products such as vaginal moisturizers and lubricants. "Bioidentical hormone therapy" and "custom compounded bioidenticals" are not regulated by the FDA and have not been thoroughly studied for safety or effectiveness. "Some may contain unsafe levels of estrogen, progesterone or even testosterone," Dr. McCollum says. Maintaining Health After Menopause This is not the time to skip annual doctor visits. "Your health care needs will change in the years after menopause, but postmenopausal women have a lot to gain by maintaining a connection with a trusted health care provider," Dr. McCollum says. OB-GYNs are specialists in women's health care and provide a full range of services, from cancer screening to sexual health discussions. Here are some wellness recommendations women can talk about with their OB-GYN: • Cancer Screenings - Women should continue with Pap tests until age 65, and longer if they have risk factors for cervical cancer. Women who have had a hysterectomy may want to talk with their OB-GYN about their need for continued Pap tests. • Mammograms - Women should continue to get screening mammograms until at least age 75. The need beyond age 75 should be discussed with an OB-GYN. • Abnormal bleeding - Whether it's light spotting or a heavy flow, abnormal bleeding should be reported to an OB- GYN. • Cardiovascular disease - Menopause usually occurs at a time when risk factors for heart disease and stroke — high cholesterol, high blood pressure, lack of physical activity — become more common. Plus, the cardiovascular protection that estrogen provided is diminished. Women should talk with their OB-GYN about appropriate screening. • Osteoporosis - During the first few years after menopause, women begin to lose bone mass more quickly due to decreased levels of estrogen. AN OB-GYN can order bone density screening and help women decide whether they should take calcium and vitamin D supplements. • Emotional Health - For women who have experienced anxiety or depression, perimenopause can reactivate those conditions. An OB-GYN can help a woman find a support network and prescribe medication if needed. women's health: Is it menopause or perimenopause? www.wRegionAl.com sundAY, sePtember 26, 2021 | OctOber - WOmen's HeAltH YOuAtYOurbest.nWAOnline.cOm | YOu At YOur best | 9

• Cover