Christiana Care Health System is one of the largest health care providers in the mid-Atlantic, serving all of Delaware and parts of PA, MD and NJ.

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Dr. Janice Tildon-Burton leads the ChristianaCare Women’s Health at Glasgow, part of the organization’s network of women’s health services. She has held leadership positions with a number of medical societies in Delaware and brings training and experience in all aspects of obstetrics and gynecology, including high-risk pregnancy, menopausal therapies and adolescent and adult gynecology.

High-Risk Pregnancy

Women's Health

Menopause

Gynecology

Obsterics

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Hormone therapy, complementary therapy and lifestyle options to consider

OB/GYN

 If you’re in your 40s and you menstruate, you may already be experiencing the effects of menopause: the point in life when your menstrual cycle stops permanently, which arrives for most people around the age of 50. This hormonal shift comes with numerous symptoms, some of which are manageable with at-home care and others—like intense mood swings, hot flashes or trouble sleeping—may need medical attention.

Menopause has officially happened when a year has passed since your last period. The roughly two to eight years before that, when periods become irregular and fertility decreases, is known as perimenopause. Some people experience perimenopause in their 30s and some as late as their early 50s, but most reach perimenopause in their late 40s.

Menopause is a naturally occurring life change, not a disease, and not everyone requires treatment for it. Many people seek medical help to deal with their symptoms. There are many new trends in menopause care, from hormones to drugs to supplements and beyond, and navigating them may feel overwhelming. 

What’s safest for managing side effects? Should I buy over-the-counter treatments or seek more involved care from a health care provider—or both? Read on for answers to these and other important questions on how best to treat menopause symptoms. 

Is hormone therapy right for me?  Menopause happens to everyone who menstruates, and it’s important to bring up any symptoms of menopause as they occur at your annual primary care checkup. A gynecologist with special training or interest in the transition from ages 40 to 55 is an ideal specialist to seek additional care and treatment from, especially if you’d like to explore medical treatments like hormone therapy.

Hormone therapy in the form of prescribed estrogen and progestin (both reproductive hormones that exist in the body naturally) has been used since the 1980s to treat the symptoms of menopause. A decline in estrogen is the culprit for many menopause symptoms, so adding estrogen back into the body through hormone therapy helps to diminish symptoms.

Not all people who go through menopause need hormone therapy, but it has numerous positive side effects, including the lessening of some symptoms and lowering the risk of osteoporosis, a loss of bone density that can be exacerbated by natural estrogen decreasing over time as we age. These therapies can be administered in a cream, a patch, or even through low-dose birth control pills. However, hormone therapies can carry an increased risk of some cancers, including breast cancer.

Non-hormonal, complementary medicine and lifestyle options  Non-hormonal options to treat menopause symptoms are growing in popularity and represent an alternative to hormone therapies. Some of these include:

Be sure to consult your provider before adding any new drugs or supplements to your daily routine. There are also many popular and effective options for treating menopause symptoms that come from Eastern and herbal medicine traditions. These include acupuncture, which has been shown to help with hot flashes and night sweats, as well as herbal supplements that often accompany treatment from a trained acupuncturist. A main downside to acupuncture can be cost, as the treatment is rarely covered by insurance. Eating mindfully and exercising regularly both also have proven benefits to treat menopause symptoms and to keep our bodies healthy more broadly as we age. This includes getting enough vitamin D and calcium through diet in order to keep bones strong as hormone levels change and to limit caffeine and alcohol consumption.  Challenges in menopause care  Despite the progress made in menopause treatment over the past years, there are still a few main challenges that you may face in menopause care. These include:

Stigmas surrounding speaking openly about symptoms, especially sexual side effects like vaginal dryness and changes in libido that can affect intimacy. It’s important for you to feel empowered to discuss all symptoms with your provider.

The increased availability of at-home tests, purchased online, for menopause and perimenopause. While these tests may be helpful in showing a snapshot of your hormone levels on a given day, more information is needed to diagnose menopause and perimenopause correctly, and at-home results can often be misinterpreted. It’s best to conduct these sorts of tests under the care of your provider, who can place them in the appropriate context.

It can be hard to find the time needed to diagnose and treat menopause symptoms in a clinical setting, especially because it often takes time and communication outside of an office setting to ensure diagnosis and treat symptoms properly. Seeking out a provider who specializes in menopause care helps a great deal to expedite this process and get you the care you need.

Not everyone experiences menopause the same way: for some people, symptoms are mild enough that at-home remedies will meet their needs. 

But for those with more intense symptoms—or anyone hoping for clinical support during this challenging time—working closely with a gynecologist will bring you relief and greater insight.


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