MsMedicine – Learning About Menopause With Dr. Eileen West

Menopause is a completely natural process, though many people struggle with the physical and emotional changes that can accompany it. Normalizing and understanding the menopause process can help! Join Dr. Cecily Havert and Dr. Natasha Beauvais for a conversation with MsMedicine’s Dr. Eileen West, a board certified physician in Internal Medicine and trained in gender-specific health, to discuss the signs of menopause, the three stages of menopause, what to expect during menopause, what to do about hot flashes, and so much more.

Virtual Town Hall Meeting

Event Highlights

• 0:19 – Dr. Cecily Havert begins the town hall with a few housekeeping items before passing it over to Dr. Natasha Beauvais.
• 1:48 – 6:03 – Dr. Natasha Beauvais introduces Dr. Maria Castillo, our new provider starting at NVFP on Monday, May 2^nd! Dr. Beauvais states her excitement for her to join the team. She then introduces Dr. Eileen West, owner of Eileen West, MD and Associates, and discusses her impressive resume and how their careers have intertwined.
• 6:57 – Dr. Eileen West begins her presentation about menopause, starting by saying that menopause is a subject that is not discussed as much as it deserves to be, yet there is so much to learn from it.
• 8:15 – 11:11 – Dr. West moves on to the definition of menopause, stating that a goal of the presentation is to help attendees understand the symptoms, which treatments can best help them manage the menopause transition, and address other health issues.
• 12:20 – 16:24 – Dr. West gives examples of the symptoms of menopause, and what happens when menopause begins. Many symptoms include hot flashes, night sweats, weight gain, memory lapses, and much more.
• 18:58 – Dr. Havert asks a question about hormones and how they are related to hot flashes. Dr. West also discusses hot flashes being linked to cardiac risk.
• 20:06 – 26:00 – Along with hot flashes, another common topic Dr. West is asked about is vaginal dryness, frequent UTI’s, and irregular periods.
• 26:02 – 28:27 – Dr. West discusses other common symptoms, including insomnia and memory lapse.
• 30:49 – 36:17 – Treatments are one of the most commonly asked questions when it comes to menopause. What can I do for my hot flashes? Dr. West provides multiple slides of information on treatments including hormone therapy, topicals, and more.
• 40:00 – 46:25 – Dr. West acknowledges the different concerns with each topical, saying that not all topicals work for everyone. She also provides recommendations for which topical is her “go-to.”
• 47:15 – Dr. West ends her presentation, and Dr. Havert and Dr. Beauvais thank her for her time.
• 47:23 – 1:08 – Q&A with Dr. West.

Q&A with Dr. Eileen West

Question 1 – My menopause started at age 45 due to a TAH (Total Abdominal Hysterectomy). Some say I experienced “surgical menopause,” could this be true? I don’t hear much about surgical menopause.

Dr. West – Surgical menopause is the term used to describe a person’s hormone status when both ovaries are removed (bilateral oophorectomy). It’s different from surgical removal of the uterus without removal of both ovaries (hysterectomy).  It would be important to know whether your surgeon removed the ovaries as well, but from the sounds of it they did if typical symptoms of menopause began shortly after. Many who go through surgical menopause can have intense symptoms for a while. Generally, it is helpful to use hormone replacement to reach the natural age of menopause (51). It relieves the symptoms and helps to protect against bone loss and early heart disease for younger women.

Question 2 – How much of a factor does incontinence play in menopause? Is it a major symptom? Is there a degree or frequency of incontinence?

Dr. Eileen West – Incontinence is very common in women as they age. It often starts after delivery of the first child, but is even more common in older women, most likely because of hormonal changes during menopause. The pelvic floor muscles that support the bladder, urethra, uterus and bowels can become weak or damaged. More than 4 in 10 women aged 65 and over have urinary incontinence. Also, women are twice as likely to develop incontinence as men. It is a big problem. And it’s important to realize that incontinence is never just “normal aging.” There are many treatments available. If you are experiencing incontinence, talk to your doctor as there are ways to improve your symptoms.

Question 3 – What herbal is good?

Dr. Eileen West – Unfortunately, none of the herbal treatments we have are particularly helpful for significant menopausal hot flashes. Black Cohosh and phytoestrogens may give a little relief. Kava may decrease anxiety, and ginseng may increase one’s overall sense of wellbeing, but they don’t do anything for hot flashes. Low dose estrogen therapy is most effective. To learn more ,here is a resource to answer more specific questions: https://www.menopause.org/for-women/menopauseflashes/menopause-symptoms-and-treatments/natural-remedies-for-hot-flashes

Question 4 – How long do peri menopause symptoms tend to last?

Dr. Eileen West – For women who experience perimenopausal symptoms, they can last anywhere from a few months to twelve or more years. The average is around 3-4 years.

Question 5 – Could you please explain why you mentioned HPV testing?

Dr. Eileen West – I did a very quick review of other health screenings to consider around the time of menopause, including breast cancer screening and risk assessment, colon cancer screening, and cervical cancer screening with a PAP smear and HPV (or human papilloma virus) test. We know that 99% of cases of cervical cancer are associated with one of the high-risk strains of HPV, as well as 75% of head and neck cancers and a high percentage of cancers of the anus. It is important for every woman over age 30 to know her HPV status which is measured at the time of the pap smear. It informs doctors to look more closely and more often for the development of cancer. Did you know that the HPV vaccine is the only vaccine we have which actually PREVENTS cancer? And it is appropriate for men and women to receive it up to age 45. In some countries, the HPV vaccine is now being given to any woman who has a positive HPV test, even if they are older than age 45, to boost immunity against the strain of HPV they have already contracted and reduce the risk of cancer in the future.