Walnut Creek Menopause Specialist: Dr. Leach OB/GYN

What is Menopause Medicine?

The definition of “Menopause” is 12 months of no periods which happens on average around 51 years old.  The North American Menopausal Society (NAMS) is the scientific organization that is committed to peri/menopausal health.  Dr. Leach is the only NAMS certified menopausal practitioner in the East Bay.  This certification requires ongoing life learning and rigorous competency testing.  A certified menopausal practitioner is aware of the most up to date treatment options for various changes in cognition, sexual health, bone and heart health associated with the menopausal transition.

What is Hormone Therapy?

Hormone therapy (HT) replaces the female hormones, typically estrogen and progesterone, that naturally cycled during a woman’s life but decrease during midlife/menopause. Contemporary use of HT typically uses scientifically studied, FDA approved doses of “bio identical” estradiol and progesterone. HT can be taken systemically via oral, transdermal, and vaginal preparations to travel throughout the body to treat bothersome symptoms of midlife/menopause most commonly temperature changes and sleep disturbances. Low-dose vaginal HT can be prescribed with significantly lower hormone dosages that only have impact on vaginal moisture, comfortable intimacy, and less bladder frequency/urgency, UTI’s.

What is Bioidentical Hormone Therapy?

Bio-identical HT literally means that a receptor on a cell membrane biologically responds to that hormone biologically the same whether that hormone was made by the ovary or taken as replacement. Some providers will use the term bio-identical and prescribe different ratios & types of estrogen that can be made by a compounding pharmacist. This is referred to as compounded bio-identical hormone therapy (HT) which implies that a pharmacist is making the HT in small batches every few months which can lead to variable blood levels of estradiol. Compounding pharmacies play a critical role in making prescription medications when there are not FDA approved options. Our office uses bio-identical FDA approved HT because there are over 20 different dosing options (vaginal, oral, transdermal) to maintain stable blood levels of estradiol, that reliably relieve menopause symptoms more consistently than with compounded bio-identical HT.

What is perimenopause?

Perimenopause also called the menopause transition, is a time of unstable hormone levels (puberty 2.0) as evidenced by change in menstrual periods that may start in a womens early/mid 40’s. Irregular & skipped periods can be associated with changes in sleep, temperature, mood that can last on average for 5- 7 years. When the perimenopause includes 12 months of no bleeding, the diagnosis is now menopause which means a woman never should menstruate again.

What Are the Most Common Symptoms of Menopause?

Hot flashes and sweats can occur in 90% of women and vaginal dryness in 70% of women in the menopausal transition. These symptoms can have a significant impact on activities of daily living and quality of sleep, leading to insomnia, lack of focus, mood swings, poor libido, extreme irritability, depression. Hormone replacement therapy for women with moderate to severe symptoms, can often reduce 80% of these symptoms.

How Often Do Women Need Treatment During Menopause?

Estrogen replacement therapy for menopausal symptoms are typically recommended for women having moderate to severe hot flashes. Mild symptoms may be relieved with lifestyle changes, mind-body techniques, dietary management and supplements, and prescription therapies. Surveys suggest that 50-80% of midlife women use nonhormonal therapies for hot flashes. Consult with a certified menopausal practitioner like Dr. Leach, to get the most up to date recommendations on treatment options.