What You Need to Know About Perimenopause & Birth Control

by Melanie Remy | Aug 27, 2021 | Menopause, Wellness

Birth control is something many women take to prevent pregnancy and help with other conditions. However, as you enter perimenopause, you might have some questions about birth control. Our providers are here to answer your questions and help you make decisions about your health before, during, and after perimenopause. It’s important to discuss the particulars of your situation with one of our medical providers. However, we do have a general guide to help answer some common questions about birth control and perimenopause.

You may still need birth control during perimenopause to prevent pregnancy.

What is Perimenopause?

First, let’s clarify what we mean by “perimenopause.” The terms perimenopause and menopause are often used synonymously, but they are actually different stages of your life. Perimenopause is the time leading up to menopause. Menopause is when you have gone 12 consecutive months without a period.

During perimenopause, your hormones may start to fluctuate more, but you’re still producing a fair amount of both estrogen and progesterone. When you reach menopause and postmenopause, your ovaries produce very little of these hormones and stop releasing eggs. Perimenopause typically begins in your 40s. It usually lasts around four years before you reach menopause. However, this can be longer or shorter for different women, even up to 10 years or more. The average age for menopause is 51 years old, though it can come earlier or later.

Symptoms of Perimenopause

There are many symptoms that can point to perimenopause. While there is no one test or sign that you’ve started perimenopause, some symptoms can signal that you may be in perimenopause. 

Some symptoms of perimenopause include:

• Irregular periods
• Fatigue
• Spotting or breakthrough bleeding
• Breast tenderness
• Headaches
• Low libido
• Difficulty concentrating (“brain fog”)
• Hot flashes
• Night sweats
• Vaginal dryness
• Mood changes

If you’re dealing with these symptoms, then it may mean that you’re starting the transition to menopause. You can talk to one of our treatment providers about your symptoms to determine whether you might be in perimenopause and how we may be able to help reduce or relieve your symptoms.

Can You Still Get Pregnant During Perimenopause?

Now, it’s a common misconception that you can’t get pregnant during perimenopause. This is incorrect. You can absolutely still get pregnant during perimenopause. Your body typically still ovulates during perimenopause. While periods might be irregular or different during perimenopause, pregnancy is still a risk with unprotected sex. Therefore, many women still need contraception in the years leading up to menopause if they don’t wish to become pregnant. The risk of becoming pregnant generally doesn’t go away until after you’ve reached menopause, one year after your last period. Hormonal birth control is one of the most common forms of contraception, so many women continue to take these medications up until they reach menopause.

Birth Control May Mask Symptoms of Perimenopause

It’s important to note that hormonal birth control, like the pill, can actually mask symptoms of perimenopause and menopause. Hormonal birth control uses synthetic versions of female hormones estrogen and progesterone, which control menstruation, pregnancy, and more. Hormonal birth control can help regulate hormone levels to control periods and reduce the risk of pregnancy.

Symptoms of perimenopause and menopause are typically caused by fluctuating and declining levels of estrogen and progesterone in your body. Therefore, if you’re taking hormonal birth control, it may mask some of the symptoms of perimenopause by replacing your natural hormones with synthetic versions. Your symptoms may not be as noticeable if you’re still on hormonal birth control when you start perimenopause.

Also, many women who do experience symptoms may not associate them with perimenopause, as birth control side effects can be very similar to perimenopause. For instance, changes in mood and sex drive can be side effects of birth control and symptoms of perimenopause.

Even after menopause where your ovaries stop producing estrogen and progesterone, birth control can make it appear that you are getting regular periods. When taking combination birth control with both estrogen and progesterone, you may experience withdrawal bleeding that mimics your period, even though you’ve reached menopause. 

Hormonal Birth Control May Help Reduce Symptoms during Perimenopause

In a similar vein, some women notice that their perimenopause symptoms get better after beginning hormonal birth control. Some doctors may even prescribe birth control during perimenopause to help with symptoms even if you’re not looking for a contraceptive. Of course, this depends on your individual circumstances. Some women may not benefit from birth control during menopause, and for some the risks outweigh the benefits. However, the hormones in birth control may help some women feel better during perimenopause.

As you transition into menopause, your hormone levels may fluctuate quite a bit. This can cause many symptoms that affect your quality of life, such as hot flashes and mood changes. Birth control can help regulate your hormones to reduce these fluctuations. This may, in turn, help alleviate some of your perimenopause symptoms. 

How to Know if You’ve Transitioned to Menopause while On Birth Control?

So, if you take birth control during perimenopause and it can mask symptoms and even cause bleeding that mimics a normal menstrual period, how do you know if you’ve reached menopause? In most cases, stopping birth control can help you determine if you have reached menopause. Just keep in mind that until you are sure you have gone for one year without a period, you may need other forms of contraception, such as condoms, to help prevent pregnancy. Even if you have gone several months without a period, you may still be perimenopausal and still able to get pregnant. Talk to one of our treatment providers about your specific circumstances.

When Should Perimenopausal Women Stop Taking Birth Control?

You might be wondering if there is a certain time you should stop taking birth control after you enter perimenopause. Once again, this is personal, so it’s important to discuss the specifics with one of our treatment providers. 

However, many doctors do recommend some women stop birth control at the average age of menopause (51 years old) to determine if they’ve reached menopause yet. Also, it’s important to understand that with age, the risks of birth control can get higher. For instance, some hormonal birth controls can increase your risk for blood clots, stroke, breast cancer, heart attacks, and other health conditions. Therefore, our treatment providers may recommend stopping or switching hormonal birth controls based on your risks, even if you’re not in perimenopause.

What’s the Difference Between Hormone Therapy and Birth Control?

You may have heard of women taking hormone therapy during and after perimenopause. If birth control typically contains hormones, what is the difference between birth control and hormone therapy for menopause? 

Hormone therapy and birth control have different purposes and do different things in your body. Therefore, one might be better than the other for your circumstances. 

Generally speaking, birth control is primarily to prevent pregnancy (though you might also use it for other things like regulating your cycle, reducing PMS symptoms, or even to help with hormonal acne). Hormonal birth control typically contains synthetic forms of estrogen and progesterone that are much stronger than you would find in the average hormone therapy medication. Also, most forms of hormonal birth control override ovarian function, meaning they tell your ovaries to take a break while they provide the hormones instead. 

By contrast, hormone therapy is primarily used to help reduce symptoms of menopause. These medications help supplement what your ovaries naturally produce. HRT also typically provides much less estrogen and/or progesterone than birth control medications, providing the minimum amount needed to help with your symptoms. Hormone therapy also isn’t an effective form of contraception.

Does Birth Control Delay Menopause?

Another question you have is whether taking hormonal birth control delays menopause. After all, if you might have fewer symptoms and might continue bleeding each month while taking the pill, that certainly sounds like you’re not in menopause. However, this is another common misconception. 

Birth control doesn’t stop, delay, or turn back the clock on menopause. Menopause is the end of your reproductive years, meaning your ovaries stop releasing eggs and producing as much estrogen and progesterone. As far as we know, there is nothing we can do or take to prevent menopause from happening. So, while birth control might mask the signs and symptoms, it won’t make your ovaries continue to function as they did in premenopausal years.

Comprehensive Women’s Health Care from Our Providers at HerKare

Our treatment providers at HerKare are here to help you address your health and feel your best. We can help you make important decisions around birth control, health risks, and symptom relief during and after menopause. Our team is dedicated to providing high quality women’s health care at every stage of life. Make an appointment today to learn more and discuss your health with one of our medical providers. 

Do I Need to Get Mammograms After Menopause?

by Melanie Remy | Jul 20, 2021 | Menopause, Wellness

Mammograms may not be your favorite thing to do, but they’re still an important part of women’s health care. Mammograms are special x-rays that look at the breast tissue. They can be a helpful screening tool to look for signs of breast cancer. Now, you may have a lot of questions about mammograms, including whether you still need them after menopause and what to expect. So, let’s talk about mammograms in general, why you need them, when you need them, and how they work. 

Why are Mammograms Important for Women’s Health Care?

Women’s health care helps you stay healthy after menopause, so make sure you schedule mammograms and other screenings to address your health.

Why do doctors recommend getting regular mammograms? Essentially, they can help with screening and early detection of breast cancer.

Mammograms can help detect abnormalities before you can even feel them during a breast exam or experience symptoms. Early detection is important because it can help reduce risks, increase the chances of survival. It can also help open up more treatment options.

Therefore, most health experts recommend regular mammograms as an important breast cancer screening tool. Also, since mammograms can help with early detection, many insurance plans cover these screenings (though you should always check your specific policy to be certain). 

What Does my Women’s Health Care Provider Look for During a Mammogram

What exactly does the radiologist look for in the mammogram images? There are many things they may be on the lookout for, including: 

• Calcifications
• Masses
• Abnormal changes

Calcifications are mineral deposits in the breasts. These are pretty common and can be either benign or malignant. Things like aging, injuries, and benign cysts can all cause calcifications. However, they can also be caused by dead abnormal cells building up and becoming hard, which may be an early indication of breast cancer. 

Masses include cysts and tumors. Once again, these can be fairly common and don’t necessarily mean you have breast cancer. In fact, most breast cysts and tumors are benign. However, since some can be cancerous, the radiologist will look for signs of these masses in your mammogram. 

Also, if you have records of previous mammograms, the radiologist may also compare them to look for changes that might be concerning. Having these past images may help the radiologist detect changes that might require additional screenings. Therefore, if you change to a different women’s health clinic, you may want to request your records be sent to your new provider to help with this process.

Do I Still Need Mammograms After Menopause?

Now, you might wonder if you still need mammograms after menopause. The answer is typically yes.

As we mentioned, you should talk to one of our medical professionals about your personal situation. However, it’s important to understand that the risk for breast cancer increases as we age. In fact, research estimates most breast cancers are found in women who are over 50. So, mammograms are still important after menopause for most women. 

Talk to a Women’s Health Care Provider about How Often to Get Mammograms After Menopause

Of course, not every woman has the same needs, even when it comes to mammograms. So, talk to one of our doctors about mammograms and how often you need one after menopause. 

General mammogram guidelines for women with average breast cancer risk recommend:

• 40-44 years old: Optional annual mammograms
• 45-54 years old: Annual mammograms
• 55-75 years old: Mammograms every 1-2 years
• 75+ years old: Mammograms based on your individual health status and risks

However, these recommendations don’t fit every single woman’s individual risks, benefits, and needs. Therefore, it’s important to discuss mammograms and mammogram frequency with your health care provider based on your situation. One of our women’s health care providers can discuss your medical history, risk factors, overall health, and more to help create a personalized plan for mammogram frequency. 

Your age and menopausal status may help you and our health care provider determine how often you should get mammograms. After menopause, you might be able to switch to getting mammograms every two years instead of every year. This depends on many different factors. However, some research suggests that after menopause, women tend to have slower-growing breast cancers than premenopausal women. This may mean that you can reduce mammogram frequency to every two years, though you should talk to our doctors about your risks and individual circumstances. 

What to Expect During a Mammogram

If you’re going in for your first mammogram, you might feel a little nervous. Knowing what to expect can help, so let’s talk about what to expect before, during, and after your mammogram.

How to Prepare for a Mammogram at your Women’s Health Clinic

There’s not much you need to do to prepare for a mammogram after you schedule the appointment. Most women find it’s more comfortable to wear a two piece outfit that day, as you’ll have to undress from the waist up for the mammogram. 

Also, it’s important not to wear deodorant, powder, lotion, or perfumes anywhere on or around the breasts the day of your mammogram. This is because these products can leave behind small particles that can show up on the mammogram and may look like calcifications or other potential concerns. Therefore, a good rule of thumb is not to apply anything to your breasts, underarms, or surrounding areas the day of your mammogram. 

Now, of course, this is a routine for many women. If you forget and realize you have deodorant or other products on, just let us know during check-in. In some cases, you may be able to remove the products enough with a cleaning cloth to still go ahead with your mammogram. 

During the Mammogram

The mammogram itself takes typically around 30 minutes. The mammographer will place your breast onto a plate and another plate compresses the breast to help with imaging. Some women might feel some discomfort with the compression, but speak up if you feel pain, especially if you experience severe pain. The compression lasts anywhere from a few seconds to a little less than a minute for each image. Most mammograms include at least two images for each breast.

Getting Your Results

After your mammogram, the images go to a radiologist who “reads” them. The office will typically contact you within a week to give you your results. The results might include explaining your breast density score, any areas of concern, or simply when the doctor recommends you have your next mammogram.

Getting Called Back After a Mammogram

Sometimes, you may need to come back for additional imaging, such as another mammogram, a breast ultrasound, or even a breast MRI. This is actually fairly common, with an estimated 5-15% of women getting called back for more images. So, while it might be concerning to you, try not to worry too much and work with your women’s health care provider to schedule the extra screening to learn more. Most repeat mammograms and breast images don’t detect cancer, so keep this in mind if you get called back after your mammogram.

Often, if the mammogram images aren’t clear, parts of the breasts were left out of the images, or if the radiologist sees an area that might be a concern, then they’ll recommend additional tests to look at the area more closely.

In some cases, if you have dense breasts, then your provider may also recommend additional imaging. Dense breasts are essentially breasts that have a higher ratio of breast tissue to fat. Dense breasts are fairly common, but they can make detecting issues on mammogram images a little more difficult and they also increase your risk for breast cancer. Therefore, in many cases, you may need additional tests done as part of your breast cancer screening. Your doctor will help you determine next steps based on your specific situation and risk factors. 

Quality Women’s Health Care at Every Stage of Life from HerKare

Looking for a women’s health care provider that understands? We’re a women’s health clinic owned and managed by women for women. Our goal is to help you address your wellness at every stage of life. We are here to help empower you to take control of your health today. Whether you need a well woman check up or are dealing with concerning symptoms, make an appointment today to discuss your health with our medical team.

Menopause Could Put You at Risk for High Cholesterol

by Melanie Remy | Jun 18, 2021 | Menopause, Wellness

Do you know your cholesterol levels? If not, it’s time to talk to our women’s health care provider about them! You may not realize, but menopause could change your cholesterol levels and put you at a higher risk for high cholesterol, which can put your health at risk. Even if your cholesterol levels have been healthy before, menopause is a critical time to get screened and talk to your doctor about strategies to help you stay healthy.

Staying healthy after menopause means knowing your cholesterol levels!

Talk to Your Women’s Health Care Provider About Your Cholesterol Levels

High cholesterol usually doesn’t cause any symptoms. It’s a silent condition, but it can put your health at risk in many different ways. So, it’s important to know whether you have high or elevated levels and learn strategies to lower them or keep them in healthy ranges. 

Here are the current cholesterol screening recommendations for women with low risk:

• 20-55: Cholesterol screening every 4-6 years
• 55-65: Cholesterol screening every 1-2 years
• 65+: Cholesterol screening every year

However, if you do have certain risk factors, our women’s health care provider may recommend more frequent screenings.

Here are some general cholesterol goals for most healthy adults:

• Total cholesterol: less than 200 mg/dL
• LDL cholesterol: less than 100 mg/dL
• HDL cholesterol: more than 60 mg/dL

The key to remember is you want your LDL (bad cholesterol) levels low and your HDL (good cholesterol) levels to be high. This is because LDL sticks to and builds up in the arteries, like hair clogging a drain in your home. HDL, on the other hand, is sort of like a drain cleaner, taking cholesterol out of the bloodstream and back to the liver.

Menopause Can Increase Your Risk for High Cholesterol

If you’re going through menopause, now may be an important time to get a cholesterol test. LDL cholesterol levels tend to rise and HDL levels tend to decrease around this time. There may be a link between low estrogen levels and this cholesterol change during menopause. Other changes during this time can also contribute to the risk for high cholesterol.

How Estrogen Affects HDL Cholesterol Levels

While both men and women can have high cholesterol levels, women are more at risk later in life after menopause. This is because estrogen drops off pretty dramatically during menopause. Estrogen is a hormone that has been linked to higher HDL cholesterol levels. Remember, HDL cholesterol is the good kind, that helps remove the LDL from your arteries and back to the liver. However, lower estrogen levels after menopause can mean your HDL levels start to decline and your LDL levels start to increase. Therefore, even if you’ve never had high cholesterol levels before, these hormone changes can have a significant impact. 

One study found that cholesterol levels rose dramatically anywhere from one year before to one year after the last period for women who participated in the study. That’s why it’s important to talk to your women’s health care provider about cholesterol and how to keep it in healthy ranges during and after menopause. 

Why Care about Cholesterol Levels?

It’s a common misconception that only middle-aged men need to worry about cholesterol, but women are at risk for high cholesterol as well, particularly after menopause. The problem with high cholesterol is that, even though it doesn’t necessarily have any symptoms, it can cause other serious health conditions. Some of the most concerning and life-threatening are cardiovascular problems from high cholesterol.

Increases Risk for Heart Disease, Heart Attack, and Stroke

Heart disease is the leading cause of death for both men and women, especially for women after menopause. Unfortunately, cholesterol awareness is particularly low among women. One survey from the American Heart Association found that most women, about 76%, didn’t know their cholesterol levels. However, cholesterol can put your health at risk. 

High cholesterol levels can increase your risk for conditions like:

• Heart disease
• Atherosclerosis (hardening of your arteries)
• High blood pressure
• Heart attack
• Stroke

The main problem with cholesterol is that it can clog your arteries. Cholesterol can become sticky plaque that sticks to the arteries and blood vessels. Over time, this can harden your arteries and make them narrower, meaning less blood can flow through them. This can make your heart work harder and even damage the heart muscle from all the overwork. 

Also, the plaque can break off and cause clots that block blood flow. If the blood clot blocks blood flow to your heart, you have a heart attack. If it blocks blood to the brain, you have a stroke. Therefore, it’s incredibly important for your heart health to keep your cholesterol levels in check. 

Where does Cholesterol Come From?

To understand how to keep your cholesterol levels healthy, you need to know what cholesterol is and where it comes from.

First, what is cholesterol? Cholesterol is a fatty, waxy substance in your blood. Cholesterol isn’t all bad, and you actually need it to make many different things in your body, like bile, sex hormones, cortisol, and vitamin D. 

Since cholesterol is so necessary for many different processes in your body, your liver actually makes most of the cholesterol you need. About 80% of cholesterol comes from your liver. The other 20% of cholesterol comes from your diet. 

It’s a common misconception that dietary cholesterol increases your blood cholesterol levels. This isn’t necessarily the case. Actually, dietary cholesterol is unlikely to significantly increase your risks for high cholesterol. However, trans fats and saturated fats certainly can. 

Some things that play a role in your risks for high cholesterol include:

• Genetics
• Diet
• Age
• Activity level

Why Get Regular Cholesterol Screenings from your Women’s Health Clinic?

Getting your cholesterol tested is a simple blood test we perform at our women’s health clinic. Our team can check your cholesterol levels as part of your annual health exam. We can also talk about strategies for keeping your cholesterol levels healthy. Even if you don’t have high or elevated levels, we can talk about things you can do to keep them low. 

If you do have unhealthy cholesterol levels, we’ll work with you to create a treatment plan to help you stay healthy and reduce your risks. So, make sure you get regular cholesterol screenings as part of taking care of your overall health.

Treatment Solutions for High Cholesterol After Menopause

If you do have high cholesterol levels after menopause, our women’s health care team can help you find treatment solutions for how to lower cholesterol. Treatment for high cholesterol can look different for different people, and it all depends on your specific situation. 

For instance, some women are able to lower cholesterol with diet and lifestyle changes, like cutting out trans and saturated fats and increasing how much they exercise. In other cases, you may need medications to help lower your cholesterol. Many women require all of these strategies. Our medical professionals will work with you to personalize your treatment and help you reduce health risks from high cholesterol. 

Quality Women’s Health Care to Help You Take Control of Your Health

Our team at HerKare is here to empower you by helping you take care of your health. We listen, understand, and help you take steps to improve your overall wellness. We’re with you at every stage of life to help you stay healthy and help you feel great. Whether you have a specific health concern or just need a checkup to get necessary screenings to help with early detection of serious conditions, our team is here for you. Make an appointment with one of our women’s health care providers today!