Health · Menopause

Reinvention at 45, Part II (Ask Dr. Pat)

5. Menopause management matters. When you need help with symptoms, be assured that you can find choices that will make this transition far easier than the media, the chatrooms, and negative menopause blogs make you think is possible. At this point you only have physical symptoms of menopause that you can very likely control with a progesterone IUD.

As you progress through the menopausal transition, there are many coping skills that help with hot flashes and night sweats. (See “Cognitive Behavioral Therapy for Management of Hot Flashes and Night Sweats.”) 

However, we know that these coping mechanisms do not work for every woman.  There is much evidence that some women need more than coping mechanisms in order to function because they suffer through significant night sweats, sleep disruption, and daytime fatigue. These symptoms can be managed with the use of low dose systemic hormone therapy begun around the time of menopause.  Timing of hormone therapy initiation, length of use of hormone therapy, dose of hormones used, and route of delivery all seem to be important in the safer use of hormone therapy.  Some women cannot or do not want to use systemic hormone therapy.  There are some medications that are used for off-label treatment of hot flashes and night sweats. Do discuss these with your health care provider if you need this alternative.

RELATED: “Is Hormone Replacement Therapy Dangerous?

You can return to the new school year in September well prepared from the hard work you can choose to do in this intensive summer program. You can be fortified with new lifestyle behaviors and new ways of eating and coping with triggers that cause overeating and bad food choices.  The daily exercise routine you can choose to have this summer needs to be part of your routine when you return to the school year. It will improve mood, energy, and brain power. Your summer weight loss program can put you well on your way to your ideal weight and give you a plan to continue to lose the rest of the weight and keep it under control. This part of your reinvention plan will make you feel better and look better:  Both are great for the providing better mood and better health for the rest of your life.

6. Finally, find women in your community whom you admire who are decades older than you: women who know how to find silver linings, who are still visible and vital, and who choose to live with positive emotions instead of anger and disappointment.  These role models can be a marvelous support for you as you make choices about what is next for you. Menopause matters, and you are just the right age to get in shape for a healthy and optimistic second half of life.



  • Choosing a Safe and Successful Weight-loss Program, The National Institute of Diabetes and Digestive and Kidney Diseases
  • Hodis HN, Mack WJ, Shoupe D, et al. Testing the menopausal hormone therapy timing hypothesis: the Early Vs Late Intervention Trial with Estradiol. Circulation. 2014;130:A13283.
  • Ayers B, Smith M, Hellier J, Mann E and Hunter MS. Effectiveness of group and self-help cognitive behaviour therapy to reduce problematic menopausal hot flushes and night sweats (MENOS 2): a randomized controlled trial. Menopause 19,7:749-759 (2012). Funded by NIHR BRC
  • Levonorgestrel Intrauterine System versus Medical Therapy for Menorrhagia
  • Janesh Gupta, M.D., Joe Kai, M.D., Lee Middleton, M.Sc., Helen Pattison, Ph.D., Richard Gray, M.Sc., and Jane Daniels, M.Sc., for the ECLIPSE Trial Collaborative Group
  • N Engl J Med 2013; 368:128-137 January 10, 2013 DOI: 10.1056/NEJMoa1204724

Start the conversation

This site uses Akismet to reduce spam. Learn how your comment data is processed.