INTERVIEW
Menopause happens to all women, often preceded by hot flashes. It regularly follows a pre-menopause, which manifests itself in different ways. Against its main symptom: hot flashes, treatments exist but not all women must follow the same. Guest of Europe 1, doctor Emmanuelle Lecornet-Sokol, endocrinologist at the hospital of Pitié Salpêtrière in Paris and author of the book Et si c'est ça hormonal?, Gives his advice and explains what the risks are.
Before menopause, pre-menopause and other risks
If menstruation stops around the age of 51, certain disorders and symptoms may occur before. They are often a sign of premenopause. It can appear from 40-45 years old, with different symptoms. The first may be "periods that become irregular", "cycles that are shorter", every two weeks, three weeks, instead of every month. It can also be "mood problems, mood swings or tiredness". Finally most commonly "it can be hot flashes, even before the cessation of menstruation we can have moments when the body will run out of hormones". Explains endocrinologist on Europe 1.
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But early signs, before the age of 45, can also be a sign of "premature ovarian failure": the ovaries stop working, especially after chemotherapy, or radiotherapy. This disease requires medical care and monitoring in order to avoid insufficient prolonged hormonal intake. You also have to watch your weight gain: the "best way is to move". It is also necessary "to continue to make smears every two years" in particular after 50 years. "It may be helpful to measure bone density" to screen for osteoporosis. Finally, there are women, for "who it stops overnight, nothing happens, no symptoms, everything is fine".
Hot flashes: main symptom sometimes disabling
Hot flashes can materialize in different ways, either "we can have the feeling of always being hot", or "it rises slowly, most often it starts at the trunk and then it rises gently at the face, we turns red and then goes down again. In any case, "the body sweats mechanically when you get too hot". Usually it lasts for a year "a little difficult" and then it fades over time. times this past year, the symptoms can last for seven years. From time to time, it happens to see "a 70 year old woman with a few hot flashes for a few months and then it goes away".
Most often, they occur at night and "this is where it will be the most disabling, it will wake you up several times at night, chop your sleep and therefore it can greatly affect your quality of life, if you are awake all the hours, that you have to change three times a night, we understand that you are tired, nervous, irritable. " It is in these cases that treatment can sometimes be offered.
One effective, but controversial treatment ...
The best treatment is hormone replacement therapy for menopause. But after studies in the United States, "we realized that it increased certain cancers and the cardiovascular risks". These studies were themselves challenged because the women were aged 60 and at high cardiovascular risk, especially overweight. In addition, in the United States, "estrogen-based treatment from horses is used while in France, natural hormones are used". "The main risk that we fear is the increase in healthy cancer, and we know that the risk is really increased after 10 years of hormone replacement therapy. We advise women not to exceed five years."
Today we reserve this treatment "for women who have a lot of hot flashes" and who can not get out of it by natural means. Most often, "we prefer to use patches or creams, because when you take hormones by mouth, the hormones will pass through the intestine and then into the liver and the fact that they pass into the liver will increase certain risks such as in particular the risks of thromboses such as clots, phlebitis or pulmonary embolism ". By passing the hormones directly through the skin, this risk is limited.
... And alternative treatments with uncertain results
"If you look at the scientific medical literature, there is not much that works." "There are estrogens from plants that can help pass but they are also hormones so if we take a lot, it can also have harmful consequences" This is the case for phytoestrogens, especially those from soy . For "all plants when doing studies, there is not necessarily an efficiency" explains Doctor Lecornet-Sokol. "But maybe for some women such a plant may work."
"For such another woman, such a dietary supplement can work. It can always be worth a try, by discussing it with her doctor of course". These supplements can be a track when one is followed for a hormone-dependent cancer and therefore one cannot take hormones. In addition, there are very interesting studies on hypnosis which could really help in these cases. Maybe anything sophrology can help. "