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Article Category: Highlights

Take the Mystery Out of Menopause with Wellstar

Published on November 19, 2024

Last updated 12:18 PM November 19, 2024

Women walking

From sleepless nights to hot flashes and brain fog to vaginal symptoms, many women feel isolated or embarrassed about discussing what they go through during menopause. At Wellstar, our compassionate women’s health team provides individualized care to help women navigate this stage of life, demystify menopause and give women back their confidence during this stage of life. 

Menopause means no more periods. Period.

Menopause is defined as the permanent absence of a period for 12 consecutive months. The average age of menopause in the U.S is 52, but generally, women will experience menopause between ages 45 to 55. 

Perimenopause is the four- to seven-year period prior to menopause when women are having menopausal symptoms.  

“During perimenopause, cycle lengths will vary. Many women experience their periods coming closer together. Hot flashes and night sweats are also common during this transition,” said Wellstar Women’s Health Nurse Practitioner Karin Hulon.  

Women may also experience brain fog, mood swings, fatigue, trouble sleeping, skin and hair changes, vaginal dryness, decreased libido, painful sex, joint pain or inability to lose weight. Every woman is unique and may not experience the same severity of symptoms. The menopause experience may be influenced by genetics, race or environmental factors. 

Many symptoms can be explained by a decrease in estrogen. 

The ovaries are the main producers of estrogen. As women age, ovarian follicular function decreases, leading to decreasing levels of estrogen. These levels can also radically decrease due to surgery, infection, medications or radiation.  

“Estrogen receptors are found all over our bodies. A decrease in estrogen can affect the part of the brain involved in thermoregulation, resulting in hot flashes and night sweats,” said Wellstar Chief of Women’s Health Dr. Paula Greaves. “Research suggests that women who have hot flashes may be at higher risk for developing heart disease. Additionally, research shows that African American women experience more intense and more frequent hot flashes for a longer duration.” 

Estrogen receptors are located in the vagina, vulva, bladder and urethra, helping to maintain blood flow, tissue turgor and microbial balance. Therefore, a decrease in estrogen can lead to vaginal dryness and atrophy, making intercourse painful. The pH of the vagina also changes with decreased estrogen, increasing the risk of infections or urinary leakage.  

These are only some examples of how menopause can impact women’s health and quality of life, and it’s important to treat menopausal symptoms as soon as possible.

Hormonal and non-hormonal treatments are available and can be beneficial—regardless of symptoms. 

Your care team will discuss your concerns and health history to tailor a safe, personalized plan that fits your needs. The choice should be guided by symptoms, medical history, contraindications and shared decision making. There are FDA-approved hormonal as well as non-hormonal options for treatment of hot flashes, vaginal dryness, painful intercourse and even decreased libido.  

“We must promote lifestyle changes such as smoking cessation, weight loss and cognitive behavioral therapy, which can help decrease symptoms,” said Dr. Greaves. 

Even if you no longer have periods, you should still see your OB/GYN.  

“Women: You need your mammograms and your health and cancer screenings, including Pap smears until age 65. Women who have had abnormal Pap smears in the past may need to continue Pap smears beyond age 65,” Hulon said. “Even if you’ve had a hysterectomy and you no longer have a uterus, you still need to ensure pelvic floor health.”

If you experience vaginal bleeding after menopause, schedule an appointment with your women’s health care team.

“The cause of bleeding could be something as simple as vaginal tearing due to dryness or as serious as endometrial cancer,” Hulon said.

Whatever your health concerns may be, Wellstar will partner with you to help you stay healthy. Other diseases can masquerade as menopause, so if something is worrying you or stopping you from feeling your best, mention it to your clinician.

“For example, if you start having joint pain, that may not be menopause. That may be arthritis. Fatigue, weight gain or night sweats may be a sign of thyroid disease, not menopause,” Dr. Greaves said. “Trust and open communication have been instrumental in aiding gynecologists to uncover other diseases affecting our patients who assumed they were menopausal.” 

Wellstar OB/GYN clinicians specialize in addressing the health needs of women and are experienced in caring for people going through menopause.

“It is important when you’re looking for a clinician to find someone who specializes in women’s health and who has a passion for treating women entering the menopause transition,” Hulon said. “Find someone who will listen to you, not dismiss you, will make you feel comfortable and treat you as an individual.” 

While troubling symptoms of menopause may be common, you don’t have to go through it alone. 

“With increasing life expectancy, women will spend more than 40% of their life in this life stage. Therefore, we need to focus our efforts in providing a smooth transition for every woman into menopause so she can enjoy her best years yet,” Dr. Greaves stated.  

Wellstar Women’s Health offers compassionate care through menopause, answering your questions and helping to manage your symptoms. Many of our clinicians are certified menopause practitioners. Find a Wellstar OB/GYN location near you.  

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Karinthian Elaine Hulon Paula Cecilia Greaves Womens Health
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It’s important for women to know the symptoms and schedule regular screenings to detect breast cancer early. Remember PINK—Prevention, Information, Next steps and Knowledge—to guide your awareness.

P: Prevention

The best way to detect breast cancer early is by staying connected with your healthcare provider and keeping up with regular visits and screenings, including mammograms.

Who should get screened, and when?

Annual mammograms are recommended starting at age 40. Women with additional risk factors or a family history should speak with their provider about starting screenings earlier.

I: Information

Research and learn as much as you can about breast cancer. Knowing the signs and symptoms could save your life.

What are the symptoms of breast cancer?

Some symptoms may be spotted early. Knowing what to look and feel for can help catch breast cancer before it progresses:

  • Lump in the breast or underarm
  • Breast swelling or thickening
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  • Change in breast size or shape
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N: Next steps

When a mammogram result is flagged for follow-up care, it can feel scary. At Wellstar, you don’t have to face the process alone. Our Comprehensive Breast Health Program offers complimentary concierge services, automatically enrolling patients with abnormal mammogram results. Dedicated nurse navigators guide you through each step of the diagnostic process—helping with scheduling, answering questions and supporting your physical and emotional well-being.

If you are diagnosed with breast cancer, it’s important to partner with your care team to plan your treatment.

What happens after a breast cancer diagnosis?

  • Schedule a follow-up visit. Meet with your healthcare provider to ask questions about your diagnosis and treatment options.
  • Consult with specialists. At Wellstar, breast surgeons and oncologists work as part of an integrated team to recommend treatment tailored to your condition. Patients also have access to advanced imaging, leading facilities and experts in surgery, radiology, pathology and oncology.
  • Explore STAT Clinic. At the Breast Cancer STAT Clinic at Wellstar North Fulton Medical Center, a full team—including a breast surgeon, medical oncologist, radiation oncologist, genetic counselor and nurse navigator—meets with you in one place on the same day. Together, they create a personalized treatment plan before you leave, helping reduce the time from diagnosis to treatment from months to just two weeks. This patient-centered model brings the specialists to you, ensuring the most seamless, supportive experience possible.

K: Knowledge

Knowing your personal health, family history and risk factors helps your care team determine if you may be at increased risk of developing breast cancer.

For women ages 24 to 39, Wellstar has partnered with Gabbi to offer a personalized, virtual breast cancer risk assessment. The program provides next-day virtual visits with specialists, coordinated imaging at Wellstar and 24/7 concierge support.

What are the risk factors for breast cancer?

  • Age. Risk increases as women get older.
  • Family history. Having a relative with breast cancer—or a male relative with prostate cancer—can increase risk.
  • Previous radiation therapy. Radiation to the chest for other cancers or lymphomas may increase risk.
  • Past diagnosis. A previous breast cancer diagnosis raises the likelihood of recurrence.

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For more information, visit wellstar.org/breastcancer.

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Let’s cut to the chase: What is the best way to lose weight?

Dr. Rubin: There is no magic fix that works for everyone. Many people have tried every fad diet out there. They’ve tried being more active. Maybe they’ve even had bariatric surgery or used injectable weight loss drugs—but nothing works. If this sounds like you, schedule an appointment at a comprehensive weight loss center. Find one that offers medical and surgical treatment options and personalized recommendations. And make sure they provide ongoing support to help you meet and maintain your weight loss goals.

Dr. Hilton: Both of our centers take this comprehensive approach. We use every tool available to treat obesity. You may be successful with lifestyle changes alone, or perhaps you need to meet with a behavioral therapist or consider surgery, medicine or a combination of therapies. Everyone is unique, and their treatment plan has to be unique too.

What’s your take on weight loss injectables—are you a fan?

Dr. Rubin: I’m excited about drugs like Wegovy and Ozempic, which people sometimes refer to as GLP-1s. They work because they control your appetite and reduce ‘food noise,’ a persistent, unwanted focus on food.

However, not everyone can tolerate the side effects, which include nausea, constipation and diarrhea. If you want to lose more than 20% of your body weight, using one of those drugs alone probably won’t get you there. Another consideration is that many people need to continue taking these drugs for life—even after they reach their weight loss goals.

What are some misconceptions about bariatric surgery?

Dr. Hilton: Two big misconceptions are that bariatric surgery is dangerous and it doesn’t work. Here’s what I’d say: First, bariatric surgery is as safe as a routine procedure like gallbladder removal. Second, bariatric surgery is the most long-lasting and effective treatment for obesity available. Most people who have bariatric surgery maintain their weight loss at the 10-year mark.

With weight loss drugs dominating the headlines, have you noticed a shift away from surgery?

Dr. Hilton: Yes, but I think that’s temporary. The drugs are sparking conversations about obesity and weight loss, which is a good thing. Patients who have never considered bringing up obesity to their primary care provider are asking about the injectables. They’re making appointments at a comprehensive weight loss center, and they are discovering they have a lot of choices. It isn’t ‘medicine or surgery’ or ‘medicine versus surgery.’ Sometimes the best answer is both.

Can you share a weight loss success story with us?

Dr. Rubin: We’ve had so many success stories. One of our rock star patients has lost 250 pounds under our care. Now, she’s living her life again. Her diabetes is in remission, and her cholesterol has improved. She’s no longer depressed and isolated. My whole team is so proud of her—she has completely changed her lifestyle, sees our dietitian regularly and attends our support group. Another patient has lost 135 pounds. He and his wife are losing weight together, and it’s fantastic.

Dr. Hilton: We ask our patients at their first visit, ‘What does success look like to you?’ Most have a number in mind, but non-scale victories are important too. Some want to get off their diabetes medicine or shop in a regular store instead of a big and tall store. Others want to take their kids to Disney World or a water park and have fun on the rides—not just watch.

What is the No. 1 key to weight loss success?

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Ready to take your first step? If you’re considering lifestyle changes, medication or surgery for weight loss, it all starts with a conversation. Schedule a visit with your primary care clinician to discuss your goals, health history and next steps.

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Let’s Talk About Mom’s Mental Health

Being a mom* is hard. From the moment your baby is born, everything changes. New moms often feel tired, worried and overwhelmed. But sometimes, the feelings go beyond just being tired. Some moms experience serious mental health concerns—and we need to talk about it.

Maternal mental health means how a mother feels in her mind and heart during pregnancy and after giving birth. Many moms go through things like depression, anxiety or even scary thoughts. This is more common than people think. 1 in 5 moms experience perinatal depression. Mental health disorders—including substance overdose and suicide—are now the No. 1 cause of maternal death in the United States, according to the Centers for Disease Control and Prevention.

There are some factors that can make it more likely for a mom to struggle with her mental health, including:

  • History of depression or anxiety
  • Difficult pregnancy or birth
  • Not having support from family or friends
  • Money problems or job stress
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  • Race as a social construct (1 in 3 Black women may experience a mood disorder during or after pregnancy)

Even though many moms need help, it can be hard for them to access it. There are barriers to care, or things that can get in the way. Some moms are afraid to speak up because they worry people will think they are a bad parent. Others may not know where to go for help. Some moms don’t have health insurance or live far from a doctor. These problems can make it harder to get better. In addition, not all obstetrics clinicians have had sufficient training on the diagnosis and treatment of perinatal mood and anxiety disorders (PMADs) and management of mental health medications during pregnancy and/or lactation. 

The good news: Help is out there. Mental health challenges after having a baby are treatable. And there are options that really work. Talking to a therapist—virtually or in person—can help moms feel heard and understood. Sometimes medicine can help too. Support groups, where moms can talk to each other, are also helpful. Getting rest, eating healthy and having help with the baby can make a big difference.

It’s very important that moms—and the people around them—know the signs of a mental health concern. Some signs to look for include:

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If you notice these signs in yourself or someone you love, speak up. It’s not a sign of weakness. It’s a sign of strength to ask for help. Every mom deserves to feel well and cared for.

Let’s be honest: Moms are superheroes. But even superheroes need support. We need to make sure that every mom knows she’s not alone. We must make it easier to talk about mental health. We must listen without judgment. And we must make sure help is easy to find.Healthy moms mean healthy families. When we take care of mothers, we take care of our whole community.

If you’re a mom who’s struggling, please know this: You are not alone. You are not to blame. And you can get better. Speak up, reach out and know that there are people who care and want to help. Ask your obstetrics care team and see these resources for moms and families.

Resources for patients and families

1. Postpartum Support International (PSI)

PSI offers education, training and resources for professionals working with families during the perinatal period. They also provide a clinician directory, helpline and certification programs.

Helpline: (800) 944-4773 (Text “HELLO” to (800) 944-4773)

2. Shades of Blue Project

This project focuses on maternal mental health support for Black and brown birthing people. They offer culturally competent resources, education and support groups and provide training opportunities for clinicians looking to improve care for underserved populations.

3. MotherToBaby

This organization provides expert, evidence-based information about medications and other exposures during pregnancy and breastfeeding. Their team also offers live chat and phone consultations.

Helpline: Call or text (866) 626-6847

Resources for clinicians

1. PEACE for Moms

This is a free psychiatric consultation service for Georgia clinicians caring for pregnant and postpartum patients. They offer provider-to-provider support on screening, diagnosis and treatment of perinatal mental health conditions.

2. Postpartum Support International Professional Resources

This group provides clinician training, consultation and certification in perinatal mental health. They also offer a perinatal psychiatric consultation service.

3. LactMed (Drugs and Lactation Database)

This is a National Institute of Health resource for up-to-date, evidence-based information on medications and their compatibility with breastfeeding.

Find a Wellstar behavioral health specialist near you or find a Wellstar OB/GYN.

*Mom and mothers are used throughout this article. However, I recognize and respect that not all birthing parents identify as female. At Wellstar, we believe in honoring every voice.

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