AdventistHealth.org/Portland 13 Q What would be helpful for women to understand about menopause before they approach it? What should I think about in, say, my 30s or 40s? A: Katie: Some people experience perimenopause fluctuations over many years, as long as seven to 10, while some never notice a thing! Track your cycles. Knowing what your “normal” is holds a lot of power. Regular exercise or movement, a well-balanced diet, and routine mindfulness practices can all help you live a healthy life and treat symptoms of perimenopause and menopause. Q What do partners need to know about menopause to best support their loved ones? A: Dr. Malmin: Some people will need care and attention; others will want to avoid talking about it. Just be supportive and know many factors — including aging, loss of fertility, life transitions, fatigue, anemia, metabolism, sleep and changing hormones — contribute to feelings about this time of life. Q In perimenopause and as we age, how can women safely control the risk of pregnancy? A: Katie: The irregular, unreliable cycles common in perimenopause make it difficult to know when one is fertile. The best practice to prevent conception is using barrier methods or another form of birth control. Many women in perimenopause opt for a hormonal IUD or a combined oral contraceptive, if you don’t have certain risk factors. Q Since menopause is a natural process, isn’t it best to avoid hormone replacement therapy? A: Dr. Malmin: Natural is a tricky term. Many “natural” processes happen to our bodies that make us feel worse, and we weigh the risks and benefits. The impact of menopause is different for each individual. Often, the benefits of treatment outweigh the risks, and women are happier and healthier with additional hormones. The best plan is to talk to an expert about your needs, risks and goals. Q Does menopause mean I don’t need gynecological care anymore? A: Katie: It does not! The American College of Obstetricians and Gynecologists recommends cervical cancer screening with co-testing for HPV every five years (if normal) from age 30 through 65. Plus, your gynecology provider loves to see you annually to check in with breast health, overall health and well-being. Q What are safe and/or natural ways to reduce symptoms? A: Katie: Some people are eligible for topical estrogen cream to alleviate symptoms such as vaginal dryness and shrinking as well as vasomotor symptoms. However, you and your provider should have a conversation and make an informed decision together. You can also discuss herbal remedies, aromatherapy, cognitive behavioral therapy (CBT), nutrition and exercise. Questions about menopause or any other phase of life? Call our women’s clinic team at 971-231-7790.