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What are the symptoms of menopause?

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Posted on Thu, 2 Apr 2015
Question: I'm premenopausal (56), probably approaching menopause now since my periods have become much more infrequent and sparser than normal. Also have noticed more hair fallout recently. Here's my issue: I have sore muscles and joints never experienced before. I exercise regularly, play tennis, etc. so this muscle and joint pain are new to me. I read estrogen fluctuations can cause muscle and joint pain. Even though I haven't started menopause yet, would it be safe to start an estriol cream applied to my face? I have been using natural progesterone cream for over 10 years with great success.
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Answered by Dr. Timothy Raichle (1 hour later)
Brief Answer:
This is probably okay / safe...

Detailed Answer:
Thank you for the question. In women who still have a uterus, whether they are in menopause or not, they should not be using "unopposed" estrogen. Estrogen alone, in any form, could increase your risk of uterine cancer.

Given that you are using a combination of estrogen AND progesterone, then I would say that this is probably safe to do. The only problem that I see is that the dose that you are getting is somewhat variable and not quite as safe as controlled doses taken orally or with a transdermal patch (with regard to estrogen). The dose is probably very low, though.

Yes, irregular / infrequent cycles and thinning of the hair are classic symptoms of menopause transition and are normal. Most women have gone through menopause at this point (defined as no period for 12 months), so I would be cautious about any additional bleeding being continued cycles versus postmenopausal bleeding. From what little you have described, it sounds like the normal cycle related changes, but if there is even the slightest question that your bleeding is NOT related to dwindling cycles, then use of estrogen is absolutely contraindicated.

Finally, while you have read that muscle and joint pain can be a symptom of menopause, it is not typical. You might benefit from a visit with an internal medicine doctor to discuss whether there is something else going on and consider a test of bone mineral density.

I hope that this helps and good luck!

Dr. Raichle
Above answer was peer-reviewed by : Dr. Prasad
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Dr. Timothy Raichle

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Practicing since :1999

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What are the symptoms of menopause?

Brief Answer: This is probably okay / safe... Detailed Answer: Thank you for the question. In women who still have a uterus, whether they are in menopause or not, they should not be using "unopposed" estrogen. Estrogen alone, in any form, could increase your risk of uterine cancer. Given that you are using a combination of estrogen AND progesterone, then I would say that this is probably safe to do. The only problem that I see is that the dose that you are getting is somewhat variable and not quite as safe as controlled doses taken orally or with a transdermal patch (with regard to estrogen). The dose is probably very low, though. Yes, irregular / infrequent cycles and thinning of the hair are classic symptoms of menopause transition and are normal. Most women have gone through menopause at this point (defined as no period for 12 months), so I would be cautious about any additional bleeding being continued cycles versus postmenopausal bleeding. From what little you have described, it sounds like the normal cycle related changes, but if there is even the slightest question that your bleeding is NOT related to dwindling cycles, then use of estrogen is absolutely contraindicated. Finally, while you have read that muscle and joint pain can be a symptom of menopause, it is not typical. You might benefit from a visit with an internal medicine doctor to discuss whether there is something else going on and consider a test of bone mineral density. I hope that this helps and good luck! Dr. Raichle