Dr. Soma Mandal is widely regarded as one of America’s top physicians in midlife women’s health. She earned her MD at New York University School of Medicine and completed a prestigious research fellowship at Oxford University in England. Dr. Mandal is board certified in Internal Medicine and authored her book to bring a fresh perspective to the topic of menopause and provide a much-needed, easy-to follow process to make the forties and fifties plus fabulous. She shares her thoughts on some hot topics in menopause with myDoqter below.
myDoqter: Dr. Mandal, you are an expert in menopause and women’s health. Can you tell us what is menopause and when does it typically start and occur?
Dr. Mandal: Menopause is the end of menstruation. It is when the ovaries stop producing eggs and hormone levels, specifically estrogen, decrease. True clinical menopause is when a woman has been without a menstrual cycle for twelve months. The average age of menopause in the United States is 50.
myDoqter: What is bioidentical hormonal replacement therapy and what are the potential benefits and side effects?
Dr. Mandal: When estrogen levels decrease during the menopausal and post-menopausal years, women can suffer from fatigue, skin and hair changes, mood disorders, decreased libido, hot flashes, night sweats and weight gain. Bioidentical hormones are man-made hormones which are derived from plant estrogens that are chemically identical to those that the human body produces. There are various forms of bioidentical hormones including pills, patches, creams, gels and injections. Bioidentical hormones are used to increase the levels of hormones that have decreased and reduce the menopausal symptoms. Like any other medication, bioidentical hormones are also associated with side effects, including acne, bloating, weight gain, fatigue, mood swings, and increase facial hair in women.
myDoqter: Hair loss in women is an extremely common complaint and is possible in menopause. What can you tell us on its presentation and treatment when associated with menopause?
Dr. Mandal: One of the most important things you can do during menopause is to take care of your hair. What you do and how you do it can have a profound effect on the health of your hair. Your hair follicles are where your live hair cells reside, so it makes sense that what you do for your inside will help to nourish them. When patients consult with me about hair loss related to menopause, I tell them to maintain a healthy diet, hydrate, exercise and get lots of fresh air, manage stress levels, quit smoking, go easy on flat irons and hair dryers, use products that moisturize your hair and comb or brush your hair gently.
There are a few treatments for hair thinning that have had some success including minoxidil, spironolactone, finasteride and estrogen therapy.
Low level laser therapy (LLLT) is a newer technology that uses low level laser light. This is delivered to the scalp to stimulate hair growth. It has shown to be effective, especially for people who have not had success with or cannot tolerate standard treatments.
In more extreme cases, hair transplantation remains an option. It has come a long way since the days of visible hair plugs and painful surgeries. Less invasive options include hair enhancements and extensions or restoration.
myDoqter: It seems like everyone today is seeking fast solutions to weight including weight loss pills, weight loss surgery, weight loss programs. What can you tell us specifically about weight loss and/or gain and menopause?
Dr. Mandal: There is a kind of resignation that many women have that menopausal weight gain is just something we have to deal with. It is true that as we age, managing our weight becomes harder. Metabolisms slow down, appetites change, the ability to exercise changes and energy levels change. Enter menopause and we are faced with challenges we may have not had before. We’re dealing with hot flashes, mood disturbances, sleep problems, and more. Menopause can also be accompanied by metabolic problems such as risks for increased body weight, especially around the midsection, insulin resistance and glucose and lipid metabolism disturbances. As a result, the risk of Type 2 diabetes, osteoporosis, cardiovascular disease and cancer increase.
It is at this time that you have to make a strong commitment to yourself and to your plan
myDoqter: If you had to give us your top 3 Do’s and Don’t when it comes to menopause, what would they be?
Dr. Mandal: Here are my top Do’s and Don’ts: