• September is National Menopause Awareness Month, and while many women may find cause to celebrate the end of their monthly visit, others dread the many painful symptoms that are often associated with this natural health milestone. If this is you, you’re not alone. Some 6,000 U.S. women reach menopause each day 1 , and it’s projected that around 1.1 billion women will be postmenopausal by 2025.

    While most women link hot flashes to menopause, few understand the painful genitourinary symptoms, which develop from the lack of estrogen that result from menopause. Most women know their menstrual cycles will stop, which could lead to hot flashes, but they do not understand that as the ovarian estrogen and testosterone production decreases, their vaginal tissues can also be affected. How you ask?

    Following menopause there is a decrease in tissue elasticity – in collagen and elastic fibers – as well as a reduction in blood vessels, which bring moisture into the vagina. This leaves many women suffering with the painful symptoms of menopause I hear it from patients everyday – “My husband thinks I don’t love him, but I don’t know how to tell him that being intimate really hurts.”

    It’s not all bad news, though. In fact, we have more options to treat these symptoms, than ever before. Lubricants can help decrease friction during sex, and vaginal moisturizers such as Replens can help keep moisture in the vagina, but to actually make the cells and the tissue return to their former youthful selves, we need something more.

    Vaginal estrogen is a well-studied and safe option. Creams, vaginal tablets, and rings all provide local release of estrogen to the tissue right where it is needed. The doses are very low and studies support the safety of such tiny amounts of estrogen. Studies have even looked at the safety of vaginal estrogen in breast cancer patients and found them to be safe. Nonetheless, many patients have fears about estrogen and are reluctant to fill a prescription or to stay on vaginal estrogen.

    In 2008, the FDA approved a non-hormone, non-estrogen oral medication, ospemifene, which turns on vaginal estrogen receptors, but does not seem to affect estrogen receptors elsewhere, making it very safe and well tolerated. Studies on breast cancer patients seem promising, but are not yet complete. There was and is still room for more advanced options.

    If medications and creams aren’t for you, you may find something to smile about with a new, FDA cleared laser called MonaLisa Touch®. This innovative laser therapy delivers fractional CO 2 laser energy to the vaginal wall tissue to promote vaginal mucosal revitalization. By using columns of light, the treatment stimulates a natural healing response, leading to new collagen and blood vessels, which are made in a matter of weeks. The protocol is three five-minute treatments spaced six weeks apart – there is no pain and no anesthesia required. In many instances, patients who’ve been experiencing painful symptoms of menopause for years are calling to tell me that they’ve noticed a drastic improvement within days of their very first treatment – it’s life-changing for them. Furthermore, patients love MonaLisa Touch™ because it has no known side effects and does not interact with medications; patients need not remember a dosing schedule or have to contend with messy creams, which can interfere with intimacy.

    MonaLisa Touch™ is available with premiere OB/GYN, Urogynecologist, and Urologist offices across the country.

    It’s an exciting time in women’s health. Just because you are menopausal, you don’t have to suffer because there are now safe, painless, effective treatments out there!

    *Brought to you by Dr. Maria Sophocles

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    Article by: Dr. Maria Sophocles

    As a resident at Johns Hopkins/GBMC, Dr. Sophocles learned the importance of empathy. "A patient's trust begins when she senses you care," she says. Throughout her over 20 years as a board certified Ob/Gyn, she has also upheld the Hopkins standards of clinical excellence and innovation. Always thinking outside the box, she promoted early development of umbilical cord blood banks, and researched non-invasive ways to detect abnormal fetal chromosomes. Now, she focuses on advancing non-invasive gynecological procedures to treat vaginal dryness and uterine bleeding. "If I can improve the health and the quality of life in my patients without the use of medications or surgery, then I have helped them with less risk." See more here.

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