Menopause

What is Menopause?

Menopause is a naturally occurring biological process that marks the end of a woman’s reproductive years. It is further defined as the point in time when your period permanently stops for 12 months. This typically occurs between the ages of 45-55, but women who have never had children or those who are smokers may begin menopause up to two years earlier.

In the years leading up to menopause, between the mid-late 40s, women may also begin experiencing symptoms. This transitional period is called perimenopause. It typically begins about four years before menopause but can start up to ten years prior.

 Symptoms that begin during perimenopause and continue or worsen throughout menopause include:

  • Hot flashes
  • Low energy
  • Vaginal dryness
  • Low libido
  • Mood changes
  • Weight gain
  • Slowed metabolism
  • Disruption of sleep
  • Urinary incontinence
  • Thinning hair and dry skin
  • Anxiety
  • Brain fog

Menopause Treatment Options

Treatment options for menopause can be started as soon as symptoms begin and continued for up to 10 years after menopause is complete. After menopause, the ovaries no longer produce estrogen, and this can cause continuing menopausal symptoms and additional health risks like osteoporosis and heart disease. The following treatment options can be considered to ease uncomfortable symptoms of menopause for women during this transitional period.

Hormone Therapy

Hormone replacement therapy can be administered in the form of topical creams, patches, sprays, oral medications, or pellets. Vaginal estrogen therapy can also be administered in the form of a ring inserted into the vagina, a dissolvable tablet, or creams. Replenishing estrogen will help to rebalance hormone levels and reduce the severity of symptoms like hot flashes and night sweats.

Vaginal Rejuvenation

For women who prefer non-hormonal treatments, we offer a variety of rejuvenating treatment options. These therapies can be used alone or in combination with hormone treatments.

MonaLisa Touch® uses laser energy for skin resurfacing to restore the health of the vaginal tissue. Radiofrequency energy used by ThermiVa®  helps with vaginal dryness, urinary incontinence, and increases sexual satisfaction.

Platelet-rich plasma (PRP) or the O-shot® can also improve vaginal dryness and assist with painful sex. PRP injections are administered to the vaginal area to stimulate tissue regeneration and renew healthy vaginal tissues.



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Menopause is inevitable for women, but it doesn’t have to negatively alter your life. Our team is here to help you through the menopausal process with fewer, less severe symptoms. Contact our office today to discuss your options in more detail and develop a personalized treatment plan with safe and effective treatment options.

TOBY F. HANDLER,
MD, FACS

Dr. Handler practices and specializes in female incontinence and pelvic floor reconstruction. She is Director of Female Urology in the Department of Urology at Winthrop University Hospital. Dr. Handler has over 20 years of experience and has recently focused on female sexual health and finding treatments for all women who have vaginal pain and sexual dysfunction.

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