Tristan E. Bickman, MD
Santa Monica | obgyn

Menopause Specialist

OB-GYN located in Santa Monica, CA


About Menopause

Menopause marks the beginning of a new stage of life, and as with menstruation, it involves a lot of changes to your body and your health. Dr. Bickman offers women in the Santa Monica area comprehensive care to help them adapt to menopausal changes and make sure they're as healthy as possible. 

Menopause Q&A

How do I know if I am going through menopause?

Although it can take place earlier or later in a woman’s life, menopause usually occurs when women are between the ages of 45 and 55 and is complete when a woman has not had a period for one full year. If you are in or nearing that age range, you should be aware of the signs and symptoms of menopause. One key indicator deals with changes in your menstrual cycle. When you entered menopause, your periods will start to occur less frequently and eventually stop all together.

Other indications that you have entered menopause include hot flashes, mood swings, vaginal dryness or frequent infections, joint pain, insomnia and more. If you are experiencing any of these symptoms, make an appointment with Dr. Bickman to make sure you are in fact experiencing menopause and to rule out any other possible health problems.

What can be done to manage the unpleasant side effects associated with menopause?

Many unpleasant side effects of menopause are due to the body no longer producing the same amounts of estrogen and progesterone it once did. Diet and lifestyle changes are often successful at relieving symptoms and are typically the first steps Dr. Bickman recommends. Depending on your symptoms, Dr. Bickman may prescribe hormone therapy as a way to help make you more comfortable. Hormone therapy replaces the hormones in your body that your body is no longer producing. Although it is not recommended for an extended period of time, this treatment can be very helpful to patients who have severe symptoms.

When can I no longer get pregnant?

You may become pregnant until you have gone one full year without a period, which is the technical definition of menopause. Some women have experienced menopausal symptoms, only to have the symptoms stop a few months later and their periods return. Although pregnancy after age 45 is unlikely, always practice safe sex and never assume you are too old to conceive. Birth control may also help to alleviate some symptoms of pre-menopause, including hot flashes and mood swings.

What occurs during menopause?

Menopause is a normal hormonal change that typically occurs in the late 40s to early 50s and involves the cessation of the menstrual cycle, which means a woman can no longer become pregnant. During this time, the body slows down its production of the hormones estrogen and progesterone. Menopause is said to have occurred when a woman has a full year with no periods, and the lack of periods is not due to another cause. Menopause can be divided into three stages: pre-menopause, when periods begin to become irregular; peri-menopause, when full symptoms begin to develop, lasting until the final period; and post-menopause, which includes life after menopause has taken place.

What are the symptoms of menopause?

Some women go through menopause with few if any symptoms. Others may experience any or all of the following:

  • hot flashes
  • moodiness
  • insomnia
  • vaginal dryness
  • forgetfulness
  • hair loss on the top of the head with possible growth on the face
  • night sweats
  • change in regularity or flow pattern of periods

Can menopause be treated?

Menopause is a natural occurrence, but the symptoms can be treated to make the process more comfortable as your body adjusts to new hormone levels. Treatment may involve hormone replacement therapy to help decrease vaginal dryness, slow bone loss that can occur when estrogen levels drop, and reduce hot flashes and night sweats. Hormone therapy does have certain risks, including potentially increasing the chance of developing breast cancer, blood clots, heart attack and stroke. Dr. Bickman will discuss these risks with you so you can decide if hormone therapy is the right option for your needs. Other types of treatments may be geared toward specific needs, such as the use of personal lubricants to avoid vaginal dryness during sex.

What is hormone therapy?

Hormone therapy is regarded as one of the most successful alternatives for the treatment of side effects and body changes due to the cessation of menstruation and beginning of menopause. Hot flashes, night sweats, sleeplessness and vaginal dryness, among much more, are considered to be typical symptoms. And it seems that these days, more and more, we search for that secret ingredient or natural element that will help relieve those later-in-life ills. So in the interest of a more natural approach to hormone therapy, bioidentical hormones have woman everywhere – from Oprah to the lady down the street – talking. Just exactly what are they? And can they really help?

Are Bioidentical Hormones Considered “Natural?”

Though the term “natural” is open to interpretation, products whose principal ingredients are extracted from animals, plants or minerals are technically considered natural. It doesn’t matter if the substance is ground, put into capsules, sold over the counter or needs a prescription. Bioidentical hormones may not be found in a natural state so to say, but they are extracted from natural plant or animal components, such as those found in yams, soy or pregnant mares.

Are Bioidentical Hormones Considered to be “Safer” than Standard FDA-Approved Hormones?

Like all medicines, hormone therapy has benefits and risks. Many women have opted out in their choice to use bioidentical hormones, citing reasons such as the interference of a natural progression later in life. Others disliked the side effects, such as breast tenderness or bleeding. And some worried about estrogen’s link to breast cancer (though estrogen is made by the body, regardless of any bioidentical hormone therapies). Studies certainly have shown bioidentical hormones to relieve menopausal symptoms, but little evidence suggests that the hormones are safer, or more effective, than standard hormone replacement approved by the Food and Drug Administration (FDA). But to this date, a handful of bioidentical hormones – those assisting with hot flashes or vaginal dryness, including estrogens and progesterones – have actually been approved by the FDA.

Are Bioidentical Hormones Right for Me?

It is very important to work closely with your physician, such as Santa Monica OB-GYN, Dr. Tristan Emily Bickman, M.D. to decide what is right for you. The risk of any hormone consumption certainly depends on more than how it was made. If your menopausal symptoms are bothersome, come in, learn more and let Dr. Bickman discuss with you, your options. Life after menstruation is a gift. Menopause should be a time of reflection, a lantern lighting the way, for transformation in all areas of your life.