Menopause Made Easy with Carolle Jean-Murat

Last Editorial Review: 10/23/2003

By Carolle Jean-Murat
WebMD Live Events Transcript

Menopause information can be confusing. Is it just a transitional stage of a woman's life, or a time of increased risk of disease that needs intervention? Carolle Jean-Murat, MD will help sort through the confusion and address your needs and concerns.

The opinions expressed herein are the guests' alone and have not been reviewed by a WebMD physician. If you have questions about your health, you should consult your personal physician. This event is meant for informational purposes only.

Moderator: Welcome to The Women's Health Place on WebMD LIVE. Our guest speaker this afternoon is Dr. Carolle Jean-Murat. Today we will be discussing menopause.

Carolle Jean-Murat, MD is a board-certified obstetrician-gynecologist who has been in private practice in San Diego since 1982. She is an assistant clinical professor at the University of California, San Diego School of Medicine and the women's health expert and columnist for San Diego, San Diego's premier local site on the Internet. Dr. Carolle Jean-Murat has her own website at where she addresses women's health issues. Her most recent book, Menopause Made Easy, empowers women in midlife to make good health decisions.

Dr. Carolle, welcome to WebMD LIVE. It is really a pleasure having you here today. Would you tell us about your background and experience in women's health, please?

Dr. Carolle: I have been a gynecologist in private practice in San Diego for 18 years. I was trained in Haiti, Mexico, Jamaica, and had my postgraduate training at Mount Sinai Medical Center in Milwaukee. I have written four books (so far) which include: Menopause Made Easy, Natural Pregnancy A-Z, which just hit the book stores. I also wrote Staying Healthy: 10 Easy Steps for Women. I currently am a columnist regarding women's health issues for many web sites. 

Moderator: We already have quite a number of member questions. Let's get to them.

Dr. Carolle: Okay.

Moderator: I should mention members that on Dr. Carolle's website, she says "Ask me anything," so please feel free to ask away! This question came in before the event. Is there a way to tell if you truly have started menopause? I have had numerous tests (D&C, biopsy, ultrasound) for breakthrough bleeding. Is this normal for premenopausal women? WebMD Nickname peteyjo

Dr. Carolle: Irregular bleeding is very common during pre-menopause. A woman is menopausal when she NO LONGER has menstrual bleeding for six months to a year.

I only received part of Briar-Rose ?

Moderator: She has been running a low grade fever for several months. Could this be part of perimenopause?

Dr. Carolle: A low grade fever could be a sign of a low grade infection, not a common symptom of perimenopause

Moderator: Another emailed question: Is it normal to have extremely heavy menstrual during the beginning of menopause? WebMD Nickname Jackie47

Dr. Carolle: Menopause means the cessation of menses. Some women may experience heavy menstrual bleeding at any time during her life, including the period that precedes menopause, which is called perimenopause. 

Moderator: I'm a Black 40 year old female just diagnosed as being in menopause after taking the FSH test. My doctor will be talking with me about therapy soon, but I understand that hormonal (horse urine and the like) is not safe. What are your views? Thank you. WebMD Nickname jl726

Moderator: This member has a follow up question also...

Dr. Carolle: Taking HRT (hormone replacement therapy) is a matter of personal decision, taking into consideration short-term relief of symptoms, as well as long term prevention of heart disease and osteoporosis, with the possibility of an increased risk of breast cancer. If you are having symptoms that are making your life miserable, you should consider taking HRT. If you are asymptomatic, you need to take a good look at your risk factors for heart disease and osteoporosis. If you have any risks, you can prevent either of them by maintaining a healthy lifestyle. My book, Menopause Made Easy, is a great resource for women such as yourself. In Chapter 9, I help women to assess their personal risks and how to decide if HRT is the right decision or not. 

Moderator: Is there anything that I can take for a dry vagina? My husband and I have trouble with irritation which contributes to an outbreak of yeast infections. That is the only problem that we have and we like to have an active sex life. Can you please help us? WebMD Nickname sweetpea9

Dr. Carolle: Dear sweetpea9, if you are menopausal and not on estrogen replacement therapy, taking estrogen will resolve the vaginal dryness. If not, it could be due to lack of foreplay. Otherwise, you can use a vaginal moisturizer such as K-Y jelly, Astroglide or Replens, or vitamin E oil.  My mother told me, "What I liked the most about menopause was that I didn't have any more periods, there was no more fear of pregnancy, and the sex was better." This has been my experience with most menopausal women, unless there are other underlying problems such as relationship issues, stressors, as well as physical challenges.  

Natural menopause typically begins around the ages of 45 to 51. For approximately 7 percent of women, it occurs prior to age 40. In places where nutrition is poor, menopause occurs even earlier. Genes may also play a role in a woman's age at menopause.  One study demonstrated that women aged 45 to 54 whose mothers had experienced early menopause had a six-fold higher probability of entering menopause early, in comparison to women whose mothers entered menopause after the age of 45. When a woman asks me to predict when she will go through menopause, I tell her to ask her mother first. Unfortunately for many women, their mother had had a hysterectomy which made it difficult to determine the exact age of menopause.

Moderator: I have terrible itching from the withdrawal of estrogen. Why is this subject not mentioned in any menopause book? How long does this last and what can I do to help myself? WebMD Nickname AtinaLee

Dr. Carolle: Dear AtinaLee, itching can be due to numerous conditions but not, that I know of, to a lack of estrogen. You may want to keep a log of what you are eating and/or any products you are using to see if there is any correlation to the itching. 

Moderator: I recently began taking HRT for osteoporosis prevention (I had not had any hot flashes in a year) and the night sweats are BACK!! Isn't that totally opposite what it should be doing?? WebMD Nickname SensBarb

Dr. Carolle: Dear SensBarb, you may be having an allergic reaction to the HRT medication. I would suggest trying another type of HRT, or looking at other choices, such as regular exercise and calcium supplements You could also try a medication such as Evista (raloxifene). 

Moderator: I'm interested in using vitamins and herbs instead of hormones. Can you recommend any we can use? I had a reaction to Prempro, the prescription hormone. I swelled up with water in the legs and feet, which disappeared when I stopped taking Prempro. WebMD Nickname arlene8

Dr. Carolle: Dear arlene8, the use of herbs and vitamins instead of hormones will depend on a woman's symptoms as well as her personal risk for diseases she wants to prevent.  My book, Menopause Made Easy, has several chapters devoted to herbs, vitamins, calcium, and maintenance of a healthy lifestyle.  Hormone replacement therapy (HRT), which includes estrogen, progesterone or a progestin, are all natural, since they are derived from naturewhether they are obtained through a drug company or a compounding pharmacy. All of them have their inherent benefits and risks. 

Moderator: Could you tell us how you might use alternative medicine and therapies to treat menopause symptoms?

Dr. Carolle: There are a number of alternative choices available to treat menopausal symptoms.  The choice of which option to use is a personal choice. I recommend to my patients that want to avail themselves of alternative methods to consult with a reliable practitioner.  In my book, Menopause Made Easy, there is a chapter discussing alternative methods as well as herbs to help with menopausal symptoms. 

Moderator: In your opinion, Dr. Carolle, is menopause just a transitional stage of a woman's life, or is it a time of increased risk of disease?

Dr. Carolle: Menopause is a transitional stage. Of course, as we age, we may be more at risk for many diseases. One's lifestyle is a very important part of decreasing any possible risk. I have been looking forward to menopause since my first period. I am approaching 50 and can't wait!!!! I see this second stage of my life as the BEST time of my life and I am looking forward to a great life!!!! 

Moderator: Here's to second stage!!!! Dr. Carolle, thank you very much for joining us today. It has really been a pleasure.

Moderator: Members, you may check out where Dr. Carolle answers women's health questions. Her most recent book, Menopause Made Easy, is available now at your local or online bookstore.

Dr. Carolle: Thanks to every one who participated. I had a great time and look forward to our next chat..

Moderator: We look forward to having you back on WebMD LIVE. You did a lovely job. Thank you very much indeed!


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