Women ask: ‘Is this normal?’

The “M” word: It could be many things, but for women between ages 45 and 55, it often means menopause, the time in a woman’s life when monthly menstrual cycles stop and the ovaries no longer release eggs and produce hormones. Perimenopause, meaning “around menopause,” refers to the time prior when the body begins the transition to menopause. Women may still have their menstrual cycle during perimenopause.

For many women, this time is not exactly a welcome part of life because of the body changes associated with it. Fortunately, there’s hope.

Dr. Ray Pourang Kamali, a board-certified OBGYN affiliated with Sharp Chula Vista Medical Center, answers some common questions from women in the post-menopause club.

1. Is discharge normal?
   Discharge is more common in younger years; however, post-menopausal women may experience it as well. Most instances of discharge are normal, but talk with your doctor — who can typically determine its cause by evaluating characteristics like appearance and smell — to make sure it’s not a sign of something more serious.
   

2. Why am I bleeding?
   Many women experience vaginal bleeding, but it’s important to know when it’s abnormal. Bleeding after menopause is always considered abnormal and should be evaluated, as it could be a sign of cancer.
   

3. Why do I sometimes leak urine?
   Menopause takes a toll on women’s bladders. We know this because the vaginal tissue becomes less elastic, the lining of the urethra begins to thin and the pelvic floor weakens.
   The most common types of incontinence in post-menopausal women are:
   
    • Stress incontinence — a little urine leaks from coughing or sneezing
    • Urge incontinence — also called an overactive bladder
    • Nocturia — waking up during the night with an urge to urinate
    • Painful urination — typically caused by urinary tract infections, which are more common in post-menopausal women
   
   Treatment for incontinence depends upon the type, but small changes like strengthening the pelvic floor with Kegel exercises; maintaining a healthy weight; and watching what you drink (coffee, soda and alcohol can be a trigger) can help.
   

4. Do I still need to see a gynecologist after menopause?
   Yes. Post-menopausal women should have regular pelvic exams, Pap smears and mammograms to keep track of any changes in their bodies. Regular checkups are especially important for post-menopausal women as a woman’s cancer risk increases with age, and early detection is an important defense against cancer.

For the news media: To talk with Dr. Pourang Kamali about women’s health questions post-menopause for an upcoming story, contact Erica Carlson, senior public relations specialist, at erica.carlson@sharp.com.