North Jersey Diabetes and Endocrinology

596 Anderson Ave, Suite #208, Cliffside Park, NJ 07010

(201) 941-5757

North Jersey Diabetes and Endocrinology

What is Menopause?


Menopause is the time in a woman's life when the ovarian production of estrogen, progesterone, and testosterone decline. The average age of menopause onset is 51 years old, plus or minus several years. Menopause is medically defined as the time in which a woman ceases to menstruate for the duration of 12 months. Although the definition properly describes the event, the process can begin up to 10 years earlier and is called perimenopause.

Long before a woman's menstruation stops, she will have already noticed a change. Over time, her periods will become shorter in length and she will notice a loss of energy, a decrease in strength, and a loss of libido. Her mood is altered and she may be more agitated, depressed, apathetic, and forgetful. While these are all symptoms of menopause, it is important to know that there is a bigger picture during this time your hormones are changing - you are experiencing the loss of estrogen, progesterone and testosterone.

There is no way to stop menopause. It's part of the natural cycle of life, which every woman will go through. However, the way you deal with this normal process can greatly affect your quality of life for years to come.

Common Symptoms of Menopause

  • Hot Flashes
  • Trouble sleeping
  • Night sweats
  • Vaginal dryness
  • Weight gain
  • Loss of sex drive
  • Mood swings
  • Urinary Incontinence
  • Depression
  • Irritability

Menopause Treatment

Menopause is a natural process. Many symptoms will go away over time. But if they’re causing problems, treatments can help you feel better and substantially improve quality of life. Common ones include:

Hormone replacement therapy (HRT).

Mainstay of the treatment is Estrogen replacement treatment with or without Progesterone. Estrogen is taken by mouth or via a skin as patch, cream, gel, or spray. Dr. Merab Joseph uses both FDA approved Estradiol preparations and compounded estrogen combinations which usually includes different Estradiol and Estriol preparations. These preparations can help with hot flashes and vaginal symptoms, as well as making your bones stronger.

Topical hormone therapy.

Vaginal dryness in general alongside with discomfort and pain during sexual intercourse are usually treated by vaginal estrogen preparations (creams, rings, tablets) which usually do not enter the bloodstream.

Nonhormone medications.

These can be used for the patients who can’t take estrogen replacement treatment or do not wish to do so.

  • The depression medications such as Paroxetine (Brisdelle, Paxil), Venlafaxine (Effexor), Desvenlafaxine (Pristiq), Escitalopram (Lexapro) and Buproprion (Wellbutrin) have been successfully used to treat hot flashes.
  • Medicines called selective estrogen receptor modulators (SERMs),(Tamoxifen, Raloxifen) can also be used for menopausal females.

These medications can help with vaginal atrophy and lower the risk of breast cancer and osteoporosis, but they do not help with hot flashes and may increase the risk of uterine cancer.

Medications for osteoporosis

Osteoporosis medications and Vitamin D supplements are used to improve bone mineral density.

A Holistic Treatment Approach to Menopausal Symptoms

This is a time for a personalized assessment of your particular menopausal risk factors. Together, we will review your personal and family history, any symptoms that you find troublesome, and openly discuss your goals. Treatment plans for menopausal symptoms are always individualized, compassionate, skillful and resourceful.

There is no plan for menopause that is universally appropriate or effective. Our goal is to help you find the best options that work for you, including natural remedies, lifestyle changes, and hormone therapies in order to improve your quality of life and decrease long term health risks.

Dr. Joseph also incorporates Mind-Body Therapies such as Acupuncture, Paced breathing, various Relaxation therapies such as meditation, yoga, breathing exercises and massage in his treatment approach. All this modalities have been successfully used to improve hot flashes, insomnia, depression and other symptoms related to menopause.

We also emphasize the importance of Lifestyle Changes for menopausal females to improve their quality of life and address menopause related long term outcomes. Exercise and a healthy diet with an adequate amount of calcium help lessen osteoporosis and heart disease risks. Other lifestyle changes to consider include smoking cessation, decreased alcohol consumption, healthy weight management and stress management.

Menopause Resources

Office Info

Cliffside Park Office

596 Anderson Ave, Suite #208
Cliffside Park, NJ 07010
Phone: (201) 941-5757
Fax: (201) 941-5779

Office Hours

Monday: 9:00am - 5:00pm
Tuesday: 10:00am - 6:00pm
Wednesday: 9:00am - 5:00pm
Thursday: 9:00am - 5:00pm
Friday: 9:00am - 5:00pm