State Sen. Meg Loughran Cappel’s Women’s Health Care Expo on Saturday at the C.W. Avery Family YMCA in Plainfield focused on women’s health awareness, menopause and nutrition.

Cappel said Women’s History Month was the “perfect time to gather” and celebrate the women who “fought for us to have fuller and healthier lives.”

“It’s all about coming together, empowering women and making sure we can get some of our questions answered,” Cappel said.

What are menopause symptoms?

Dr. Hysoo Ka-Widmann, a board-certified obstetrician and gynecologist at Silver Cross Hospital in New Lenox, said menopause begins one year after the menstrual period ceases.

Perimenopause is the transitional time – typically four to eight years – and is typically the time women experience symptoms, Ka-Widmann said.

“It’s a time when ovaries decide, ‘This month I’m going to work and next month I’m not going to work,’” Ka-Widmann said.

Symptoms may include hot flashes, vaginal changes, insomnia, brain fog, osteoporosis and even joint pain, Ka-Widmann said.

“Estrogen in women has got its tentacles everywhere in your body. There’s not a part of your body that estrogen doesn’t influence. You really have to dissect each symptom and treat each symptom differently. … We are very complicated individuals and not just our hormones.”

For instance, no one should shrug off chest pain as part of perimenopause, Ka-Widmann said.

“Maybe you’re having a heart attack,” Ka-Widmann said.

When should women get (and not get) hormone tests?

Ka-Widmann said symptomatic women sometimes want their hormones checked to see if they are “hormonally imbalanced.”

But hormone levels fluctuate in perimenopause, so hormone tests aren’t helpful, Ka-Widmann said.

Dr. Gamilah Pierre, a board-certified obstetrician/gynecologist at Silver Cross Hospital, said checking hormone levels is different from checking iron levels.

“We’re not trying to get to a number,” Pierre said. “We’re not trying to replace an estrogen level that might be low, appropriately low. With anemia (lack of healthy red blood cells), you’re trying to get you to a certain number. In menopause, we’re trying to support the transition. We’re not trying to get you to a certain number.”

What about hormone replacement products?

With women reaching menopause about age 51 with a life expectancy of 80, women need to lead healthy lives in menopause, Ka-Widmann said.

For instance, hot flashes can create “a cascade of inflammation” in a woman’s body, including the arteries, which may lead to heart disease.

Nevertheless, hormone replacement products should be initiated before age 60, Ka-Widmann said.

“At 60, we believe some of the changes have inherently happened already,” Ka-Widmann said. “Plaque in arteries and veins might be there already.”

Ka-Widmann said not all women are good candidates for hormone replacement therapy.

“If we see somebody who has diabetes, hypertension and high cholesterol…throwing estrogen in there can cause more problems,” Ka-Widmann said.

However, vaginal estrogen is likely safe for nearly everyone because the absorption rate is extremely low, Ka-Widmann said.

What if periods return?

Periods should never return after menopause, both Ka-Widmann and Pierre stressed.

“Once that clock stops – once women are done having periods – we don’t want to see any more blood,” Pierre said.

Some women will dismiss bleeding by saying their period ‘just came back,” Ka-Widmann said. “It does not come back. The ovaries, once they’re gone, have no more eggs to give.”

Any bleeding 12 months after the last period warrants a phone call or doctor visit, Pierre said.

“And don’t be surprised if we want to work that up.”

When to stop pap smears?

Pierre said women should have a pap smear every three years. However, if a woman has never had an abnormal result, she could reasonably stop at age 65.

Women still need an annual gynecologist visit for an exam and mammogram order, Pierre said.

Do fibroids need treatment?

Do uterine growths, called fibroids, need to be treated? Not necessarily if they are small and asymptomatic, Pierre said.

But fibroids causing pain, pressure, frequent urination, problems with intercourse, constipation and heavy bleeding likely need treatment, Pierre said.

Nutrition basics

Gabriela Mucha, manager for the Women, Infants, and Children program at the Will County Health Department, reminded women of the basics of good nutrition and proper exercise.

That included eating a balanced diet of whole grains, lean protein and fruits and vegetables; watching portion sizes, limiting sodium and refined sugar; and checking with the doctor before beginning supplements.