With larger vaginal doses on a regular basis (greater than .3mg premarin or an eighth of an applicator) you will still need to take a progesterone for at least ten days three or four times a year, or get an endometrial biopsy of the uterine lining done once a year.

A new estrogen releasing vaginal ring is being developed and one study showed that Swedish women preferred it over creams.

Other Symptoms Of Menopause

If you have other symptoms of menopause, your doctor may not believe they are related to menopause, but they could be.

More than 50 percent of women experience joint pain at some time during menopause. Migraine headaches may start for the first time or worsen around menopause.

According to Janine O'Leary Cobb, author of UNDERSTANDING MENOPAUSE, and editor of A FRIEND INDEED newsletter, up to 20 percent of post-menopausal women may experience a bothersome condition called burning mouth syndrome, which consists of a very dry and burning mouth.

There may be changes in the skin and hair. Underarm hair, pubic hair and scalp hair may thin out and change texture. Unwanted facial hair may also appear.

Many women experience bloating, indigestion and gas. Some women temporarily experience unusual changes in one or more of their five senses.

Changes in sleep patterns are very common. Insomnia may be very debilitating for women and make other problems seem worse.

Mental And Emotional Changes

Emotional and psychological changes of menopause are probably related both to shifting hormone levels as well as to the diverse ways in which women handle major change in their lives, and the quality of women's support systems, family, friends and community.

Many women report depression, irritability, mood swings and emotional over-reaction. Women also note increased forgetfulness, memory loss, disorientation, and lack of concentration. Hormonal levels are probably at least partially responsible for these symptoms.

Hormonal changes particularly affect women who have premenstrual symptoms. During menopause these symptoms may be exaggerated. This is due again to high levels of estrogen without the opposing progesterone.

Levels of satisfaction with yourself, your work, your mate, family and friends also has a lot to do with mental and emotional states; as does attitudes to the visible signs of aging that occur around the same time as menopause, like wrinkles, weight gain, grey hair, and the need for reading glasses.

At this time of life, women may also find themselves "sandwiched" between looking after the needs of aging and ill parents, and dealing with the increased demands and difficulties of teenaged children.

There is no peak of mental illness at menopause but there is the added stress of major physical and emotional changes added to already existing problems.

This time around menopause is an ideal time to cut back on commitments to family, friends, community and career, in order to create more space to really look after your needs, improve your level of health, and celebrate this important transition.

Depression, Self-esteem And Unrewarding Roles

Depression may be a realistic response of a woman to her restrictive role in the family, at least in this culture. This is the view of Dr. Beverly Burnside, Research Associate at the University of British Columbia. She has developed SHOP (Social Health Outreach Program), a grass roots program to help women deal with depression and other problems of aging.