| Introduction
to Menopause
 What is menopause?
When
a woman permanently stops having menstrual periods, she has reached the
stage of life called menopause. Often called the "change of
life," this stage signals the end of a woman’s ability to have
children. Many physicians actually use the term menopause to refer to the
period of time when a woman’s hormone levels begin to change. Menopause
is said to be complete when menstrual periods have ceased for one
continuous year.
The transition phase before menopause is medically referred to as climacteric,
but more recently perimenopause. During this transition
time before menopause, the supply of mature eggs in a woman's ovaries
diminishes and ovulation becomes irregular. At the same time, the
production of estrogen and progesterone decreases. It is the enormous drop
in estrogen levels that causes most of the symptoms commonly associated
with menopause.
When does menopause occur?
While the average age of menopause is 51, menopause can actually occur any
time between the ages of 40 and 55. Women who smoke and are underweight
tend to experience an earlier menopause, while women who are overweight
often experience a later menopause. Generally, a woman tends to experience
menopause at about the same age as her mother did.
Menopause can also occur for reasons other than natural reasons. These
include, but are not limited to, the following:
premature menopause
Premature menopause may occur when there is ovarian failure before the
age of 40, and may be associated with smoking, radiation exposure,
chemotherapeutic drugs, or surgery that impairs the ovarian blood
supply.
surgical menopause
Surgical menopause may follow an oophorectomy (removal of an ovary or
both ovaries), or radiation of the pelvis, including the ovaries, in
premenopausal women. This results in an abrupt menopause, with women
often experiencing more severe menopausal symptoms than if they were to
experience menopause naturally.
What are the symptoms of menopause?
The following are the most common symptoms of menopause. However, each
woman may experience symptoms differently - with some having few and less
severe symptoms, while others have more frequent and stressful ones. The
signs and symptoms of menopause may include:
| hot
flashes |
Hot
flashes are, by far, the most common symptom of menopause, with
about 75 percent of all women experiencing sudden, brief,
periodic increases in their body temperature. Usually hot
flashes start before a woman’s last period. For 80 percent of
women, hot flashes occur for two years or less. A small
percentage of women experience hot flashes for more than two
years. These flashes seem to be directly related to decreasing
levels of estrogen. Hot flashes vary in frequency and intensity
for each woman.
In addition to the increase in the
temperature of the skin, a hot flash may cause an increase in a
woman's heart rate. This causes sudden perspiration as the body
tries to reduce its temperature. This symptom may also be
accompanied by heart palpitations and dizziness.
Hot flashes that occur at night are
called night sweats. A woman may wake up drenched in sweat and
have to change her night clothes and sheets.
|
| vaginal
atrophy |
Vaginal
atrophy involves the drying and thinning of the tissues of the
vagina and urethra. This can lead to dyspareunia (pain during
sexual intercourse), as well as vaginitis, cystitis, and urinary
tract infections. |
| relaxation
of the pelvic muscles |
Relaxation
of the pelvic muscles can lead to urinary incontinence and also
increase the risk of the uterus, bladder, urethra, or rectum
protruding into the vagina. |
| cardiac
effects |
Intermittent
dizziness, paresthesias (an abnormal sensation such as numbness,
prickling, tingling, and/or heightened sensitivity), cardiac
palpitations, and tachycardia may occur as symptoms of
menopause. |
| hair
growth |
Changing
hormones can cause some women to experience an increase in
facial hair and/or a thinning of the hair on the scalp. |
| mental
health |
While
it is commonly thought that mental health may be negatively
affected by menopause, several studies have indicated that
menopausal women suffer no more anxiety, depression, anger,
nervousness, or feelings of stress than women of the same age
who are still menstruating. Psychological and emotional symptoms
of fatigue, irritability, insomnia, and nervousness may be
related to both the lack of estrogen, the stress of aging, and a
woman’s changing roles. |
Q: "I am 49 years old and have started exhibiting signs of
menopause, with the most bothersome being hot flashes. I wondered if there
is anything I can do to cope with these?"
A: Hot flashes appear as a result of decreasing estrogen levels. In
response to this, your glands release higher amounts of other hormones
that affect the brain’s thermostat, causing your body temperature to
fluctuate. Discuss hormone replacement therapy with your physician, as
this has proven to relieve some of the discomfort of hot flashes for many
women. Some women may experience some minor relief by taking vitamin E,
although this has not been confirmed in scientific studies. Some other
practical suggestions for coping with hot flashes include:
- Dress in layers, so that you can remove clothing when a hot flash
begins.
- Avoid foods and beverages that may cause hot flashes, such as spicy
foods, alcohol, coffee, tea, and other hot beverages.
- Drink a glass of cold water or fruit juice when a hot flash begins.
- Reduce your stress level, which may aggravate hot flashes.
- Keep a thermos of ice water or an ice pack next to your bed during
the night.
- Use cotton sheets, lingerie, and clothing that allow your skin to
breathe.
- Keep a diary or record of your symptoms to determine what might
trigger your hot flashes.
Treatment for menopause:
Specific treatment for menopausal symptoms will be determined by your
physician based on:
- your age, overall health, and medical history
- current symptoms
- your tolerance for specific medications, procedures or therapies
- your opinion or preference
Several therapies that help to manage the symptoms often associated
menopause include the following:
| hormone replacement therapy (HRT) |
Hormone
replacement therapy (HRT) involves the administration of a
combination of the female hormones estrogen and progesterone
during perimenopause and menopause. HRT is most commonly
prescribed in pill form. However, estrogen can also be
administered by using transdermal skin patches and vaginal
creams. |
| estrogen replacement therapy (ERT) |
Estrogen
replacement therapy (ERT) involves the administration of
estrogen alone, which is no longer being produced by the body.
ERT is often prescribed for women who have had a hysterectomy.
Estrogen is prescribed in the following forms: pills,
transdermal skin patches (where the estrogen is absorbed through
the skin), and vaginal creams. |
| non-hormonal treatment |
This type of
treatment often involves the use of over-the-counter creams that
do not contain estrogen to relieve some of the symptoms
associated with menopause. |
| estrogen alternatives |
Estrogen
alternatives are the so-called "synthetic estrogens",
such as raloxifene, which may offer the bone-building benefits
of estrogen without many of the possible coinciding risks (i.e.,
an increased risk of endometrial cancer). |
| alternative therapies |
Homeopathy and
herbal treatments may offer some relief from some symptoms of
menopause. |
Research studies are continually being conducted to evaluate the
benefits and possible side effects of hormone replacement therapy, as well
as the other treatments for menopause. When approaching menopause, every
woman should discuss each option - the potential risks and benefits -
with her physician.
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