Menopause

What is menopause?

Ovaries stop producing the hormone estrogen at some time during a woman's 40s or 50s, and menstruation will stop a stage of life called menopause. The phase beginning before menopause and continuing after it, during which a woman passes from her reproductive stage, is properly referred to as the climacteric, although most people refer to it as menopause.

The average age of natural menopause is 51, but it can happen from ages 40 to 55 (approximately).

Perimenopause refers to the transitional period of time before menstruation actually stops. During these years:

• ovaries release eggs less regularly
• ovaries gradually produce less estrogen and other hormones
• periods may begin to change
• you are less fertile
• you have shorter menstrual cycles, fewer ovulations, and more cycle irregularity
• circulating levels of estrogens and progesterone are markedly reduced
• androgen (androstenedione) is reduced
• testosterone decreases

Menopause may also occur for other than normal reasons:

Premature menopause refers to ovarian failure of unknown cause that occurs before age 40. It may be associated with smoking, radiation exposure, chemns.otherapeutic drugs, surgery that impairs ovarian blood supply, or other reaso

Surgical menopause follows oophorectomy (removal of an ovary or ovaries), or radiation of the pelvis, including the ovaries.

What are the symptoms of menopause?

• Hot flushes (or flashes) and sweating, often followed by cold shivering, affect 60 to 75 percent of women. For 80 percent of these women, the hot flushes occur for two years or less, with a smaller percentage of women experiencing hot flushes for more than two years. These flushes appear to be directly related to decreasing levels of estrogen.
• Mental health may be negatively affected, although some 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 and the stress of aging and changing roles.
  • Lack of sleep due to hot flushes can contribute to fatigue and irritability.
• Risk of heart disease increases.
• Changes in the vagina and urinary tract occur.
  • Dyspareunia (pain during sexual intercourse) may occur, as well as:
    • pelvic relaxation
    • urinary incontinence
    • cystitis
    • vaginitis
• Osteoporosis may become a concern.
• Nausea, flatulence, constipation, diarrhea, arthralgia, and myalgia are also common complaints associated with menopause.

Treatment for menopause:

Specific treatment for menopausal symptoms will be determined by your physician(s) based on:

• your overall health and medical history
• extent of the condition
• your tolerance for specific medications, procedures, or therapies
• expectations for the course of the condition
• your opinion or preference

Maintaining a healthy diet and exercise program are essential for women going through menopause, and supplemental calcium and vitamin D may be suggested by your physician.

Counseling about physical changes, as well as the concerns, fears, and stresses related to this phase of life may be needed. Sometimes, antidepressants, mild tranquilizers or sedatives may be used for depression, anxiety and irritability, and insomnia.

Estrogen replacement therapy (ERT) or hormone replacement therapy (HRT) has been helpful to some women, and is a treatment that should be discussed with your physician as soon as symptoms begin to appear. However, ERT/HRT is not suggested for all women. A thorough physical examination and consultation with a physician is highly recommended for every woman approaching menopause.