Menopause
(from the National Library of Medicine)

What is menopause?

Menopause is the transition period in a woman's life when the ovaries stop producing eggs, menstrual activity decreases and eventually ceases, and the body decreases the production of the female hormones, estrogen and progesterone.

Some of the hormone-related stages in your life are:

• Puberty. This is the age when body changes begin and breasts develop. A young girl begins to have a monthly period, often around 12-1/2 years of age.
• Perimenopause. This probably begins about 3 to 5 years before your last menstrual period. It lasts until 12 months after your final period. Some signs or symptoms of menopause may appear during this time.
• Menopause. The event that marks menopause is your final menstrual period. You will know for sure that you have experienced menopause when you have not had a period in a year. Only then can you be sure that you are no longer able to get pregnant.
• Postmenopause. Because this time follows menopause, it begins with your final period and lasts the rest of your life. Like menopause, you do not know you are there until 1 year later. The signs of menopause usually go away in a few years. You no longer have to worry about periods or getting pregnant. You are, however, at greater risk for some health problems.

What are the signs?

Changing levels of estrogen and progesterone can cause a variety of symptoms. You may have little or no trouble with hot flashes or other signs of menopause. Some women, however, have slight discomfort or worse. Common changes you might have are:

• Irregular periods. One of the first signs is a change in your periods. They may become less regular, lighter. Some women have short times of heavy bleeding. These are all fairly common.
• Hot flashes. A hot flash or flush is common in perimenopause. Possibly 80 % of American women have them. Suddenly you feel heat in the upper part or all of your body. Your face and neck become flushed. Red blotches may appear on your chest, back, and arms. Heavy sweating and cold shivering can follow. Flashes can be as mild as a light blush or severe enough to wake you from a sound sleep (called night sweats). Most flashes last 30 seconds to 5 minutes. They should disappear within a few years after menopause.
• Problems with the vagina and bladder. Body tissue in the genital area becomes drier and thinner as estrogen levels change. Sexual intercourse might become painful for you because of this dryness. You might also be more likely to have an infection in your vagina. As you get older, you may begin to have urinary tract problems. These could be more infections, trouble holding urine when you feel the need to go to the bathroom (urge incontinence), or problems holding urine when you sneeze, cough, laugh, run, or step down (stress incontinence). If you have any of these problems, see your doctor.
• Sex. Until you have gone 1 year without a period, you should still use birth control if you do not want to become pregnant. Around the time of menopause, your feelings about sex might change. You might have trouble becoming sexually aroused because of hormone changes, discomfort due to changes in the vagina, or medicines you are taking. Or, you might feel freer and sexier after menopause---relieved that pregnancy is no longer a worry. Remember that after menopause you can still get sexually-transmitted diseases, such as HIV/AIDS (acquired immunodeficiency syndrome).
• Fatigue and sleep problems. Feeling tired is another common symptom. You might have trouble getting to sleep, waking early, or getting back to sleep after waking up in the middle of the night. Women may be awakened by night sweats or the need to go to the bathroom.
• Mood changes. Some people think that women may be more moody, irritable, or depressed around the time of menopause. There might be a connection between changes in the estrogen level and your emotions. Other causes for these mood shifts might be stress, family changes such as children leaving home, and feeling tired.
• Changes in your body. Visible changes with menopause may include a thickening at the waist, loss of muscle mass and increase in fat tissue, or thinning and loss of stretchiness in the skin.
• Other possible signs. Some women may experience headaches, memory problems, and joint and muscle stiffness or pain.

What about heart and bones?

You may not even notice two important aspects of menopause. These are a loss of bone tissue, which can weaken bones and cause osteoporosis, and higher cholesterol levels, which may lead to cardiovascular (heart) disease.

• Osteoporosis. Many people do not know they have weak bones until they break a hip, wrist, or vertebrae (bones in the spine). Osteoporosis develops as people age because their bones grow thinner and become less dense. With time bones may become weak and may break. For women, the loss of estrogen around the time of menopause means that they may lose bone strength faster.
• Heart disease. Young women have a lower risk of heart disease than do men. This changes with age. Falling estrogen levels during menopause may lead to higher cholesterol levels in older women. This, in turn, increases the chance of heart disease, stroke, and other diseases that affect the heart and blood vessels. After menopause, a woman’s risk of heart disease grows to almost equal the risk for a man. In fact, heart disease kills more women than lung or breast cancer.

What can I do about menopause?

You may first try to make some changes in the way you live. Start with a nutritious diet. Contact the National Heart, Lung, and Blood Institute for more information about reducing your risk of heart disease. Also, be careful in your use of alcohol and caffeine, and try to avoid stress. For vaginal discomfort, use a water-based lubricant, but not petroleum jelly. Be sure to get a Pap test, mammogram, and pelvic and breast examinations every year.

What about estrogen supplements?

In perimenopause, your doctor might suggest birth control pills. These will provide birth control, make your periods more regular, and lower your chance of cancer of the uterus and ovaries. It may also help with symptoms like hot flashes. However, the pill hides the arrival of menopause.

When you think you might have reached menopause, you could stop taking the pill for several months to see if you still have a regular period. Once you have reached menopause, your doctor might suggest estrogen and progesterone, known as hormone replacement therapy or HRT. For women without a uterus, the doctor will recommend estrogen alone. This is called estrogen replacement therapy or ERT. The hormones are usually taken as pills, but can be given as skin patches, creams, or vaginal inserts, depending on a woman’s particular needs.

Taking hormones for a short time (less than 5 years) may help relieve any symptoms of menopause. Taking HRT/ERT for more than 5 years will also help delay osteoporosis and may protect against heart disease. It should improve your cholesterol levels and may also help your memory. However, there are side effects and possibly health risks. This is particularly true if you have liver problems, high levels of triglycerides (a type of fat in the blood), or a history of blood clots. Blood clots and an increase in your chance of developing breast cancer are two risks of HRT/ERT.

For more information on HRT/ERT, see the NIA Age Page on hormone replacement therapy.

More information:

American College of Obstetricians and Gynecologists (ACOG)
409 12th Street, SW Box 96920
Washington, DC 20090
202-484-8748

North American Menopause Society
Box 94527
Cleveland, OH 44101
216-844-8748

Planned Parenthood Federation of America, Inc.
810 Seventh Avenue
New York, NY 10019
800-230-PLAN

For information on heart disease:

National Heart, Lung, and Blood Institute Information Center
Box 30105
Bethesda, MD 20824
301-592-8573

Osteoporosis and Related Bone Disease National Resource Center
1232 22nd Street, NW
Washington, DC 20037
800-624-BONE

---
Dee Adams' "Minnie Pauz" (Humor Relief Therapy)
www.minniepauz.com

[Back to Healthy Living Resources]

[More Healthy Living stories]