What Is The Menopause?
The menopause is the cessation of the reproductive phase in women. The "change" as it is sometimes known, also signifies the cessation of menstruation and the end of the childbearing years. It is a natural biologic process, it is not an illness, nor it is a disease. While it is generally a unique experience for each woman, the menopausal syndrome can be diagnosed by a group of relatively characteristic symptoms that are produce by this process. The onset of the menopause generally occurs between the ages of 48 to 55, however, the process it self can start any time from the late 30's to the late 50's.
Its onset is usually signaled by changes in the menstrual cycle: decreased bleeding, skipped periods, unusually heavy menstrual flow over a shorter than usual time. This may last for several months or to several years. Irregular menstruation may not occur in all women, for some may simply stop having menstrual periods with no menstrual irregularities at all.
What Is Happening To Cause The Menopause?
During this period of time, the production of female hormones and ovulation ceases. During the childbearing phase each woman produces two female hormones, estrogen and progesterone. They are produced by her ovaries and are integral to the cyclic release of an egg each month from the ovary. As the childbearing period comes to an end this cyclic production of the female hormones begins to wain and eventually stops.
It is this failing of the cyclic release of her hormones that leads to the irregularities of the menstrual cycle. There is, however, more to it. Not only does the hormone production become irregular and start to fail but the estrogen receptor sites throughout her body may also no longer be able to recognize the presence of the estrogen that has been produced. Hence, "the menopausal syndrome," the symptoms that most women have learned to associate with menopause are caused by the combination of the failure of the ovary to produce estrogen and progesterone and failure of the estrogen and progesterone receptors to recognize the hormones when the are available.
What Are The Symptoms Of The Menopause?
To better understand what the menopause is we need to divide the menopause into its two component parts: the Premenopause (also known as the Perimenopause) and the Postmenopause.
The Premenopause is that part of the menopause that occurs from the onset to the actual failure of the ovary and the hormonal function. It accounts for the majority of the "symptoms" that are most annoying and frequently associated as the menopause: irregular periods, lighter or heavier periods, hot flushes, night sweats, mood swings, etc. While these symptoms are often quite disturbing and uncomfortable few, if any, long-term harmful changes have taken place. If the cause of this process, hormonal deficiency, is not dealt with serious problems can ultimately result.
The postmenopause period is that part that occurs after the complete failure of the ovary and its hormonal function. It usually and arbitrarily starts one year after the last menstrual bleeding. Symptoms such as: skin changes, genital atrophy, osteoporosis (demineralization of bones), weight gain, vaginal itching and dryness, changes in skin texture and increased body and facial hair, are most likely caused by the bodily changes which are created with the loss of the female hormone, estrogen. It is during this time that most of the harmful health problems occur.
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Symptoms of the Menopause
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Hot Flashes
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Insomnia
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Depression
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Night Sweats
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Visual Changes
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Body Flushing
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Irregular Menstruation
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Memory Loss
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Skin Aging
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Cessation of Menstruation
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Genital Skin Atrophy
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Crying
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Offensive Menstrual Odors
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Skin Tingling-Itching
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Mood Swings
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Weight Gain
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Backaches
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Increased Facial and Body Hair
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Anxiety
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Emotional Instability
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Osteoporosis
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What Happens With Sexuality And Childbearing?
Nothing or everything. Many women lose their interest in being sexual during the perimenopausal period. Often this is caused by the loss of female hormones and the "symptoms" that are making their life uncomfortable. Sometime depression occurs for the same reason but often because of anger at losing the childbearing capacity. Many women have increased sexuality for the fear of "getting pregnant" is now gone and they can finally "be their real selves" without fear or penalty. Vaginal skin atrophy and dryness may become a problem of the woman does not know how to deal with it.
What Treatment Is Necessary And Available?
During the early stages many of the symptoms and future problems can be relieved and alleviated by proper medical attention. There are however, things that each woman can do on her own. A good diet will be very important to help prevent weight gain, depression, anxiety, mood swings, etc. Hormonal replacement therapy can be valuable in stabilizing the menstrual periods, relieving the flushes and flashes, vaginal dryness, etc. Certain herb preparations, such as, Dong Quai can help reduce the flushes and the flashes.
Think young, feel young and keep your mind and thoughts on today and the future, do not get caught up in the drama of the menopause and the "old wife's tale" about what is supposed to happen. Create your own positive experience. Develop a daily exercise routine to keep body tissues fit, trim and youthful. Keep active, develop new interests in work or hobbies, enjoy friends and life experiences. Remember the menopause is a rebirth not a death.
Major Health Problems Of The Postmenopause
Bone demineralization (osteoporosis), atherosclerosis (hardening of the arteries), heart disease, stroke and cancer are the most common medical problems of this period of a woman's life. Many "menopausal" women feel that these problems are just inevitable. They are not! With good medical follow up and education most can be prevented. Periodic preventive examinations which include interim medical history, pap smear, pelvic, breast, rectal and skin examinations are important.
Estrogen Replacement: "To Do Or Not To Do?"
We are strong believers in estrogen replacement therapy (ERT) for we believe that the greatest risk of the menopause is the risk of osteoporosis and prevention of fractures. Statistically 30% of all women over the age of 65 are at risk for fractured hip. Ten to 15 percent of these women will die prematurely of complications due to osteoporotic fractures each year. A larger percentage will become crippled and will lose their ability to be mobile and maintain a free life style. ERT has been proven to be effective, safe and valuable in prevention of osteoporosis.
Recent studies have convincingly demonstrated that neither ERT or HRT are associated with causing or worsening breast cancer. These statistics tell us that overall women do better on ERT and HRT and that their quality of life is greatly improved. Many physicians are now returning their patients who have history of breast cancer back to ERT or HRT. HRT's value in reducing the risk of osteoporosis, relief of symptoms of the menopause, as well as depression, anxiety and mood swings associated with the menopause. These alone scan significantly increase feelings of well-being increasing the menopausal woman's quality of life, However, it is now clear that HRT can also have a significant value in reducing the risks of cardiovascular disease, respiratory diseases and either reversing memory loss or slowing it down. These benefits along with HRT's ability when combined with diet to eliminate and even reverse osteoporosis suggest that it should be an important consideration for every woman over 40 years of age. While it is still unclear as to role of ERT and HRT in slowing down or reversing the aging process, some studies have demonstrated very positive results in this area.
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