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:

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 (HRT) with your physician, as HRT has shown to relieve some of the discomfort of hot flashes for many women. However, the decision to start the supplementation or replacement of these hormones should be made only after you and your physician have evaluated the risk versus benefit ratio based on your individual medical history.

Some women who experience hot flashes 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 with menopause include the following:

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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