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MenopauseMenopause Overview Menopause is not a disease or an illness. It is a transition between two phases of a woman's life. Menopause occurs when a woman permanently stops menstruating (having periods). Many women experience a variety of symptoms as a result of the hormonal changes associated with the transition through menopause. Around the time of menopause, women often lose bone density and their cholesterol may worsen, increasing their risk of heart disease. Premature menopause: The average age of US women in whom menopause occurs is 51 years. The most common age range at which women experience menopause is 48-55 years. If menopause occurs in a woman younger than 40 years, it is considered premature. Menopause is considered late if it occurs in a woman older than 55 years. For most women, menopause is a normal occurrence. Menopause is more likely to occur at a slightly earlier age in women who smoke, have never been pregnant, or live at high altitudes. If premature menopause occurs, a health care provider will check for other medical problems. About 1% of women experience premature menopause. Perimenopause: The hormonal changes associated with menopause actually begin prior to the last menstrual period, during a 3- to 5–year period called perimenopause. During this transition, women may begin to experience menopausal symptoms and may lose bone density, even though they are still menstruating. Surgical menopause: Surgical menopause is the removal of the ovaries. Women who have had surgical menopause have an increased risk of early heart disease and often experience menopausal symptoms, unless they are given medication. Menopause Causes Menopause occurs when a woman's ovaries run out of functioning eggs. At the time of birth, most females have about 1-3 million eggs, which are gradually lost throughout a woman's life. By the time of a girl's first menstrual period, she has an average of about 400,000 eggs. By the time of menopause, a woman may have fewer than 10,000 eggs. A small percentage of these eggs are lost through normal ovulation (the monthly cycle). Most eggs die off through a process called atresia. Normally, FSH, or follicle-stimulating hormone (a reproductive hormone), is the substance responsible for the growth of ovarian follicles (eggs) during the first half of a woman's menstrual cycle. As menopause approaches, the remaining eggs become more resistant to FSH, and the ovaries dramatically reduce their production of a hormone called oestrogen. Oestrogen affects many parts of the body, including the blood vessels, heart, bone, breasts, uterus, urinary system, skin, and brain. Loss of oestrogen is believed to be the cause of many of the symptoms associated with menopause. At the time of menopause, the ovaries also decrease their production of testosterone—a hormone involved in the libido, or sexual drive. Menopause Symptoms Hot flashes: Hot flashes are the most common symptom of menopause. According to some studies, hot flashes occur in as many as 75% of perimenopausal women. Hot flash symptoms vary among women. Commonly, the hot flash may begin with a feeling of nausea or a headache, followed by a wave of heat, flushed skin, and palpitations (feeling a strong heartbeat). Hot flashes often increase skin temperature and pulse, and they often cause insomnia, or sleeplessness. Urinary incontinence and burning on urination Vaginal changes: Because oestrogen affects the vaginal lining, perimenopausal women may also have pain during intercourse and may note a change in vaginal discharge. Breast changes: Menopause may cause changes in the shape of the breasts. Thinning of the skin Bone loss: Rapid bone loss is common during the perimenopausal years. Most women reach their peak bone density when aged 25-30 years. After that, bone loss averages 0.13% per year. During perimenopause, bone loss accelerates to about a 3% loss per year. Later, it drops off to about a 2% loss per year. No pain is usually associated with bone loss. However, bone loss can cause osteoporosis, a condition that increases the risk of bone fractures. These fractures can be intensely painful and can interfere with daily life. They also can increase the risk of death. Cholesterol: Cholesterol profiles also change significantly at the time of menopause. Total cholesterol and LDL (bad) cholesterol increase. Increased LDL cholesterol is associated with an increased risk of heart disease. Heart disease risk increases after menopause, although it is unclear exactly how much is due to aging and how much is caused by the hormonal changes that occur at the time of menopause. Women who undergo premature menopause or have their ovaries removed surgically at an early age are at an increased risk of heart disease. Weight gain: A 3-year study of healthy women nearing menopause found an average gain of 5 pounds during the 3 years. Hormonal changes and aging are both possible factors in this weight gain. When to Seek Medical Care All perimenopausal and postmenopausal women should see their health care provider annually for a full physical exam. This exam should include a breast exam, pelvic exam, and mammogram. Women should learn about the risk factors for heart disease and colon cancer from their health care professional and consider being screened for these diseases. Women who are still menstruating and are sexually active are at risk of becoming pregnant (even if their periods are irregular). Birth control pills containing low doses of estrogen can be useful for perimenopausal women to prevent pregnancy and to relieve perimenopausal symptoms, such as hot flashes. Doctors may check the FSH level of women aged 50 years to determine if they have reached menopause. Over-the-counter medications, prescription medications, and lifestyle changes, such as diet and exercise, help control hot flashes and other menopausal symptoms, including high cholesterol and bone loss. Menopause Treatment Menopause is not a disease that has a definitive cure or treatment. Health care providers, however, can offer a variety of treatments for hot flashes and other menopausal symptoms that become bothersome. Many prescription medications exist to prevent and control high cholesterol and bone loss, which can occur at menopause. Some women do not need therapy, or they may choose not to take medications at all during their menopausal years. Self-Care at Home Heart disease: A low-fat, low-cholesterol diet helps to reduce the risk of heart disease. Weight gain: Regular exercise is helpful in controlling weight. Osteoporosis: Adequate calcium intake and weight-bearing exercise are important. Strength training (lifting weights or using exercise bands in resistance training) can strengthen bones. Hot flashes: Several non-prescription treatments are available, and lifestyle choices can help. Soy protein is a popular remedy for hot flashes, although data on its effectiveness are limited. Some doctors recommend 60 grams of soy protein, or about 2 cups of soy milk, daily. Soy contains phytoestrogens, or natural plant oestrogens (isoflavones), which are thought to have effects similar to oestrogen therapy. The safety of soy in women who have a history of breast cancer has not been established, although clinical studies indicate soy is no more effective for treating symptoms than a placebo. Soy comes from soybeans and is also called miso or tempeh. The best food sources are raw or roasted soybeans, soy flour, soy milk, and tofu. Soy sauce and soy oil do not contain isoflavones. Regular aerobic exercise was found to reduce hot flashes. Foods that may trigger hot flashes, such as spicy foods, caffeine, and alcohol, should be avoided. Aromatherapists can help women suffering from menopausal symptoms. Essential oils which can help with menstrual irregularities can also menopause symptoms. Geranium essential oil is a hormonal balancer and Rose essential oil can help to regulate the menstrual cycle and tone and cleanse the uterus. Chamomile Roman essential oil can be helpful as it is gentle and calming, soothing and antidepressant. Essential oils such as Bergamot, Clary Sage, Jasmine, Lavender, Neroli, Sandalwood and Ylang Ylang all are reputed to have antidepressant qualities. In the early stages of the menopause heavy bleeding can be a problem and Cypress essential oil is particularly indicated for this although it is important to consult your GP if this happens. As many women do not want to take replacement hormones they look to herbal medicines and aromatherapy treatments to help with the symptoms. Herbal remedies such as Agnus castus, False Unicorn Root and Ladies Mantle all are reputed to help to maintain hormone levels in the body and Evening Primrose supplements can help. Oestrogenic oils such as Clary Sage, Fennel. Star Anise and Tarragon can help to maintain hormone levels in the body. Calcium supplements are recommended. |
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