Menopause has occured when a woman has not had a period for twelve months. The average age of menopause is 52. Menopausal symptoms can being as many as ten years prior to actual menopause. Surgical menopause occurs when the ovaries are removed, and symptoms of menopause may occur suddenly. Many believe that menopause is better tolerated when allowed to occur naturally.
Physiology FSH (Follicle stimulation hormone) is secreted by the brain during a woman's reproductive years and following menopause. FSH signals the ovaries to produce estrogen and progesterone. As a woman approaches menopause, her ovaries become less able to produce hormones, as the life span of ovarian function is nearing completion.The brain senses low levels of hormones and responds by secreting larger amounts of FSH. Sometimes this increase is FSH stimulates ovarian hormone production and FSH levels fall again. This can result in larger fluctuations in the production of hormones by the ovaries, as well as seeming inconsistencies in FSH levels. Ovaries that respond to FSH stimulation can result in the return of menses after many months without menstruating. So a woman may think that she is menopausal and then experience a resumption of periods. This can also cause confusing fluctuations in the presence and severity of menopausal symptoms. Finally, because menopause can seemingly come and go before it is actually completed, blood testing of FSH levels to determine menopausal status is often misleading. Confirmation that a woman is peri-menopausal or menopausal can usually be best made by history and symptomatology.
Symptoms
Hot flashes
A sudden rush of heat and flushing that begins in the upper body and spreads to the face and arms, lasting about 30 seconds to several minutes. Hot flashes can be mild or severe, and can occur infrequently or several times an hour. A minority of woman will not experience hot flashed. Most women will experience hot flashes for several years before and following menopause. Some women will experience hot flashes for many years. Exactly why hot flashes occur is unknown.
Night Sweats
Hot flashes that occur during sleep
Sleep disturbance
Palpitations
A sensation that the heart is beating hard or fast, or is skipping beats
Shortness of breath
Headache
Fluctuating hormones precipitate headaches
Fatigue
From sleeplessness or depression
Weight gain
From fatigue or depression
Joint pain
Joint pain may increase when estrogen levels drop
Decreased sexual desire and response
Vaginal dryness and painful intercourse
The vaginal skin needs estrogen to remain moist, health and stretchable. After estrogen levels drop, vaginal skin gradually becomes thin and tight. This results in discomfort with intercourse.
Urinary control problems
Estrogen helps to keep the urinary tissues healthy. When levels frop, women are at greater risk of urinary control problems.
Memory loss
Anxiety
Depression
Osteoporosis
Health Issues Menopausal women experience increase in risks for osteoporosis and heart disease.
All women should strive to maintain an active lifestyle, and should consume a balanced diet, supplemented by a multivitamin, 400 IU of Vitamin Dm and 1200-1500 mg/day of Calcium. Regular exercise should include aerobic activity, weight training and stretching, 3 to 4 times each week.
Women over 50 should have yearly gynecological exams and mammograms. Bone density testing should be considered. Your primary care physician should perform complete physical exams including testing for cholesterol and lipids regularly. Screening colonoscopy should be performed at age 50 and then every 10 years.
Treatment options Treatment options for menopause are directed at controlling symptoms, maintaining quality of life, and decreasing menopausal health risks.
Treatment options available for women include:
Traditional combination estrogen/progesterone therapy, or hormone replacement therapy (HRT)
Traditional estrogen replacement therapy (ERT)
Bioavailable or "natural" hormone replacement therapy
Nurtrional and herbal supplements
Medications utilized to relieve specific symptoms of menopause
