Menopause


    Definition

    Menopause refers to a natural stop in a woman’s menstrual period and fertility. Menopause happens because the woman’s ovary stops producing the hormones estrogen and progesterone. All women go through menopause, usually between the ages of 40 and 55. A woman has reached menopause when she has gone 12 months without having a period.

    In a recent study, a significantly higher number (46 percent) of African American women said they experienced menopausal symptoms while only 30 percent of white women said they had experienced symptoms of menopause. African American women who completed daily symptom reports also reported significantly more physiological symptoms of menopause including hot flashes, dizziness, poor coordination and/or clumsiness, urine leakage, and vaginal dryness compared to the white women who completed the DSR. Another finding of the study found that symptoms particularly hot flashes increased with age in African American women, while white women reported a decrease in menopausal symptoms with age.

    African American women who experienced menopause resulting from hysterectomy experienced more hot flashes than white women, regardless of weight or whether the women used hormone replacement therapy.

    Psychological symptoms were not affected by either race or age.

    Alternative Names

    Perimenopause; Postmenopause


    Causes

    During menopause, a woman’s ovaries stop making eggs and they produce less estrogen and progesterone. Changes in these hormones cause menopause symptoms. Periods occur less often and eventually stop. Sometimes this happens suddenly. But most of the time, periods slowly stop over time.

    Menopause is complete when you have not had a period for 1 year. This is called postmenopause. Women who are post-menopausal can no longer get pregnant.

    Surgical menopause is when medical treatments cause a drop in estrogen. This can happen if your ovaries are removed, or if you receive chemotherapy or hormone therapy for breast cancer.


    Symptoms

    Although menopause itself is the time of a woman’s last period, symptoms can begin several years before that (in a stage called peri-menopause).

    Menopause and peri-menopause affect every woman differently. There are some common symptoms, including:
        •    Changes in periods (they may be shorter or longer, heavier or lighter, or have more or less time in between)
        •    Hot flashes
        •    Night sweats
        •    Trouble sleeping through the night
        •    Vaginal dryness
        •    Mood changes
        •    Hair loss or thinning on the head, more hair growth on the face

    Another health problem that can start during menopause is estrogen loss. This can lead to osteoporosis, a condition where bones become weak and break easily.


    Exams and Tests

    Blood and urine tests can be used to look for changes in hormone levels. Test results can help your doctor determine if you are close to menopause or if you have already gone through menopause.

    Tests that may be done include:
        •    Estradiol
        •    FSH
        •    LH

    Your health care provider will perform a pelvic exam. Decreased estrogen can cause changes in the lining of the vagina.
    Bone loss increases during the first few years after your last period. Your doctor may order a bone density test to look for bone loss related to osteoporosis.


    Treatments

    In the past, some women would take hormones to replace the estrogen and progesterone their bodies were losing during menopause. Taking these hormones, known as hormone replacement therapy (HRT), might help with menopause symptoms and with bone loss.
    But new research shows that, for some women, taking hormones has risks, including greater risk of heart disease, stroke, blood clots, and breast cancer. Therefore, for post-menopausal women, the U.S. Food and Drug Administration advises that HRT be used for the shortest time and at the lowest doses possible.


    Possible Complications

    The loss of estrogen associated with menopause has been linked to a number of health problems that become more common as women age.

    After menopause, women are more likely to suffer from:
        •    Osteoporosis.
        •    Heart disease.
        •    Poor bladder and bowel function.
        •    Poor brain function (increased risk of Alzheimer’s disease).
        •    Poor skin elasticity (increased wrinkling).
        •    Poor muscle power and tone.
        •    Some deterioration in vision, such as from cataracts (clouding of the lens of the eye) and macular degeneration (breakdown of the tiny spot in the center of the retina that is the center of vision).

    When to Contact a Medical Professional

    Call your health care provider if:
        •    You are spotting blood between periods
        •    You have had 12 consecutive months with no period and suddenly vaginal bleeding or spotting begins again, even if it is a very small amount

    Preventions

    Menopause is a natural and expected part of a woman’s development and does not need to be prevented. You can reduce your risk of long-term problems such as osteoporosis and heart disease by lowering risks of complications associated with these diseases.


    Natural Remedies

    Menopause is not a disease—it’s a natural part of life. According to research or other evidence, the following self-care steps may be helpful:

    What You Need To Know:

    • Control symptoms with isoflavones
    Supplements containing at least 80 to 100 mg a day of isoflavones from soy or red clover may help control symptoms

    • Cool down with black cohosh
    Some people have found 20 mg of a concentrated herbal extract twice a day relieves hot flashes

    • Eat soy and flaxseed
    Make foods high in phytoestrogens, such as flaxseed, tofu, soy milk, tempeh, and roasted soy nuts, a regular part of your diet

    • Find relief with exercise
    Even light aerobic activities can help reduce menopausal symptoms

    • Quit smoking
    Smokers are more likely to experience hot flashes and other menopausal symptoms

    These recommendations are not comprehensive and are not intended to replace the advice of your doctor or pharmacist. Continue reading the full menopause article for more in-depth, fully-referenced information on medicines, vitamins, herbs, and dietary and lifestyle changes that may be helpful.

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