Menopause
What is menopause?
Menopause is the point in a woman's life when menstruation stops permanently. It is a normal consequence of the aging process. Often called the "change of life," menopause is the last stage of a gradual biological process in which the ovaries reduce their production of female sex hormones — a process which begins about three to five years before the final menstrual period. This transitional phase is called the climacteric, or perimenopause. Menopause is an individualized experience. Some women have severe symptoms and find the change extremely bothersome and disruptive, while others have only mild symptoms and notice little difference in their bodies or moods.
If a woman has not had her menstrual period for six months, she is usually considered to be menopausal. When she has been without it for one year, menopause is usually considered complete. The actual cessation of menstruation is preceded by a transition period of gradual physical change that may last a few months or even several years. Menopause usually occurs between the ages of 45 and 55. But like the beginning of menstruation in adolescence, timing varies from person to person. Cigarette smokers tend to reach menopause earlier than nonsmokers. Smokers and underweight women tend to have an earlier menopause, while overweight women have a later menopause.
What happens during menopause?
During the transition period preceding menopause, a woman's fertility is reduced as the supply of eggs in her ovaries diminishes and ovulation becomes irregular. Also, the production of estrogen and other hormones drops. At menopause, the ovaries stop releasing eggs completely and the production of estrogen decreases significantly. Estrogen is a hormone that plays many roles in the body. In addition to regulating a woman's menstrual cycle, it affects the reproductive tract, the urinary tract, the heart and blood vessels, bones, breasts, skin, hair, mucous membranes, pelvic muscles and brain. It is the enormous drop in estrogen levels that causes the most common symptoms during menopause. Some women pass through menopause without any significant problems, although most women experience at least some symptoms.
What are its symptoms?
Five years prior to menstruation coming to a halt, menopausal symptoms may begin and last for a year or two. Many woman find that the first sign of menopause is irregularity in their menstrual cycle such as heavy bleeding. Symptoms disappear when menopause is complete (which usually lasts between one and five years).
Other symptoms include:
- Hot flashes in the upper body (in the head and chest) lasting for a few minutes to an hour
- Arms that become red and hot due to hot flashes
- Heavy sweating
- Anxiety, panic or depressive feelings
Long-term effects of menopause:
- Drying and wrinkling of the skin
- Thinning of the vaginal lining
- Urinary infections that occur from the thinning of the lining of the urethra
How is it treated?
Patients with severe menopause symptoms can be treated for a limited time with hormone replacement therapy (HT). HRT boosts the level of estrogen in the body and can relieve symptoms such as hot flashes, vaginal dryness and some urinary problems. There are some risks associated with HT, so be sure to talk with your internist about whether this treatment is appropriate for your symptoms. Alternative treatments are also available to help relieve hot flashes.
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