A Natural Biological Product of Aging
Menopause is the cessation of menstrual periods that occurs in most women sometime between the ages of 45 and 53, at that time the body's reproductive machinery shut down, though the shutdown is hardly an overnight thing.
Some women's periods stop abruptly, while the most common pattern is for irregular menstrual flow tapering off gradually, where eventually, your ovaries shut down and you have no more periods.
The permanent end of menstruation and fertility, a natural biological process not a medical illness, begins naturally when your ovaries start making less estrogen and progesterone, the hormones that regulate menstruation.
Because this process takes place over years, it is commonly divided into the following two stages:
- Perimenopause: This is the time you begin experiencing menopausal signs and symptoms, even though you still menstruate. Your hormone levels rise and fall unevenly, and you may have hot flashes and other symptoms. Perimenopause may last four to five years or longer.
- Postmenopause: Once 12 months have passed since your last period. Your ovaries produce much less estrogen and no progesterone, and they don't release eggs.
The signs and symptoms of menopause can appear long before the one-year anniversary of your final period. They include:
- Irregular periods: Some women have minimal problems with abnormal bleeding during perimenopause whereas others have unpredictable, excessive bleeding. Menstrual periods may occur more frequently or get farther apart than your regular cycle with no pattern.
- Vaginal dryness: Dryness can occur as a result of the lining tissues of the vagina becoming thinner, drier, and less elastic as estrogen levels fall.
- Hot flashes: This is the most common problem occurring in 40% of women with a felling of warmth that spreads over the body and is most pronounced in the head and chest. Hot flashes usually last from 30 seconds to several minutes with no current method available to predict when they will begin and how long they will last. On average, hot flashes can last about 5 years.
- Sleep disturbances: Cause by hot flashes and the general physiological changes happening in your body
- Urinary symptoms: The lining of the urethra also undergoes changes similar to the tissues of the vagina, and becomes dryer, thinner, and less elastic with declining estrogen levels. This can lead to an increased risk of urinary tract infection, feeling the need to urinate more frequently, or leakage of urine.
- Mood swings: women in perimenopause often report a variety of cognitive (thinking) and/or emotional symptoms, including fatigue, memory problems, irritability, and rapid changes in mood.
- Increased abdominal fat: Distribution of body fat may change, with fat being deposited more in the waist and abdominal area than in the hips and thighs. Changes in skin texture, including wrinkles, may develop along with worsening of adult acne in some women.
Usually a natural process, certain surgical or medical treatments or medical conditions can bring menopause earlier than expected, including:
- Chemotherapy and radiatio therapy
- Premature ovarian failure
Most women make it through menopause without any serious medical complications, but at times, the transition can have effects on chronic medical conditions, such as:
- Osteoporosis: The density of the bone (bone mineral density) normally begins to decrease in women during the fourth decade of life. However, that normal decline in bone density is accelerated during the menopause transition. Lifestyle changes including cessation of cigarette smoking, curtailing alcohol intake, exercising regularly, and consuming a balanced diet with adequate calcium and vitamin can help as preventative measures against osteoporosis.
- Cardiovascular disease: Around this time, a women's risk of cardiovascular disease increases. Coronary heart diseases in postmenopausal women are two to three times higher in women of the same age who are still menstruating. Lifestyle changes including cessation of cigarette smoking, controlling your blood pressure and cholesterol, losing weight, regular exercise, reducing salt intake, eating a healthy low-fat diet, exercising regularly, curtail alcohol use, and reducing stress can help as preventative measures against coronary heart disease.
Menopause itself is a normal part of life and not a disease that requires treatment. However, treatment is possible if the symptoms become substantial or severe:
- Hormone therapy (HT): Consists of estrogens or a combination of estrogens and progesterone used to control the symptoms related to declining estrogen levels such as hot flashes and vaginal dryness. But caution must be taken; studies have shown an increased risk of breast cancer, endometrial cancer, and stroke can be associated with hormone therapy.
- Oral contraceptive pills: Another form of hormone therapy prescribed for women in perimenopause to treat irregular bleeding.
- Local (vaginal) hormone treatments: Local treatments include the vaginal ring, vaginal estrogen cream, or vaginal estrogen tablets.
- Antidepressant medications: The class of drugs known as selective serotonin reuptake inhibitors (SSRIs) and related medications have shown to be effective in controlling the symptoms of hot flashes in up to 60% of women.
- Other medications: Some medications such as the anti-seizure drug gabapentin and clonidine a high blood pressure drug have shown good results in providing relief from hot flashes.
- Alternative medical therapies: Plant-derived estrogens found in foods like soy beans, chick peas, and lentils have shown to relieve hot flashes and other symptoms and acupuncture seems to be promising.
- Vitamin E: some women report that vitamin E supplements can provide relief from mild flashes, but scientific studies are lacking to prove the effectiveness.Black Cohosh: An herbal preparation popular i Europe for the relief of hot flashes. There have been very few studies done to establish the benefits and safety of this product to date.
- "Natural" treatments: Many supplements and substances have been advertised as "natural" treatments for symptoms, including licorice, dong quai, chasteberry, and wild yam. Studies to prove the safety and effectiveness of these products have not been performed.
As with every big change in the body's chemistry, good nutrition is essential for a smooth transition. What you eat can help you deal with some of the unpleasant side effects of menopause and protect you against ailments that commonly afflict women after the change is complete.
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