Menopause-when?
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Most women think of menopause as the time of life when their menstrual periods end. This usually occurs during middle age, when women are also experiencing other hormonal and physical changes. For this reason, menopause is sometimes called the "change of life". A woman is said to be in menopause after she has gone for one full year without periods. While most women in the United States go through menopause around the age of 51, a small number will experience menopause as early as age 40 or as late as their late 50s. Rarely, menopause occurs after age 60. When menopause is diagnosed before age 40, it is considered to be abnormal or premature menopause. In women, the ovaries produce the female hormones estrogen and progesterone. Estrogen and progesterone control a woman's periods and other processes in her body. As a woman approaches menopause, her ovaries gradually makes less and less of these hormones. A woman can have irregular periods for several months to years before her periods finally stop. Any vaginal bleeding that develops after a year of no periods is abnormal and should be evaluated by a doctor. Some women report irritability or other mood changes. Irritability is commonly caused by poor sleep resulting from nighttime hot flashes. A number of women, however, do not feel irritable. As estrogen levels drop and remain low during menopause, the risk of developing osteoporosis increases. The risk is greatest for slender, white or light-skinned women. You can help prevent osteoporosis by getting enough vitamin D through sunlight or a daily multivitamin, eating a diet rich in calcium and performing regular exercise. Women should start taking these actions well before menopause begins. This is because women begin to lose bone mass as early as age 30 but fractures resulting from osteoporosis don't occur until 10 to 15 years after menopause. Before menopause, women have lower rates of heart attack and stroke than men. After menopause, however, the rate of heart disease in women continues to rise and equals that of men after age 65. Because women can still become pregnant while they are perimenopausal, doctors may do a pregnancy test when a woman's periods become irregular, infrequent or light. In some cases, a blood test for levels of follicle-stimulating hormone (FSH) may be recommended. FSH levels are normally high in menopause, so high FSH levels can help to confirm that a woman is in menopause. At the time of menopause, doctors often recommend a bone density measurement. The test result sometimes will detect early osteoporosis. More often the result is used as a baseline to compare rate of bone loss in the future. Menopause is a natural event and cannot be prevented. Medications, diet and exercise can prevent or eliminate some symptoms of menopause and enhance a woman's quality of life as she grows older. Estrogen taken as a pill or applied to the skin as a patch can reduce hot flashes, sleep disturbances, mood changes and vaginal dryness. Estrogen can be prescribed alone when a woman no longer has her uterus. A combination of estrogen and progesterone is used when a woman still has her uterus. Progesterone is necessary to balance estrogen's effect on the uterus and prevent changes that can lead to uterine cancer. Medications such as venlafaxine (Effexor) and paroxetine (Paxil) are often the first choice for women with hot flashes who are not on hormone replacement therapy. They relieve the symptoms of hot flashes in 60% of women. The Gabapentin (Neurontin) moderately effective in treating hot flashes. Gabapentin's main side effect is drowsiness. Taking it at bedtime may help improve sleep while decreasing hot flashes. Etidronate (Didronel), alendronate (Fosamax) and other similar drugs are the most effective medicines that can be used to both prevent and treat osteoporosis. They increase bone density and decrease the risk of fractures. Raloxifene (Evista) drug has some of the beneficial effects of estrogen without the increased risk of breast cancer. It is effective in building bone strength and preventing fractures. Calcitonin - hormone produced by the thyroid gland and helps the body keep and use calcium. A nasal spray form of this drug is used to help prevent bone loss in women at risk. Doctors may prescribe calcitonin to help relieve pain from fractures due to osteoporosis. There is no relation between the time of a woman's first period and her age at menopause. The age at menopause is not influenced by a woman's race, height, number of children or use of oral contraceptives. Headaches, bloating, irritability, depression and fatigue are just a few of the unpleasant symptoms of premenstrual syndrome, which affects millions of women every month. But fortunately, PMS -- though widely believed to be a result of changes in hormone levels during a woman's menstrual cycle -- is not entirely beyond a woman's control. Menstrual cycling in women results from a complex interplay of reproductive hormones that surge and ebb at various points during the course of an approximately lunar month (28 days). Research shows that diet and nutrition play a significant role in the severity of PMS symptoms, and many women could ease their monthly bouts with discomfort simply by changing their diets or taking nutritional supplements. So why do some women suffer more than others, and what can these women do to stop PMS from interrupting their lives? The answer may be found in nutrition and natural health remedies. Primrose oil, flaxseed oil, lavender, parsley, bee pollen and chaste berries, used widely in Europe, are other proven natural remedies that can ease common symptoms. PMS-sufferers are also frequently deficient in calcium, zinc and B-vitamins, particularly vitamin B6, and can often benefit greatly from supplementation. Experts still aren't sure exactly what causes PMS. Some research shows that it's related to hormonal changes that occur during a woman's menstrual cycle. The symptoms may arise during ovulation or just before menses, or they may appear, disappear and reappear during the same cycle. For about one in 20 women, the combination is so bad that it creates a general depression that affects the daily course of their lives. A deficiency of progesterone can exacerbate symptoms of premenstrual syndrome (PMS) and menopausal discomforts, and may increase the risk of osteoporosis. It is caused by normal changes in breast tissue related to monthly fluctuations in levels of estrogen and progesterone, which cause the glands and ducts in the breast to enlarge. As a result, the breasts become swollen, painful, tender, and lumpy. For many women, these symptoms occur as part of the premenstrual syndrome and usually disappear during or after menstruation. If you have menstrual problems, you may be able to alleviate them with diet. Scientists have long known that food can influence the female hormone estrogen, affecting menstruation, and that carbohydrates are strongly linked to premenstrual syndrome (PMS). Now research reveals surprising new clues about how certain foods and nutrients, including calcium, manganese, and especially dietary fat and cholesterol, may influence menstruation. For prevention, we advise that a woman reduce her activities as much as possible for the first three days of her period each month, though this might be an unpopular suggestion to most busy women today. For exercise, we recommend a gentle walk rather than jarring aerobics classes at this time.
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