Menopause is the transition period in a woman's life when her ovaries stop producing eggs, her body produces less estrogen and progesterone, and menstruation becomes less frequent, eventually stopping altogether.
Menopause Causes, incidence, and risk factors
Menopause is a natural event that normally occurs between the ages of 45 and 55.
Once menopause is complete (called postmenopause), you can no longer become pregnant.
The symptoms of menopause are caused by changes in estrogen and progesterone levels. As the ovaries become less functional, they produce less of these hormones and the body responds accordingly. The specific symptoms you experience and how significant (mild, moderate, or severe) varies from woman to woman.
In some women, menstrual flow comes to a sudden halt. More commonly, it tapers off. During this time, your menstrual periods generally become either more closely or more widely spaced. This irregularity may last for 1 to 3 years before menstruation finally ends completely.
A gradual decrease of estrogen generally allows your body to slowly adjust to the hormonal changes. When estrogen drops suddenly, as is seen when the ovaries are removed surgically (called surgical menopause), symptoms can be more severe.
The potential symptoms include:
In addition, the long-term effects of menopause include:
Menopause Signs and tests
Blood and urine tests can be used to measure hormone levels that may indicate when a woman is close to menopause or has already gone through menopause. Examples of these tests include:
A Pap smear may indicate changes in the vaginal lining caused by changes in estrogen levels. A bone density test may be performed to screen for low bone density levels seen with osteoporosis.
Menopause is a natural process. It does not require treatment unless the symptoms, such as hot flashes or vaginal dryness, are particularly bothersome.
One big decision you may face is whether or not to take hormones to relieve your symptoms. Discuss this thoroughly with your doctor, weighing your risks against any possible benefits. Pay careful attention to the many options currently available to you that do not involve taking hormones.
If you have a uterus and decide to take estrogen, you must also take progesterone to prevent endometrial cancer (cancer of the lining of the uterus). If you do not have a uterus, progesterone is not necessary.
Menopause Hormone Replacement Therapy
For years, hormone replacement therapy (HRT) was the main treatment for menopause symptoms. Many physicians believed that HRT was not only good for reducing menopausal symptoms, but also reduced the risk of heart disease and bone fractures from osteoporosis. However, the results of a major study -- called the Women's Health Initiative -- has led physicians to revise their recommendations.
In fact, this important study was stopped early because the health risks outweighed the health benefits. Women taking the hormones did see some benefits. But they greatly increased their risk for breast cancer, heart attacks, strokes, and blood clots.
If your symptoms are severe, you may still want to consider HRT for short-term use (two to four years) to reduce vaginal dryness, hot flashes, and other symptoms.
To reduce the risks of estrogen replacement therapy and still gain the benefits of the treatment, your doctor may recommend:
Alternatives to HRT
The good news is that you can take many steps to reduce your symptoms without taking hormones:
There are also some medications available to help with mood swings, hot flashes and other symptoms. These include low doses of antidepressants such as paroxetine (Paxil), venlafaxine (Effexor) and fluoxetine (Prozac), or clonidine, which normally used to control high blood pressure.
Estrogen is responsible for the buildup of the lining of the uterine cavity. During the reproductive years, this buildup occurs and then is shed (menstruation). This usually happens about a once a month.
Calling your health care provider
Call your health care provider if:
Menopause is a natural and expected part of a woman's development and does not need to be prevented. However, there are ways to reduce or eliminate some of the symptoms that accompany menopause. You can also reduce your risk of long-term problems like osteoporosis and heart disease.
Menopause is the transition in a woman's life when the ovaries stop releasing eggs, menstrual activity decreases and eventually ceases, and the body decreases the production of the female hormones estrogen and progesterone.
Weismiller D. The Perimenopause and Menopause Experience: An Overview. Clin Fam Practice. 2002; 4(1).
Stenchever, MA. Comprehensive Gynecology, 4th ed. St. Louis, Mo:Mosby, Inc.; 2001:1217-1250.
Article from the MedLine Plus Medical Encyclopedia of the US National Library of Medicine and the National Institutes of Health
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