Menopause

• Menopause Articles

Many women wonder and worry about what will happen when they reach menopause, but in fact it can be a liberating experience! We know that menopause marks the end of the time in life when you can become pregnant, but it can also represent a new beginning - a time to focus on yourself and your needs. The first step is to learn all you can about the physical and emotional changes that may be ahead for you.

What are the body changes involved in menopause? 

The transformation into the beauty of mid life usually doesn't happen all at once. In premenopause, or the transition period to menopause, the production of the female hormones estrogen and progesterone begin to fluctuate, causing a variety of symptoms, including hot flashes and mood swings. During this time, a woman may or may not have a period. These changes can begin as early as age 35 or as late as 59. In younger women who are having menopausal symptoms, and in women who have had a hysterectomy but still have one or both of their ovaries, a blood test called an FSH level, or follicle stimulating hormone level may be useful to confirm menopause. If you have your ovaries removed or undergo some cancer treatments, you may experience rapid onset of menopause, and may need special management of your symptoms. Menopause starts when the estrogen production falls permanently to very low levels and menstrual periods stop for good.

What is hormone replacement therapy (HRT)?

HRT refers to the use of prescription drugs to "replace" the hormones that the ovaries quit making at the time of menopause. For many years, to relieve the symptoms of menopause, health care providers prescribed estrogen replacement therapy (ERT). The most common brand name of ERT is Premarin. It was discovered, however, that taking ERT alone raised the risk of cancer in the lining of the uterus (endometrial cancer). Research showed that adding progestin, the artificial form of the hormone progesterone, prevented the overgrowth of cells in the uterus (called hyperplasia) which dramatically reduces the risk of endometrial cancer. Women who do not have a uterus can take ERT alone. ERT usually is taken by pill or skin patch. Hormone replacement therapy (HRT) refers to a combination of hormones used to treat menopausal symptoms, usually estrogen with progestin. Progestin Estrogen Replacement Therapy is sometimes abbreviated as "PERT". HRT is most always taken by pill.

What are some practical things women can do to help deal with the symptoms of menopause?

There are things you can do to help relieve some menopausal symptoms.

• Hot Flashes - Hot flashes are sometimes brought on by specific things, such as a hot environment; eating or drinking hot or spicy foods, alcohol, or caffeine; and stress. You can try to decrease hot flashes by avoiding these triggers. Dress in layers and keep a fan in your home or workplace. Some women find that a program of regular exercise brings relief of hot flashes and other symptoms.
• Vaginal Dryness - You can help vaginal dryness and irritation by using an over-the-counter vaginal lubricant. There are also prescription estrogen and replacement creams that your doctor may recommend to help relieve vaginal dryness and pain intercourse. If you have spotting or bleeding while using estrogen creams, you should see your health care provider.
• Difficulty Sleeping - One of the best ways to get a good night's sleep is to participate in regular exercise - such as walking 30 minutes a day. However, avoid vigorous exercise too close to bedtime. Also avoid alcohol, caffeine, large meals, and working right before bedtime. Many women find that they sleep better after drinking something warm, such as herb tea or a glass of warm milk. Try to keep your bedroom at a comfortable temperature. Also avoid napping during the day, and try to go to bed and get up at the same times every day.

What other steps can women take to help prevent osteoporosis and heart disease during menopause?

Besides taking HRT, women can help prevent osteoporosis and heart disease by making sure they get enough calcium, doing regular weight-bearing exercises, and eating a low-fat balanced diet. Other healthy behaviors to prevent disease include stopping smoking and drinking alcohol only in moderation.

Symptoms of Menopause

• Hot flashes
• Sweating
• Sleep problems
• Depression
• Mood swings
• Vaginal dryness and irritation
• Memory loss
• Changes in sex drive and sexual response
• Weight gain
• Hair loss
• "Spotting" and abnormal bleeding (may be normal, but report to doctor)

Important Notice

On July 9, 2002, the National Heart, Lung, and Blood Institute (NHLBI) of the National Institutes of Health (NIH) stopped early a major clinical trial of the risks and benefits of combined estrogen and progestin in healthy menopausal women. The trial was stopped due to an increased risk of invasive breast cancer.