Menopause treatment

Menopause, the time when a woman stops having menstrual periods, is not a disease or an illness. It is a transition between two phases of a woman's life.
Many women experience a variety of symptoms as a result of the hormonal changes associated with the transition through menopause. Around the time of menopause, women often lose bone density and their blood cholesterol levels may worsen, increasing their risk of heart disease.
Premature menopause: The average age of US women at the time of menopause is 51 years. The most common age range at which women experience menopause is 48-55 years. If menopause occurs in a woman younger than 40 years, it is considered to be premature. Menopause is considered late if it occurs in a woman older than 55 years. For most women, menopause is a normal occurrence.

  • Menopause is more likely to occur at a slightly earlier age in women who smoke, have never been pregnant, or live at high altitudes.
  • If premature menopause occurs, a health care practitioner will check for other medical problems. About 1% of women experience premature menopause.

Perimenopause: The hormonal changes associated with menopause actually begin prior to the last menstrual period, during a three to five year period called the perimenopause. During this transition, women may begin to experience menopausal symptoms and may lose bone density, even though they are still menstruating.
Surgical menopause: Surgical menopause is menopause induced by the removal of the ovaries. Women who have had surgical menopause often have a sudden and severe onset of the symptoms of menopause.
Menopause Causes
Menopause occurs due to a complex series of hormonal changes. Associated with the menopause is a decline in the number of functioning eggs within the ovaries. At the time of birth, most females have about 1-3 million eggs, which are gradually lost throughout a woman's life. By the time of a girl's first menstrual period, she has an average of about 400,000 eggs. By the time of menopause, a woman may have fewer than 10,000 eggs. A small percentage of these eggs are lost through normal ovulation (the monthly cycle). Most eggs die off through a process called atresia (the degeneration and subsequent resorption of immature ovarian follicles - fluid filled cysts that contain the eggs).

  • Normally, FSH, or follicle-stimulating hormone (a reproductive hormone), is the substance responsible for the growth of ovarian follicles (eggs) during the first half of a woman's menstrual cycle. As menopause approaches, the remaining eggs become more resistant to FSH, and the ovaries dramatically reduce their production of estrogen.
  • Estrogen affects many parts of the body, including the blood vessels, heart, bone, breasts, uterus, urinary system, skin, and brain. Loss of estrogen is believed to be the cause of many of the symptoms associated with menopause. At the time of menopause, the ovaries also decrease their production of testosterone-a hormone involved in the libido, or sexual drive.

Menopause Symptoms

  • Hot flashes: Hot flashes are the most common symptom of menopause. According to some studies, hot flashes occur in as many as 75% of perimenopausal women. Hot flash symptoms vary among women. Commonly, the hot flash is a feeling of warmth that spreads over the body, lasting from around 30 seconds to a few minutes. Flushed (reddened) skin, palpitations (feeling a strong heartbeat), and sweating often accompany hot flashes. Hot flashes often increase skin temperature and pulse, and they can cause insomnia, or sleeplessness. Hot flashes usually last 2-3 years, but many women can experience them for up to 5 years. An even smaller percentage may have them for more than 15 years.
  • Urinary incontinence and burning on urination
  • Vaginal changes: Because estrogen affects the vaginal lining, perimenopausal women may also have pain during intercourse and may note a change in vaginal discharge.
  • Breast changes: Menopause may cause changes in the shape of the breasts.
  • Thinning of the skin
  • Bone loss: Rapid bone loss is common during the perimenopausal years. Most women reach their peak bone density when aged 25-30 years. After that, bone loss averages 0.13% per year. During perimenopause, bone loss accelerates to about a 3% loss per year. Later, it drops off to about a 2% loss per year. No pain is usually associated with bone loss. However, bone loss can cause osteoporosis, a condition that increases the risk of bone fractures. These fractures can be intensely painful and can interfere with daily life. They also can increase the risk of death.
  • Cholesterol: Cholesterol profiles also change significantly at the time of menopause. Total cholesterol and LDL ("bad") cholesterol levels increase. Increased LDL cholesterol is associated with an increased risk of heart disease.
  • Heart disease risk increases after menopause, although it is unclear exactly how much is due to aging and how much is caused by the hormonal changes that occur at the time of menopause. Women who undergo premature menopause or have their ovaries removed
  • Weight gain: A three year study of healthy women nearing menopause found an average gain of five pounds during the three years. Hormonal changes and aging are both possible factors in this weight gain.

When to Seek Medical Care

  • All perimenopausal and postmenopausal women should see their health care practitioner annually for a full physical exam. This exam should include a breast exam, pelvic exam, and mammogram.
  • Women should learn about the risk factors for heart disease and colon cancer from their health care professional and consider being screened for these diseases.
  • Women who are still menstruating and are sexually active are at risk of becoming pregnant (even if their periods are irregular). Birth control pills containing low doses of estrogen can be useful for perimenopausal women to prevent pregnancy and to relieve perimenopausal symptoms, such as hot flashes.
  • Over-the-counter medications, prescription medications, and lifestyle changes, such as diet and exercise, help control hot flashes and other menopausal symptoms, including high cholesterol and bone loss.

Menopause Treatment
Menopause is not a disease that has a definitive cure or treatment. Health care practitioners, however, can offer a variety of treatments for hot flashes and other menopausal symptoms that become bothersome. Many prescription medications exist to prevent and control high cholesterol and bone loss, which can occur at menopause. Some women do not need therapy, or they may choose not to take medications at all during their menopausal years.

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