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The menopause-what is next?
The time of menopauseWhat doctors officially call menopause is an event - namely, the point at which you get your last menstrual period. This permanent cessation of menstruation is usually marked by 12 consecutive months of having no periods. Most women experience menopause from 40 to 58 years of age, with a median age of 51.4 years. 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. As hormone levels fall, a woman's pattern of menstrual bleeding usually becomes irregular. Many women experience light, skipped or late periods for several months to a year before their periods stop altogether. Some women may experience heavier-than-normal bleeding. It is important to realize that until menopause is complete, a woman still can become pregnant even when periods are light or missed. For most women, menopause is a normal process of aging. If a woman has had her ovaries removed by surgery or has had damage to her ovaries for other reasons, such as radiation therapy, she may become menopausal from that process. Some women don't have any symptoms during menopause or only have a few symptoms. Others develop disturbing and even severe, disabling symptoms. Studies of women around the world suggest that differences in lifestyle, diet and activity may play a role in the severity and type of symptoms women have during menopause. Symptoms can be noticed for several months to years before the last menstrual period and can continue for several years after. A hot flash is a feeling described as suddenly being hot, flushed and uncomfortable, especially in the face and neck. Hot flashes come in bursts or flushes that usually last a few seconds to a few minutes. They are caused by changes in the way blood vessels relax and contract and are thought to be related to the changes in a woman's estrogen levels. 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. As estrogen levels fall, the vagina's natural lubricants decrease. The lining of the vagina gradually becomes thinner and less elastic (less able to stretch). These changes can cause sex to be uncomfortable or painful. They can also lead to inflammation in the vagina known as atrophic vaginitis. These changes can make a woman more likely to develop vaginal infections from yeast or bacterial overgrowth and urinary tract infections. Sleep often is disturbed by nighttime hot flashes. A long-term lack of sleep can lead to changes in moods and emotions. The chemical changes that happen during menopause do not increase the risk of depression. However, many women experience major life changes during their middle age including menopause and sleep disturbances, which can increase the risk of developing depression. 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. For most women, the diagnosis of menopause is made based on a woman's description of her symptoms and the ending of her menstrual periods. Laboratory testing is not usually needed. 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. Perimenopause usually lasts three to five years but it can take as few as two years or as many as eight years for some women. The changes in the body that occur during menopause last for the rest of a woman's life. However hot flashes usually improve over time, becoming less frequent and less severe 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. However, recent evidence has shown that there are some risks associated with the use of these medicines. Estrogen therapy can increase the risk of heart disease, stroke, breast cancer and blood clots in a small number of women. On the other hand, it prevents fractures and can decrease the risk of colon cancer. Therefore, the decision to use hormone replacement therapy to treat symptoms of menopause is an individual decision. A woman should talk to her doctor about the risks and benefits of hormone replacement therapy for her. 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. 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. The use of soy products in the diet such as tofu may have benefit for some women. Soy has small amounts of phytoestrogens (plant estrogens) that may help relieve hot flashes. Researchers speculate that the soy-based diet of Japanese women plays a role in preventing hot flashes. However, it's not clear whether Japanese women have fewer hot flashes or whether they report this problem less often. Premenstrual syndrome affect millions of women every monthMenstrual 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). By researches, as many as one-third of women suffer from PMS-related symptoms as their hormones fluctuate in the last week or two of their monthly cycle. Increasing evidence shows premenstrual syndrome might also be triggered by dietary deficiencies in certain vitamins or minerals, especially magnesium. Red blood cell magnesium levels in PMS patients have been shown to be significantly lower than in normal subjects. Besides nutritional supplementation, women can help prevent PMS by making changes to their diets. Eating more foods rich in omega-3 fatty acids, like fatty fish and green leafy vegetables, is important since omega-3 deficiencies have also been linked to PMS. Many women accept premenstrual syndrome as a fact of life and merely suffer through it, but there are many natural remedies available to help prevent and treat the aches and pains of PMS. Like all health issues, it just takes the recognition that you can help control the way you feel by giving your body what it needs. 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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