The time of menopause

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".

What 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 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.

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.

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.

Another test is endometrial biopsy. An endometrial biopsy is an office procedure in which a tiny piece of endometrial tissue from inside the uterus is taken and examined under a microscope for signs of cancer. This test may be done when a woman is having irregular, frequent or heavy bleeding, but it is not routinely recommended as a test for 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

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.

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.

All postmenopausal women who have osteoporosis or are at risk of osteoporosis should take calcium and vitamin D supplements. The usual recommended supplemental dose is 1,000 milligrams of calcium carbonate (taken with meals) or calcium citrate daily. It is best to take this as 500 milligrams twice a day. Women also need 800 international units of vitamin D daily.

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.

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.

Women's pain and discomfort from premenstrual syndrome

Many women pass through cycle after cycle, blissfully unaware of the rising and falling of these hormones except during the specific several days of bleeding. As many as one-third of the women, however, suffer unpleasant symptoms that correlate with the hormonal fluctuations during especially the last 7 to 14 days of their monthly cycle. For perhaps 1 in 10 of these women, the symptoms--called premenstrual syndrome or PMS--trouble them nearly every month, while other women suffer only intermittently.

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.

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.

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.

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.

Definitions and terms

Anxiety

• A state of uneasiness and apprehension, as about future uncertainties.


• Worry or tension in response to real or imagined stress, danger, or dreaded situations. Physical reactions such as fast pulse, sweating, trembling, fatigue, and weakness may accompany anxiety.

Chlorella

• Chlorella is a genus of single-celled green algae, belonging to the phylum Chlorophyta. It is spherical in shape, about 2 to 10 nm in diameter, and is without flagella. Chlorella contains the green photosynthetic pigments chlorophyll-a and -b in its chloroplast. It depends on photosynthesis for growth and multiplies rapidly, requiring only carbon dioxide, water, sunlight, and a small amount of minerals..

Estrogen

• Any one of a group of hormones synthesized by the reproductive organs and adrenal glands in females and, in lesser quantities, in males. The estrogens cause the thickening of the lining of the uterus and vagina in the early phase of the ovulatory, or menstrual, cycle; in lower animals cyclical estrogen secretion also induces estrus, or "heat". The estrogens are also responsible for female secondary sex characteristics such as, in humans, pubic hair and breasts, and they affect other tissues including the genital organs, skin, hair, blood vessels, bone, and pelvic muscles..

Menopause

• The period marked by the natural and permanent cessation of menstruation, occurring usually between the ages of 45 and 55.

PMS

• Premenstrual syndrome.

Perimenopause

• The time period prior to menopause that may last 10 to 15 years, even beginning in one's 30s. It is associated with decreased ovarian function and decreasing estrogen levels.

Progesterone

• Steroid hormone secreted by the female reproductive system that functions mainly to regulate the condition of the endometrium (see uterus), preparing it to accept a fertilized egg. If the egg is not fertilized, the level of progesterone drops, the uterine lining breaks down, and menstruation ensues. If the egg is fertilized, the placenta produces progesterone, whose effects include preparing the mammary glands for lactation..

Biopsy

• Bone marrow aspiration, also called bone marrow sampling, is the removal by suction of fluid from the soft, spongy material that lines the inside of most bones. Bone marrow biopsy, or needle biopsy, is the removal of a small piece of bone marrow.

Climacteric

• A period of life characterized by physiological and psychic change that marks the end of the reproductive capacity of women and terminates with the completion of menopause.


• A corresponding period sometimes occurring in men that may be marked by a reduction in sexual activity, although fertility is retained.

Depression

• In psychiatry, a symptom of mood disorder characterized by intense feelings of loss, sadness, hopelessness, failure, and rejection.

Estrogen

• Any one of a group of hormones synthesized by the reproductive organs and adrenal glands in females and, in lesser quantities, in males.

Hormone

• A substance, usually a peptide or steroid, produced by one tissue and conveyed by the bloodstream to another to effect physiological activity, such as growth or metabolism.

Osteoporosis

• A disease in which the bones become extremely porous, are subject to fracture, and heal slowly, occurring especially in women following menopause and often leading to curvature of the spine from vertebral collapse.

Premenstrual syndrome

• The syndrome occurs in several distinct forms: emotional upheaval, including anxiety, irritability, insomnia, depression, forgetfulness, confusion, and lethargy; cravings for sweets, increased appetite, and intolerance to sugar (headache, heart palpitations, fatigue, and fainting); and fluid retention symptoms with weight gain, puffiness of hands and feet, breast swelling and tenderness, and abdominal bloating and tenderness. Some women suffer with symptoms of all these forms, others only a few..

Progesterone

• A drug prepared from natural or synthetic progesterone, used in the prevention of miscarriage, in the treatment of menstrual disorders, and as a constituent of some oral contraceptives.


• A female hormone that acts on the inner lining of the uterus and prepares it for implantation of the fertilized egg.

Stress

• A state of extreme difficulty, pressure, or strain.


• A physical and psychological response that results from being exposed to a demand or pressure.

Testosterone

• A white crystalline steroid hormone, C19H28O2, produced primarily in the testes and responsible for the development and maintenance of male secondary sex characteristics. It is also produced synthetically for use in medical treatment.

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