Menopause – be informed

Article by Tom Nuckels

Menopause is a natural part of life and does not necessarily require treatment. You need to be informed of your options. Symptoms and health risks associated with low estrogen can be treated, often, in natural ways that don't include drug related risks.

Definition

When a woman's menstrual period ceases, and the ovaries permanently stop releasing eggs, a woman has entered the time in life called menopause. It is considered complete when a woman has been without her period for a full year. Menopause can occur anytime between the ages of 40-58, however, the average age is 51 years old.

The Cause

Menopause is a natural part of life and is a gradual process. The ovaries begin producing lower amounts of hormones prior to menopause during a phase called perimenopause.

If menopause occurs before the age of 40 it is called premature menopause. Premature menopause can occur naturally but can also be the result of several conditions, including:

• Family history of premature menopause

• Autoimmune diseases

• X-chromosome abnormalities

• Medical treatments (pelvic surgery, surgical removal of ovaries, chemotherapy, or pelvic radiation therapy)

• Medications that lower estrogen levels

• Smoking

The Risk Factors

A risk factor is something that increases your chance of getting a disease or condition. Since menopause is a natural process associated with aging, there are no risk factors, but risk factors for premature menopause include:

* Family history of premature menopause

Symptoms

A number of physical and emotional symptoms may occur as menopause approaches. Women entering menopause often experience:

• Irregular menstrual periods

• Hot flashes and night sweats

• Disturbed sleep patterns, insomnia

• Anxiety

• Depression

• Dry skin

• Irritability

• Vaginal dryness and pain with sexual intercourse

• Difficulty concentrating

• Trouble remembering things

• Diminished interest in sex

• Frequent urination or leaking of urine

• Headaches

• Achy joints

• Fatigue

• Early morning awakening

The Diagnosis

Your doctor will ask about your symptoms and medical history, and perform a physical exam. Blood tests, a pelvic exam, and a Pap smear may also be performed. Natural menopause is usually diagnosed when a woman has not had a menstrual period for 12 consecutive months.

If a woman had a hysterectomy before menopause, and no longer has periods, menopause may be suspected. It can be confirmed by an FSH test. This test is considered the most accurate for the diagnosis of menopause. It is the measurement of follicle stimulating hormone. High levels of FSH (greater than 40) may indicate menopause.

Treatment

Menopause is a natural part of life and does not automatically require treatment. Symptoms and health risks associated with low estrogen can be treated. These include hot flashes, vaginal dryness, and osteoporosis.

Hormone Replacement Therapy (HRT)
Be sure you completely understand the benefits and risk before starting HRT.

A number of different types of hormones are available. These include natural, synthetic, and plant-derived estrogens and progesterone. Combined therapies may include combinations of estrogen and progesterone; or the addition of small amounts of male hormones. Hormone preparations are available as tablets, gels, skin patches, vaginal rings, vaginal tablets, injections, and pellets inserted into the skin.

There is significant scientific evidence that the global health risks associated with combined estrogen and progesterone HRT on a long-term basis (more than 3-5 years) outweigh the benefits for many women. The average age of the women in these research studies is over 60 years old.

Use of combined HRT at the time of menopause (around age 50) may pose less risk. Also, most of these studies used conjugated estrogens and medroxyprogesterone. Other evidence suggests that use of estradiol and natural progesterone may pose less risk.

Phytoestrogens
A high intake of phytoestrogens (or plant estrogens) may help menopausal women. Phytoestrogens are found in soybeans, black cohosh, whole grains, legumes, tempeh, and flax seed. They are also found in concentration in capsule form. Phytoestrogens may reduce the risk for diseases associated with estrogen.

Healthful/Helpful Diet
Diet can play an important and beneficial roll. A healthful diet during menopause can improve a woman's sense of well-being, and may also reduce the risk of heart disease, osteoporosis, and certain cancers. The diet should be low in fat and high in fruits, vegetables, whole grains, calcium, and vitamin D. Low-fat does not mean no-fat. Some fats, especially the Omega-3 fats are essential.

Limit Caffeine and Alcohol
High use of caffeine or alcohol is never a good choice. Cutting back on caffeine and alcohol may reduce symptoms of anxiety, insomnia, and loss of calcium.

Quit Smoking
There are no health benefits derived from smoking. Giving up smoking can reduce the risk of early menopause, heart disease, and osteoporosis.

Regular Exercise
A healthy lifestyle should embrace regular exercise. It may reduce hot flashes. Weight-bearing exercises such as walking, climbing stairs, and resistance exercises such as lifting weights help strengthen bones and decrease the risk of osteoporosis.

Stress Management
Stress management may help ease tension, anxiety, and possibly other menopausal symptoms. Deep breathing, massage, warm baths, and quiet music are relaxation techniques that may lessen stress.

Over-the-Counter Medications
Moisturizers and lubricants are used to help vaginal dryness.

Non-Hormonal Medications
Certain blood pressure medicines (like "Catapres" and "Aldomet") taken in lower doses than are used to treat high blood pressure have been somewhat helpful in relieving some menopausal symptoms such as hot flashes.

SSRI medications (serotonin reuptake inhibitors like "Prozac", "Paxil", and "Effexor") have shown a modest benefit on hot flash severity scores. These medications should not be used if you are taking tamoxifen to reduce risk of breast cancer recurrence.

Prevention
Menopause does not need to be prevented. It is a natural biological event. If you smoke, quitting could slightly delay the onset of menopause.