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Menopause is a normal and universal event. It begins when you have not had a menstrual period for at least 1 full year. If you are female and live long enough, you will inevitably experience this change in hormone production. Clinicians differentiate between types of menopause. The expected cessation of menstruation at midlife is considered natural menopause. When periods stop because a woman has undergone an oper- ation in which her ovaries are removed, this condition is referred to as artificial or surgical menopause. And premature menopause describes menopause that occurs before age 40, and from unknown causes. About 8% of women have a premature menopause.\r\n Facts and Figures Much data have been collected about when menopause is likely to occur, the number of women currently passing through menopause, and so forth. Here are some of the details: \r\n - As the populous baby-boom generation ages, 3500 American women enter the menopausal years—ages 45 to 54 every day.
- Between 1990 and 2010, almost 40 million Amer ican women will pass through menopause.
- The average age of natural menopause is 51 to 52.
- By age 55, 95% of American women cease menstruating.
- As many as 25% of women report no discomfort during menopause. Only about 10 to 20% experience discomforts severe enough that they seek medical attention.
- Because women are healthier than they were in the past, they can expect to live one-third of their adult lives post-menopause.
- Although depression has been considered a sign of menopause, no clear causal relationship has been proven.
- Most women report that their sexual relations remain the same or even improve after menopause
Symptoms of Perimenopause During true menopause, estrogen and progesterone levels are low and fairly constant. However, during perimenopause, their levels may fluctuate in an irregular pattern. Some perimenopausal women have an exacerbation of their premenstrual symptoms. Fortunately, when menopause occurs, the PMS symptoms cease. - Hot flashes are experienced by up to two-thirds of perimenopausal women. They usually occur one to five years before the end of menstruation. These symptoms are more severe in women who have had their ovaries surgically removed. It is thought that low levels of estrogen cause the brain to release a surge of Gonadotropin-releasing hormone. This may be the cause of the hot flash. A woman suddenly feels hot and may perspire profusely. She may then have a cold chill. They are more common at night but can occur at any time of day. They last from a few seconds up to an hour.
- Changes in menstrual cycles: Menses may be heavier, or lighter. There may be increased or decreased cramping. Eventually, menses lighten, become less frequent and then stop. \r\n
- Increased PMS symptoms\r\n
- Mood changes and irritability: This may be more common in women who have had difficulty with PMS. There is some suggestion that estrogen levels influence the production of serotonin. \r\n
- Difficulty with memory and attention span: Some women report difficulty with concentrating or remembering specific words. A woman with attention deficit disorder may first come for treatment at this age because declining estrogen level has exacerbated her ability to concentrate.
Insomnia is a common complaint of women in perimenopause or menopause itself. Night sweats may disrupt sleep. Irritability and depression can impair sleep. Reduced sleep can lead to tiredness and irritability during the day. - Vaginal dryness: Before and after menopause, lowered estrogen levels cause the lining of the vagina to become drier and thinner. This may lead to painful intercourse and decreased interest in sexual relations.
Urinary leakage: Some urinary symptoms may be related to pelvic floor changes that occurred years ago during labor and delivery. As the estrogen level drops, further changes can occur. Low estrogen levels may weaken the urethral sphincter that helps hold in urine. If the woman has gained weight, it may put more strain on the bladder. - Skin and hair changes
Dealing Actively With Your Midlife Changes
There are many choices in dealing with symptoms associated with approaching menopause. These include healthy lifestyle changes, hormone replacement therapy, other medications, social support and therapy.
Healthy Lifestyle Changes: Regular exercise may decrease depression and irritability. Good muscle tone can also improve energy level and decrease aches and pains. Some forms of exercise may help decrease bone loss. Yoga or Tai Chi decrease stress and may reverse the decreased flexibility often associated with aging. Regular Tai Chi has been shown to decrease the incidence of hip fractures in older individuals. A diet high in complex carbohydrates, including multiple small meals may reduce irritability and improve one’s feeling of well-being. Social support: Many women experience menopause as a time of increased freedom and new possibilities. As their own children grow up, they may have more time and flexibility. However, some women experience the empty nest as the loss of their central role in life. Loss of a spouse through death or divorce can increase isolation. The physical changes associated with hormonal fluctuations can be confusing. Menopause may cause some women to start to think about the finite nature of life. Supportive friends and family can help a woman understand and cope with life changes. Reading about menopause or talking to one’s doctor can help make the changes less mystifying. A return to spirituality can spur growth at this phase of life. |
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