By Mary Moss
What is Menopause?
Technically, menopause is defined as a cessation of menses. In fact, menopause is a transition period for women and a natural part of the aging process. Estrogen and progesterone levels decrease, egg production decreases, and menstruation becomes less frequent, eventually stopping completely.
When will Menopause begin for me?
Menopause is a natural part of the aging process for women with an onset as early as 40 or as late as 60 years old, though the average age is 52, with typical onset between 45 and 55.
Experts report the age for onset of menopause is not impacted by the number of pregnancies you’ve had, your birth control pill use, your age when you first began menses or whether or not you breast-fed your baby(ies).
However, the age your mother or older sisters began menopause can have a bearing on when you will begin menopause. Also some studies indicate smokers are likely to start menopause 1-2 years earlier than their non-smoking counterparts.
What Are the Symptoms of Menopause?
As the ovaries are shutting down they will produce less estrogen and progesterone which brings about a host of unpleasant symptoms, which are as varied as the women who experience them.
Some women linger for two to ten years in perimenopause, a transitional period from normal menstrual periods to no periods at all, with a combination of PMS and menopausal symptoms. Some women enter menopause rather abruptly and have a number of severe symptoms. Still others seem to suffer little more than typical PMS symptoms which diminish after a few years.
When estrogen drops suddenly, as when the ovaries are removed surgically (called surgical menopause), symptoms can be more severe. In all, women report up to thirty-five symptoms associated with menopause. The most common symptoms include:
Experiencing one or more of these symptoms does not mean you are in menopause. For example, if you experience bouts of fatigue and anxiety, it may be due to the daily pressures of life. But if you experience these accompanied by sudden hot flushes and night sweats, or intermittent periods, then it is time to check out whether you have entered the pre-menopause stage.
It is equally as important not to assume these symptoms are due solely to menopause as any of these symptoms could indicate other conditions, including hypertension, diabetes or other medical conditions
Are There Tests For Menopause?
A probable first step will be for your doctor to conduct a pelvic exam, which could allow him to observe any changes in the vaginal lining due to decrease in estrogen levels. Your doctor will also likely order blood and urine tests to check FSH, LH and estradoil levels. An increased FSH level will be a solid indicator a woman has entered menopause. An LH test will also be ordered if a woman’s periods are irregular. Estradoil is the prime ovarian estrogen that is secreted before women enter into menopause, so production level also indicates whether or not a woman is menopausal.
What is the Best Treatment for Menopausal Symptoms?
The best treatment for symptoms depends on many factors. The main treatment for menopause symptoms, and the one generally preferred by many doctors is to start women on Hormone Replacement Therapy (HRT) as soon as the first few symptoms are experienced. A woman needs to discuss the risks vs. benefits of this course of treatment with her doctor. Many factors may determine the individual risks of HRT for women including the estrogen dosage and family medical history.
If you still have a uterus (have not had a hysterectomy) and you decide to take estrogen you must also take progesterone, to reduce the risk of uterine cancer. For many years, physicians believed that HRT was not only good for reducing menopausal symptoms, but also reduced the risk of heart disease and bone fractures from osteoporosis.
Based on the results of a recent major study, the Women’s Health Initiative, physicians are now revising their recommendations somewhat. In fact, this study was stopped early because the health risks for some women outweighed the health benefits. Women taking the hormones during the study did see some benefits. But some we at a greatly increased risk for breast cancer, heart attacks, strokes, and blood clots.
In spite of the risks associated with long-term HRT, you may still want to consider this treatment for a short term of up to 2 to 4 years, to reduce vaginal dryness, hot flashes, and other troubling symptoms. Today, though, many other options besides hormone replacement therapy are available to women who want to treat their menopausal symptoms.
If you and your doctor do decide that estrogen replacement therapy is the best route for you, your doctor will likely recommend using a low dose estrogen therapy, using estrogen/progesterone treatments that contain a different form of progesterone than that used in the study, and having regular pelvic exams, Pap smears and mammograms to help detect any potential problems as early as possible.
Alternatives to Hormone Replacement Therapy (HRT)
If you and your doctor determine that Hormone Replacement Therapy is not suitable or appropriate for treatment of your menopausal symptoms, there are other options available. These include alternative medical approaches such as acupuncture, relaxation techniques like yoga or meditation, incorporating more soy-based foods into your diet and eliminating caffeine and alcohol from your diet.
Some other general recommendations to improve your quality of life during menopause include dressing lightly and in layers, remaining sexually active to preserve elasticity of your vagina, performing Kegel exercises to maintain and strengthen muscles of your vagina and pelvis, and using water-based lubricants during sexual intercourse. As with any other medical condition, maintaining an active life and keeping a positive attitude will help alleviate the mental and emotional impact of the physical symptoms.
There are also some medications available to help with mood swings, hot flashes, and other symptoms. Low doses of antidepressants such as Paxil, Effexor, and Prozac may be prescribed if your symptoms are severe and problematic enough to interfere with your quality of life
Can I Prevent Menopause?
Menopause is a natural and expected part of a woman’s development and does not need to be prevented. Some of the symptoms of menopause can be treated and you can also reduce your risk of long-term problems from menopause – like osteoporosis and heart disease. If you smoke, quit smoking now. Cigarette smoking has been shown to cause early menopause in some women. Keep your bones strong and your body healthy by exercising regularly, including resistance exercise. If you take a multi-vitamin, keep it up. You may want to check for the Recommended Daily Allowance for calcium and Vitamin D. If the amount is less than 100%, look to supplements or add more dairy foods to your diet.
When Should I Call My Health Care Provider?
Call your health care provider if you are spotting blood between periods, if you have had 12 consecutive months with no period and suddenly vaginal bleeding begins again, and any time a new symptom appears or an existing symptom intensifies.
So Men Don’t Experience Menopause?
Some studies indicate that just under half of men aged 40-60 experience some degree of lethargy, depression, increased irritability, mood swings, and difficulty in attaining and sustaining erections that characterize male menopause. The symptoms of male menopause are not as overwhelming as the wholesale changes women experience though, and male menopause does not affect all men.
So Hormones Play a Role in Male Menopause?
Although the causes of male menopause have not been fully researched, some factors that are known to contribute to this condition include testosterone deficiency, excessive alcohol consumption, smoking, hypertension, prescription and non-prescription medications, poor diet, lack of exercise, and psychological problems.
Low testosterone has been found to cause many of the symptoms considered to be indicative of male menopause. Testosterone is more important in libido or sex drive than in the erectile mechanism, but men with low testosterone levels will generally have problems with erections also.
Usually there is more than one explanation or cure for the phenomenon known as male menopause. Aging, hormones and overall physical and mental well-being all factor into the condition. Many doctors agree that if a man monitors his medications, reduces alcohol intake and improves eating habits, stops smoking, and enhances his cardiovascular system through aerobic workouts, he will certainly see an improvement in his overall wellness and sexual potency.
In cases where it’s determined specialized treatment is needed, studies suggest that men can improve in sexual function, muscle strength, and general well-being if they are treated with supplements to bring their testosterone levels into a high – normal range. Testosterone replacement is not, unfortunately, an effective treatment for erectile dysfunction.