MENOPAUSE

General Information

DEFINITION--The permanent cessation of menstruation. This occurs as early as age 40 or as late as age 55 and usually spans 1 to 2 years. It is usually diagnosed in females after 1 year of absent periods. Menopause is only one event in the "climacteric," a biological change in all body tissue and body systems that occurs in both sexes between the mid-40s and mid-60s. Menopause occurring before age 40 is termed premature and may need medical evaluation.

BODY PARTS INVOLVED--Female reproductive system, with secondary effects in other body parts.

SEX OR AGE MOST AFFECTED--Women, especially between ages 45 and 50.

> Hot flashes or flushes--

sensations of heat spreading from the waist or chest toward the neck, face and upper arms.

• Headaches; dizziness.
• Rapid or irregular heartbeat.
• Vaginal itching, burning or discomfort during intercourse, beginning a few years after menopause.
• Bloating in the upper abdomen; bladder irritability; breast tenderness. Emotional changes (associated with lower hormone levels and conflicting feelings about aging and loss of fertility):
• Mood changes; pronounced tension and anxiety; sleeping difficulty; depression or melancholy and fatigue.

CAUSES

• A normal decline in ovary function, resulting in decreased levels of the female hormones, estrogen and progesterone.
• Surgical removal of both ovaries.

RISK INCREASES WITH--Menopause is a natural part of the aging process for women.

HOW TO PREVENT--Menopause cannot be avoided, but its effects may be controlled.

What To Expect

DIAGNOSTIC MEASURES--

• Medical history and exam by a doctor.
• Laboratory blood studies of hormone levels (sometimes).

APPROPRIATE HEALTH CARE

• Doctor's diagnosis to rule out other causes of menstrual changes.
• Self-care after diagnosis.
• Psychotherapy or counseling, if emotional changes interfere with personal life or work.

POSSIBLE COMPLICATIONS

• Increased irritability and susceptibility to infection in the urinary tract.
• Decreased skin elasticity and vaginal moisture.
• Increased risk of hardening of the arteries, heart disease, stroke and osteoporosis after menopause.
• Changes in feelings of self-worth.

PROBABLE OUTCOME--Menopause is a normal process--not an illness. Most women make an easy transition without crisis.

How To Treat

GENERAL MEASURES--

• Continue to use birth-control measures until 12 months after your last menstrual period.
• Reduce stress in your life.
• If you take estrogen-replacement therapy, have a Pap smear annually or as recommended.
• Lifestyle changes may be brought about by menopause. Stay as healthy and happy as you can and live life to the fullest.
• See Resources for Additional Information.

MEDICATION--Your doctor may prescribe:

• Estrogen replacement therapy (ERT) or it may be referred to as HRT (hormone replacement therapy). Because hormone treatment has benefits as well as risks, learn all you can about replacement therapy before deciding on treatment. ERT helps prevent osteoporosis and coronary heart disease, as well as bringing relief of symptoms of menopause (hot flashes, vaginal dryness).
• Calcium supplements if your diet does not provide at least 1000 mg of calcium a day.
• Vaginal creams to help dryness.

ACTIVITY--No restrictions. Active exercise is beneficial. Weight-bearing activities (such as walking) help strengthen bones.

DIET--No special diet. Increase calcium intake.

Call Your Doctor If

• You have symptoms of menopause. Other causes should be ruled out.
• You experience excessive bleeding, prolonged periods or spotting between your expected periods. These may be signs of other disorders.
• Bleeding appears 6 months or more after your last period.
• New unexplained symptoms develop. Hormones used in treatment may produce side effects.