Menopause is the normal, natural stage in a woman's life when her menstruation and ovulation cycles stop, ending her reproductive years. Also called the climacteric, or the change of life, menopause occurs around age 50 but can start anywhere between age 35 and 60.

Cause

Scientists do not fully understand what causes menopause. They believe it is triggered when the ovaries stop responding to the sex hormones that are secreted by the pituitary gland. The subsequent decline in the production of the female hormone estrogen sets off the bodily changes.

Symptoms

During the years immediately preceding the onset of menopause, menstrual periods may become irregular and menstrual flow scanty.

Other physical symptoms of menopause include hot flashes (a warm and flushed feeling over the face, neck, and chest that lasts a few minutes and recurs throughout the day), excessive perspiration, vaginal dryness  (which can lead to painful or difficult sexual intercourse), pounding heartbeat, joint pains, headaches, itching skin, increased facial hair, and decreased armpit and pubic hair.

Nonphysical symptoms of menopause include depression, anxiety, irritability, apprehension, decreased ability to concentrate, lack of confidence, and insomnia.

The duration of symptoms ranges from a few weeks to more than five years. Not every woman experiences the same changes, other than an end to menstruation; about 25 percent notice no other changes, 50 percent discern some physical or psychological symptoms, and the other 25 percent are troubled by very uncomfortable or distressing menopausal symptoms.

Diagnosis

It is important not to attribute all physical changes to menopause to the point of overlooking the symptoms of some disease. This is a good time to schedule an examination and discuss the bodily changes with a doctor. A woman should see a doctor immediately if she starts to bleed in between menstrual periods, bleeds excessively, or has another period six months or more after they have apparently stopped.

Treatment

The primary treatment for the physical symptoms of menopause is replacement of the female sex hormones (commonly estrogen or a combination of estrogen and progesterone in the form of an oral tablet). Estrogen in the form of a vaginal cream may be prescribed specifically to treat vaginal dryness. The lowest effective dose is administered because of possible side effects. Any treatment merely lessens the discomfort of menopause; it cannot stop or slow down the process.

Estrogen is not usually given to women with severe circulatory or liver disorders and is carefully controlled when prescribed to those with diabetes, epilepsy, or heart or kidney disease. Progesterone is not prescribed for women with liver disease and is carefully controlled in those with asthma, epilepsy, or heart or kidney disease. The benefits and hazards should be discussed with a doctor; other medication is available to treat certain menopausal symptoms in women who cannot take hormones.

Treatment for the psychological or emotional symptoms may include tranquilizers, antidepressants, sleeping pills, or psychotherapy. During this time, it may also be difficult for a woman to face the aging process and its physical ramifications -- the end of the childbearing years and a sense of uselessness because of a possible decrease in family responsibilities. Some form of counseling may be helpful in such a situation.

Fertility and the need to practice birth control at this stage depend upon a woman's age at the time of her last period. In general, a woman under the age of 50 may still be able to conceive for up to 24 months after the date of her last period; over 50, conception may be possible for up to one year.

After menopause, a woman is more liable to suffer osteoporosis (a disease that makes bones porous, brittle, and more susceptible to breaking). This thinning of the bones can often be prevented or controlled with medication therapy and calcium supplementation under medical supervision. The risk of heart attack also increases after menopause, so a woman should discuss with her physician which other risk factors she may have for the disease and what steps can be taken to lower her overall risk.



This information is solely for informational purposes. IT IS NOT INTENDED TO PROVIDE MEDICAL ADVICE. Neither the Editors of Consumer Guide (R), Publications International, Ltd., the author nor publisher take responsibility for any possible consequences from any treatment, procedure, exercise, dietary modification, action or application of medication which results from reading or following the information contained in this information. The publication of this information does not constitute the practice of medicine, and this information does not replace the advice of your physician or other health care provider. Before undertaking any course of treatment, the reader must seek the advice of their physician or other health care provider.