Menopause

What is menopause?
Menopause is the time in a woman's life when her periods stop and she can't
have children anymore. This happens because as a woman ages, her ovaries
stop making enough of the female hormones estrogen and progesterone.

When does menopause occur?
The average age for women to have their last period is about 50. But it's
normal for menopause to occur any time from age 41 to 59. A woman often goes
through menopause at about the same age as her mother.
Women who have both ovaries removed will go through "surgical menopause" at
the time of their surgery. If the uterus is taken out but the ovaries are
left, a woman won't have periods but she will only go through menopause when
her ovaries stop making estrogen.
If you stop having periods early--before age 40--your family doctor can do a
blood test to see if you're going through menopause.
Menopause is a gradual process that can take several years. You're not
really through menopause until you haven't had a period for 12 months.
(During this time, keep using birth control if you don't want to become
pregnant.)
Talk to your family doctor if you have:
A change in your monthly cycle
Heavy bleeding
Bleeding that lasts longer than usual
Bleeding more often than every 3 weeks
Bleeding after sexual intercourse
Any blood staining between periods

What are the common signs and symptoms of menopause?
Some women just stop having periods. Others experience symptoms, such as the
following:
A change in your menstrual cycle. This is one of the first signs of
menopause. You may skip periods or they may occur closer together. Your flow
may be lighter or heavier than usual.
Hot flashes. Hot flashes are the most common symptom of menopause.
When you have a hot flash, you'll feel warm from your chest to your head,
often in wave-like sensations. Your skin may turn red and you may sweat. You
may feel sick to your stomach and dizzy. You may also have a headache and
feel like your heart is beating very fast and hard.
Thinning of your vagina and vulva (the area around your vagina). The skin of
your vagina and vulva becomes thinner with menopause. Your vagina also loses
its ability to produce as much lubrication (wetness) during sexual arousal.
These changes can lead to pain during sex.
You can use an estrogen cream (put in and around your vagina) or a
water-based lubricant (such as K-Y Jelly) to make sex less painful.
Urinary tract problems. You're more likely to have bladder and urinary tract
infections during and after menopause. Talk to your family doctor if you
have to go to the bathroom often, feel an urgent need to urinate, feel a
burning sensation when urinating or are not able to urinate.
Headaches, night sweats, trouble sleeping and tiredness are other symptoms.
Trouble sleeping and feeling tired may be caused by hot flashes and night
sweats.

Does menopause have emotional symptoms?
Many women experience emotional symptoms during menopause. These symptoms
may include sadness, anxiety and loss of sleep. For some women, symptoms can
be severe. If you find that you're having emotional problems, talk to your
family doctor.

What is hormone replacement therapy?
Hormone replacement therapy (HRT) involves taking estrogen alone or estrogen
combined with another hormone, progestin. Some women have found that HRT can
relieve symptoms such as hot flashes, vaginal dryness and some urinary
problems. However, HRT is not for everyone. New information from recent
studies suggests that for many women, the risks of using HRT may outweigh
the benefits. Talk to your family doctor about the risks and benefits of
HRT.

Are other treatments available?
Yes. Medicines such as estrogen cream, antidepressants, soy products and
certain herbal supplements may help ease some menopausal symptoms. Discuss
these options with your family doctor.

Help for hot flashes
Turn your thermostat down. Sleep in a cool room.
Dress in layers, so you can remove clothing when you get too warm.
Wear cotton and other natural fabrics that "breathe" so you don't get
overheated. Use cotton sheets on your bed.
Drink cool water or other beverages when a hot flash starts.
Avoid alcohol. [AAFP]