Health Care and Menopause

Menopause, or the permanent end of menstruation and fertility, is a natural biological process, not a medical illness. Even so, the physical and emotional symptoms of menopause can disrupt your sleep, sap your energy and — at least indirectly — trigger feelings of sadness and loss, according to the Mayo Clinic. Hormonal changes cause the physical symptoms of menopause, but mistaken beliefs about the menopausal transition are partly to blame for the emotional ones. First, menopause doesn't mean the end is near — you've still got as much as half your life to go. Second, menopause will not snuff out your femininity and sexuality. In fact, you may be one of the many women who find it liberating to stop worrying about pregnancy and periods.

Most important, even though menopause is not an illness, you shouldn't hesitate to get treatment if you're having severe symptoms as described by the Mayo Clinic. Technically, you don't actually "hit" menopause until it's been one year since your final menstrual period. In the United States, that happens about age 51, on average. The signs and symptoms of menopause, however, often appear long before the one-year anniversary of your final period. They include:
--Irregular periods
--Decreased fertility
--Vaginal dryness
--Hot flashes
--Sleep disturbances
--Mood swings
--Increased abdominal fat
--Lost of breast fullness
--Thinning hair

Menopause affects every woman according to WebMD. Premature menopause symptoms (or early menopause symptoms) may include irregular periods or hot flashes. Other signs of menopause include night sweats, sleep difficulties, and irritability. Menopause treatments may include hormone replacement therapy, although this is not for every woman. Herbal remedies for menopause may include soy foods and natural supplements. If you have bleeding after menopause, call your doctor as it may indicate a more serious problem.

Menopause, according to the Mayo Clinic, begins naturally when your ovaries start making less estrogen and progesterone, the hormones that regulate menstruation. The process gets under way in your late 30s. By that time, fewer potential eggs are ripening in your ovaries each month, and ovulation is less predictable. Also, the post-ovulation surge in progesterone — the hormone that prepares your body for pregnancy — becomes less dramatic. Your fertility declines, perhaps partially due to these hormonal effects. These changes are more pronounced in your 40s, as are changes in your menstrual pattern. Your periods may become longer or shorter, heavier or lighter, and more or less frequent.

Eventually, your ovaries shut down and you have no more periods according to Mayo Clinic. It's possible, but very unusual, to menstruate every month right up to your last period. You're much more likely, though, to have a gradual tapering off. Unfortunately, there's no way to know exactly which period will be your last. You have to wait until well after the fact — 12 months after, by official definition. In your final months before reaching menopause, it's still possible to get pregnant, but it's quite unlikely. The signs and symptoms of menopause are enough to tell most women they have begun going through the transition. If you have concerns about irregular periods or hot flashes, talk with your doctor. In some cases further evaluation may be recommended.

Because this process takes place over years, menopause is commonly divided into the following two stages as reported by the Mayo Clinic:
1.) Perimenopause: This is the time you begin experiencing menopausal signs and symptoms, even though you still menstruate. Your hormone levels rise and fall unevenly, and you may have hot flashes and other symptoms. Perimenopause may last four to five years or longer.
2.) Postmenopause: Once 12 months have passed since your last period, you've reached menopause. Your ovaries produce much less estrogen and no progesterone, and they don't release eggs. The years that follow are called postmenopause.

Researchers at Rush University Medical Center in Chicago have recently discovered some new and interesting relationships between menopause and sleep. In a recent study, they found that difficulty falling asleep and staying asleep increase as women go through menopause. The study also said that waking up earlier than planned also increases through late perimenopause -- before menopause -- but decreases when women become postmenopausal.

Also according to the Mayo Clinic, several chronic medical conditions tend to appear after menopause. By becoming aware of the following conditions, you can take steps to help reduce your risk:
1.) Cardiovascular disease: When your estrogen levels decline, your risk of cardiovascular disease increases. Heart disease is the leading cause of death in women as well as in men. Yet you can do a great deal to reduce your risk of heart disease. These risk-reduction steps include stopping smoking, reducing high blood pressure, getting regular aerobic exercise, and eating a diet low in saturated fats and plentiful in whole grains, fruits and vegetables.
2.) Osteoporosis: During the first few years after menopause, you may lose bone density at a rapid rate, increasing your risk of osteoporosis. Osteoporosis causes bones to become brittle and weak, leading to an increased risk of fractures. Postmenopausal women are especially susceptible to fractures of the hip, wrist and spine. That's why it's important during this time to get adequate calcium and vitamin D — about 1,200 to 1,500 milligrams of calcium and 800 international units of vitamin D daily. It's also important to exercise regularly. Strength training and weight-bearing activities such as walking and jogging are especially beneficial in keeping your bones strong.
3.) Urinary incontinence: As the tissues of your vagina and urethra lose their elasticity, you may experience a frequent, sudden, strong urge to urinate, followed by an involuntary loss of urine (urge incontinence), or the loss of urine with coughing, laughing or lifting (stress incontinence).
Weight gain. Many women gain weight during the menopausal transition. You may need to eat less — perhaps as many as 200 to 400 fewer calories a day — and exercise more, just to maintain your current weight.

According to the U.S. Health & Human Services, eating a healthy diet and exercising at menopause and beyond are important to feeling your best. Most women do not need any special treatment for menopause. But some women may have menopause symptoms that need treatment. Several treatments are available. It's a good idea to talk about the treatments with your doctor so you can choose what’s best for you. There is no one treatment that is good for all women. Sometimes menopause symptoms go away over time without treatment, but there’s no way to know when.

The National Institute on Health has suggestions on health care after menopause. Staying healthy after menopause may mean making some changes in the way you live.
--Don’t smoke. If you do use any type of tobacco, stop—it’s never too late to benefit from quitting smoking.
--Eat a healthy diet, low in fat, high in fiber, with plenty of fruits, vegetables, and whole-grain foods, as well as all the important vitamins and minerals.
--Make sure you get enough calcium and vitamin D—in your diet or with vitamin/mineral supplements.
--Learn what your healthy weight is, and try to stay there.
--Do weight-bearing exercise, such as walking, jogging, or dancing, at least 3 days each week for healthy bones. But try to be physically active in other ways for your general health.

The NIA also offers other things to remember:
--Take medicine if your doctor prescribes it for you, especially if it is for health problems you cannot see or feel—for example, high blood pressure, high cholesterol, or osteoporosis.
--Use a water-based vaginal lubricant (not petroleum jelly) or a vaginal estrogen cream or tablet to help with vaginal discomfort.
--Get regular pelvic and breast exams, Pap tests, and mammograms. You should also be checked for colon and rectal cancer and for skin cancer. Contact your doctor right away if you notice a lump in your breast or a mole that has changed.

Menopause is a change of life for all women who live to the age when it happens. It can be very frustrating and confusing for many women who have trouble dealing with the symptoms. Other family members also must deal with the physical and emotional issues that are brought on during this time. Consultation with primary care providers and other health care counselors will help you deal with the complications that are part of menopause. Remember that there are many resources available to you if you are experiencing this particular season of life. Use them.

Until next time. Let me know what you think.