Menopause

Menopause is a natural event in women aged 49–55. Menopause is not a disease but a normal biological transition and inevitable process of change. Major hormonal [Page 455]shifts occur which may affect a woman's entire being. In many ways, this hormonal shift is likened to puberty as it is a time of symptoms before a change. Like puberty, the hormonal shifts of menopause mark a rite of passage and an entrance to a new life phase.

Menopause begins once a woman has ceased to menstruate for 365 days. The years preceding are referred to as perimenopause or the climacteric, commonly referred to as “the change.” The duration may last up to 10 years. Each woman is different and there is no way of predicting how long this phase may be. It is possible that a woman is thrown into a surgical or chemical menopause. A hysterectomy that includes removal of both ovaries will result in immediate menopause. Chemotherapy and radiation may cause a premature menopause. Stress, anorexia, and intense exercise may stop menstruation, but if it returns, a natural menopause may still occur.

The ovaries are an endocrine organ the size and shape of an almond. The role of the ovary is to produce eggs and hormones including estrogen, progesterone, and androgen, which affects libido. The glands of the endocrine system are the main hormone producers. The pituitary gland secretes hormones that control ovulation and menstruation. The pituitary and the ovaries respond to each other by instructing the rise and fall of hormone levels. At menopause, these levels fluctuate; less progesterone is produced in the ovaries followed by a decrease in estrogen. The ovaries cease egg production.

Symptoms of the climacteric may include hot flashes, irregular periods, fuzzy thinking, insomnia, headaches, vaginal dryness, irritability, and mood swings. Decreased ovulation causes an increase in estrogen relative to progesterone manifesting in the onset of symptoms. Because each woman is individual and unique, many of the symptoms may be absent or mild. In others, they may be devastating and disruptive to a woman's overall health and well-being. There are options to ease the discomfort and disturbances, but what works for one woman may not work for another. It is important to identify your particular issues and address them with a combination of remedies including a frank discussion with your physician.

The least invasive option is to make positive lifestyle changes. These changes may have the added benefit of increasing your quality of life physically, emotionally, and cognitively.

Menopause is best treated by taking into account a woman's health history, her family history, and her individual symptoms.

Exercise is an important element before, during, and after menopause. Women who exercise often experience fewer symptoms. They have the added benefit of muscle strength which helps strengthen bones, aid in balance, and protect the heart muscle.

Hot flashes and night sweats are a common complaint. It is advisable to avoid spicy food, caffeine, and alcohol. Keep rooms cool and dress in layers. Exercise and stress reduction may also help. Adding one to two daily servings of soy may be beneficial. Soy contains phytoestrogens which mimic estrogen. Good sources include soy milk, tofu, tempeh, and soy nuts. Black cohosh is a supplement that may combat hot flashes. It has been endorsed by the North American Menopause Society for a duration of up to six months.

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