Menopause is defined as the state of an absence of menstrual periods for 12 months. The menopausal transition starts with varying menstrual cycle length and ends with the final menstrual period. Perimenopause means “the time around menopause” and is often used to refer to the menopausal transitional period. It is not officially a medical term, but is sometimes used to explain certain aspects of the menopause transition in lay terms. Postmenopause is the entire period of time that comes after the last menstrual period.
Menopause is the time in a woman’s life when the function of the ovaries ceases. The ovary (female gonad), is one of a pair of reproductive glands in women. They are located in the pelvis, one on each side of the uterus. Each ovary is about the size and shape of an almond. The ovaries produce eggs (ova) and female hormones such as estrogen. During each monthly menstrual cycle, an egg is released from one ovary. The egg travels from the ovary through a Fallopian tube to the uterus.
The ovaries are the main source of female hormones, which control the development of female body characteristics such as the breasts, body shape, and body hair. The hormones also regulate the menstrual cycle and pregnancy. Estrogens also protect the bone. Therefore, a woman can develop osteoporosis (thinning of bone) later in life when her ovaries do not produce adequate estrogen.
Symptoms Of Menopause:
During the perimenopausal period some subtle — and some not-so-subtle — changes in your body may occur. Some things you might experience include:
- Menstrual irregularity. As ovulation becomes more erratic, the intervals between periods may be longer or shorter, your flow may be scanty to profuse, and you may skip some periods. Early peri menopause is defined as a change in your menstrual cycle length of more than seven days. Late perimenopause is characterized by two or more missed periods and an interval of 60 days or more between periods.
- Hot flashes and sleep problems. About 65 to 75 percent of women experience hot flashes, most commonly during late peri menopause. The intensity, duration and frequency vary. Sleep problems are often due to hot flashes or night sweats, but sometimes sleep becomes erratic even without them.
- Mood changes. Some women experience mood swings, irritability or increased risk of depression during peri menopause, but the cause of these symptoms may be sleep disruption caused by hot flashes. Mood changes may also be caused by factors not related to the hormonal changes of peri menopause.
- Vaginal and bladder problems. When estrogen levels diminish, your vaginal tissues may lose lubrication and elasticity, making intercourse painful. Low estrogen levels may also leave you more vulnerable to urinary or vaginal infections. Loss of tissue tone may contribute to urinary incontinence.
- Decreasing fertility. As ovulation becomes irregular, your ability to conceive decreases. However, as long as you’re having periods, pregnancy remains a possibility. If you wish to avoid pregnancy, use birth control until you’ve had no periods for 12 months.
- Changes in sexual function. During peri menopause, sexual arousal and desire may change. But for most women who had satisfactory sexual intimacy before menopause, this will continue through perimenopause and beyond.
- Loss of bone. With declining estrogen levels, you start to lose bone more quickly than you replace it, increasing your risk of osteoporosis.
- Changing cholesterol levels. Declining estrogen levels may lead to unfavorable changes in your blood cholesterol levels, including an increase in low-density lipoprotein (LDL) cholesterol — the “bad” cholesterol — which contributes to an increased risk of heart disease. At the same time, high-density lipoprotein (HDL) cholesterol — the “good” cholesterol — decreases in many women as they age, which also increases the risk of heart disease.
Risk Factors Of Menopause:
Menopause is a normal phase in a woman’s life. But in some women, it may occur earlier than in others. Although not always conclusive, some evidence suggests that certain factors may predispose you to entering perimenopause at an earlier age, including:
- Smoking. The onset of menopause occurs one to two years earlier in women who smoke, compared with women who don’t smoke.
- Family history. Women tend to experience menopause around the same age as their mothers and sisters, although the link between family history and age at menopause is still inconclusive.
- Never having delivered a baby. Some studies show that never having had a baby may contribute to early menopause.
- Childhood cancer treatment. Treatment for childhood cancer with chemotherapy or pelvic radiation therapy has been linked to early menopause.
- Hysterectomy. A hysterectomy that removes your uterus, but not your ovaries, usually doesn’t cause menopause. Although you no longer have periods, your ovaries still produce estrogen. But such an operation may cause menopause to occur earlier than average.
Complications Of Menopause:
The decline in estrogen after menopause can increase the risk for a number of health problems for women.
- Menopause and Heart Health. Heart disease is the number one killer of women. Although young women have a much lower risk for cardiovascular disease than young men, after menopause women catch up. After age 60, women’s risk of dying from heart disease is very close to that of men. Estrogen loss is believed to play a major role in this increased risk. Woman who reach menopause before the age of 35 have a significant increase in risk for heart disease as they age. This increase is primarily due to a rise in levels of LDL (“bad” cholesterol) and triglycerides, and a decrease in levels of HDL (“good”)cholesterol).
- Menopause and Bone Density. Osteoporosis is a disease of the skeleton in which bones become “thin” and prone to fracture. In other words, the bone loses calcium and density. At age 65, about 30% of women have osteoporosis, and nearly all of them are unaware of their condition. After age 80, up to 70% of women develop osteoporosis. Osteoporosis is a major risk factor for fracture in the spine and hip. The decrease in bone density can also lead to bone loss in the jaw and subsequent tooth decay.
- Menopause And Urinary Incontinence. The drop in body estrogen levels brought on by menopause can thin the linings of the urethra and bladder, which may contribute to both urinary stress and urge incontinence.
- Menopause And Urinary Tract Infections. Because of vaginal drying, women are at increased risk for recurrent urinary tract infections after menopause.
- Menopause And Weight Gain. Weight gain is common during a woman’s middle-aged years, especially between the ages of 50 – 59 years. The hormonal changes associated with menopause contribute to these body changes. Gaining weight around the abdomen (the so-called apple shape) is a specific risk factor for heart disease, diabetes, and many other health problems. Higher body mass index (BMI) may also be associated with increased risk for more frequent or severe hot flashes.
When To See A Doctor About Menopause?
Some women seek medical attention for their perimenopausal symptoms. But others either tolerate the changes or simply don’t experience symptoms severe enough to warrant attention. Because subtle symptoms of menopause may come on gradually, you may not realize at first that they’re all connected to the same thing — fluctuating levels of estrogen and progesterone, another key female hormone.
If you do experience menopause symptoms that interfere with your life or well-being, such as hot flashes, mood swings or changes in sexual function that concern you, see your doctor.
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Category: womens health