Overview, Causes, & Risk Factors
Menopause is the point in a woman’s life whenmenstruationstops for good. This means she is no longer able to have children.Menopause occurs in most women between the ages of 35 and 58. It is anatural event in a woman’s life. Surgical menopause occurs when awoman has both of her ovaries removed.
What is going on in the body?
By the time a woman is in her mid 30s, the level of thehormone estrogen in her body begins to drop. Levels gradually declineuntil a woman stops menstruating.The period during which estrogen levels are dropping but the woman isstill menstruating is called perimenopauseor premenopause. The point at which the estrogen level has declinedenough so that menstruation stops is called menopause. Theperiod of time that begins after menstruation permanently stops isknown as postmenopause.
What are the causes and risks of the condition?
Menopause is a natural part of a woman’s life. A woman’sestrogen level decreases over time, causing her to stopmenstruating.A woman who has her ovaries removed because of disease will also gothrough menopause.
Symptoms & Signs
What are the signs and symptoms of the condition?
Symptoms of menopause vary from woman to woman.Some women will have severe symptoms. Others will have mild symptomsor none at all. The symptoms may occur for a few weeks, a few months,or even several years. The symptoms may come and go. Some commonphysical symptoms include:
Women who are menopausal do not experience any moremental illnesses than any other group. However, the followingpsychological symptoms are common during menopause:
Menopause usually occurs during a time in life whenother dramatic changes are taking place. Common changes during midlifeinclude:
These changes along with the changes going on in awoman’s body during menopause may result in increasedstress.
Diagnosis & Tests
How is the condition diagnosed?
Diagnosis is usually made by the woman’s medical historyand supporting symptoms. A blood test can be used to measureestrogen levels. A pelvic examand Pap smearmay show effects of decreased estrogen.
Prevention & Expectations
What can be done to prevent the condition?
There is no prevention. All women will experiencemenopause.
What are the long-term effects of the condition?
Certain diseases are associated with estrogen loss in women.A woman who is past menopause is at higher risk for the followingconditions:
Many women have more desire for sex aftermenopause. This may be because pregnancyis no longer a worry. However, women who are stillmenstruating,and women who have stopped menstruating within the past year, may stillget pregnant. Barrier birth controlmethods, intrauterine devices,which are also called IUDs, or tubal ligationcan prevent pregnancy.
What are the risks to others?
Menopause is not catching. It poses no risks to others.
Treatment & Monitoring
What are the treatments for the condition?
Menopause itself is not treated. Certain health problems,such as osteoporosisare linked to the loss of estrogen. To help prevent such problems,many women take estrogen to replace what their body is no longerable to produce. This treatment is called estrogen replacement therapy,which is also called ERT, or hormone replacement therapy,which is also called HRT.
The American Heart Association recently issuedrecommendations about HRT in women. For women who have alreadyhad a heart attackor have heart disease,it appears that HRT does not protect against having another heart attackor dying from heart disease.
For women who have not already had a heart attack orwho do not have heart disease, HRT should not be started for the solepurpose of preventing heart disease. In fact, a recent study has shownthat there is a slight increase in the risk for heart attackand strokein women who are on HRT.
Overall, the decision to use HRT should be based uponthe proven benefits and risks of HRT. A woman should discuss thebenefits and risks with her doctor. Together, they canchoose the best course of action.
Symptoms associated with menopause may also betreated. During menopause, sexual intercourse may become painful,a condition known as dyspareunia.This condition is often caused by vaginal drying, and can result in adecline in sexual interest. Creams are available to help with lubrication.Kegel exercisesof the pelvic muscle can treat urinary leakage. Surgery or medicinemay also be used.
What are the side effects of the treatments?
Side effects to HRTcan include headaches,bloating, vaginal bleeding, breast tenderness, andirritability.Recent studies have also linked HRT to an increased risk of heart attack,stroke, and cancers of the breast,ovary, anduterus.
What happens after treatment for the condition?
Most menopausal symptoms will go away oncemenstruationstops.
How is the condition monitored?
A woman’s progress through menopause is monitoredthrough regular Pap smearsand pelvic exams.Any new or worsening symptoms should be reported to the doctor.
Article type: xmedgeneral