Menoapuase

INTRODUCTION

Menopause is the time in a woman's life when the function of the ovaries ceases. The ovary, or 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.

Menopause does not occur overnight, but rather is a gradual process of transition. This transition period (known as perimenopause) is different for each woman. Scientists are still trying to identify all the factors that initiate and influence this transition. Women in perimenopause transition typically experience abnormal vaginal bleeding such as erratic periods or abnormal bleeding patterns. Eventually a woman's periods will completely stop as she completes this transition into menopause.

As a rough "rule of thumb" women tend to undergo menopause at an age similar to that of their mothers.

BODY

A woman is in menopause if she has had no menstrual periods (menses) for 12 months and has no other medical reason for her menses to stop. That means she has to be evaluated by her doctor to exclude other medical causes of missed menses.

Because hormone levels may fluctuate greatly in an individual woman, even from one day to the next, hormone levels are not a reliable indicator for diagnosing menopause. Even if levels are low one day, they may be high the next day in the same woman. There is no single blood test that reliably predicts when a woman is going through menopause, or menopausal transition. Therefore there is currently no proven role for blood testing regarding menopause except for tests to exclude medical causes of erratic menstrual periods other than menopause. The only way to diagnose menopause is to observe lack of menstrual periods for 12 months in a woman in the expected age range.

Menopause is defined as absence of menstrual periods for 12 months. The menopause transition starts with varying menstrual cycle length and ends with the last menstrual period. Perimenopause means "around the time of menopause." It is not officially a medical term, but is sometimes used to explain certain aspects of the menopause transition in lay terms. Postmenopause encompasses the entire period of time that comes after the last menstrual period.

Signs and Symptoms of Menopause

The symptoms of the menopause transition can be divided into early and late onset symptoms. Early symptoms include irregular vaginal bleeding, hot flashes, and night sweats. Late symptoms include vaginal dryness and irritation and sometimes osteoporosis.

Early Onset Symptoms

Irregular Vaginal Bleeding

Irregular vaginal bleeding may occur during menopause. Some women have minimal problems with abnormal bleeding during perimenopause whereas others have unpredictable, excessive bleeding. Menstrual periods (menses) may occur more frequently (meaning the cycle shortens in duration), or they may get farther and farther apart (meaning the cycle lengthens in duration) before stopping. There is no "normal" pattern of bleeding during the menstrual transition, patterns vary from woman to woman. It is common for women in perimenopause to get a period after going for several months without one. There is also no set length of time it takes for a woman to complete her menopausal transition, as all women are different. It is important to remember that all women who develop irregular menses should be evaluated by her doctor to confirm that the irregular menses are due to menopause and not as a sign of another medical illness.

Hot flashes & night sweats

Hot flashes are common among women undergoing menopause. A hot flash is a feeling of warmth that spreads over the body. A hot flash is sometimes associated with flushing and is sometimes followed by perspiration. Sometimes hot flashes are accompanied by night sweats (episodes of drenching sweats at nighttime). The cause of hot flashes is not yet understood. Recent research theory suggests that women with hot flashes seem to start sweating at a lower environmental temperature than women without hot flashes. There is currently no method to predict when hot flashes will begin and how long they will last. Hot flashes occur in up to 40% of regularly menstruating women in their forties, so they may begin before the menstrual irregularities characteristic of menopause even begin. About 80% of women will be finished having hot flashes after 5 years. Sometimes (in about 10% of women), hot flashes can last as long as 10 years. There is no way to predict when hot flashes will cease, though they tend to decrease in frequency over time. On average, hot flashes last about 5 years. For more, please read the Alternative Treatments for Hot Flashes article.

Mood Symptoms

There is considerable controversy about exactly which behavioral symptoms are due directly to menopause. Research in this area has been difficult for many reasons. First, mood symptoms are so common to begin with, that it is sometimes difficult in a given woman to know if they are due to menopause. Also, women who have been diagnosed with depression in the past may be sensitive to a recurrence of depression toward the time of menopause, but the menopause isn't really "the cause" of the depression, strictly speaking. To further complicate matters, mood swings could actually be linked with the sleep disturbance triggered by menopausal night sweats. Researchers are now trying to determine what factors can influence mood symptoms during menopause. Factors that have been suspected and are being analyzed for