Menopause |
OverviewMenopause comes from the Greek mens meaning monthly and pauses meaning cessation. It is a natural biological process that results in the permanent end of menstruation and fertility. Every woman experiences menopause in their own individual way. Once few women lived beyond menopause. Today however the average Canadian woman lives to 81 years of age so it is possible that you could spend one third of your life in menopause. It is important to understand that this does not mean the end of your youth or sexuality. Indeed it is a great time to assess your overall health and perhaps re-evaluate certain lifestyle choices. CausesMenopause begins naturally when your ovaries produce lower levels of estrogen and progesterone two hormones that regulate ovulation and menstruation. According to the Society of Obstetricians and Gynaecologists of Canada this usually begins when a woman is in her late 40s and finishes at about age 51 but some women may still be in transition until age 55 or later. Eventually you'll notice that you are no longer menstruating. When you haven't had your period for a full year you are menopausal and no longer able to become pregnant. No woman can forget when she got her first period. But menopause doesn't begin with such unexpected suddenness. It is a gradual process which occurs over a number of years and can be divided into two clear stages: Perimenopause. This is the time you begin experiencing menopausal signs and symptoms even though you're still ovulating. Your hormone levels rise and fall unevenly and you may have hot flashes and variations in your periods. For instance your flow may be irregular or heavier or lighter than usual. This process can last five years or more. Postmenopause. Once 12 months have passed since your last period you've entered the postmenopausal stage. Your ovaries no longer produce estrogen or progesterone and they don't release eggs. While menopause is a natural process it is possible to experience it earlier than expected as a result of certain surgical or medical treatments including: Hysterectomy. If you have had a hysterectomy (removal of the uterus) you will no longer have monthly menstrual periods but your ovaries should continue to function until you run out of eggs. If you have both of your ovaries removed before you reach menopause naturally then you will enter menopause immediately no matter how old you are. Chemotherapy and radiation therapy. These cancer therapies can induce menopause. But they usually do so gradually and you may have months or years of perimenopausal symptoms before you actually reach menopause. SymptomsSome women have few symptoms other than irregular periods and decreased fertility. Others experience a wide range of physical and emotional changes. The Society of Obstetricians and Gynaecologists of Canada says these could include: Mood and memory. Menopause may bring mood swings irritability anxiety and occasional difficulties with memory or concentration. Some women suffer from low self-esteem and depression at menopause especially those who see it as a sign of aging. Hot flashes. One of the ways that your body keeps its temperature constant is by changing the amount of blood that flows to the skin. Estrogen influences this process. With the changing estrogen levels of menopause your body may have trouble keeping its temperature constant. As a result you may have hot flashes. Besides making you feel hot these episodes may even make you sweat. If they happen while you are sleeping they are called "night sweats". Three out of four menopausal women have hot flashes. Without treatment up to half of these women will have hot flashes for 5 years or more. Some women can even have hot flashes up to the age of 70. Bladder control. Lower estrogen levels may lead to thinning of the tissues lining the bladder and urinary tract resulting in decreased bladder control or the leakage of a small amount of urine when you don't mean to such as when you laugh cough or sneeze. You may have to urinate more frequently especially at night and you may become prone to urinary infections. Appearance. Lower estrogen levels may cause gradual changes in your appearance. When estrogen levels drop during menopause you may notice increased wrinkling because estrogen normally helps maintain the collagen supporting structure of your skin. Sexual changes. Low levels of estrogen can cause decreased lubrication vaginal dryness and as a result painful intercourse. Lower hormone levels can affect the sensitivity of and the blood flow to your sexual organs. Some women may lose interest in sex. Other signs. Some women may experience sleep disturbances fatigue and even joint pain during this transition period. Most of the time these symptoms will lessen or go away after a woman has finished menopause. Treatment Menopause is not an illness. Treatment therefore is aimed solely at easing your symptoms and lessening your risk for certain chronic conditions that tend to crop up after menopause. These include: Cardiovascular disease. As your estrogen levels drop your risk of cardiovascular disease including heart attack and stroke rises. If you still smoke you'll need to stop. You'll also want to keep your blood pressure as normal as possible. Eat a well-balanced diet and exercise regularly. Osteoporosis. Women can lose up to 20 percent of their bone mass in the five to seven years following menopause making them more susceptible to osteoporosis. Postmenopausal women are especially susceptible to fractures of the hip wrist and spine. To maximize your bone strength the Osteoporosis Society of Canada recommends 1000 milligrams of calcium daily for people aged 19-49 and 1000- 1500 milligrams daily for people aged 50 and older (one cup [250 mL] of milk contains almost 300 milligrams of calcium). Weight gain. As your body's metabolism slows and your estrogen level declines you may find you need to eat less and/or exercise more to maintain your normal weight. Reducing your intake of fat and sugar and increasing the amount of fibre in your diet will help. Check Canada's Food Guide to Healthy Eating and Canada's Physical Activity Guide to Healthy Active Living for Older Adults for more details. Self-care Fortunately many of the signs and symptoms associated with menopause are temporary. The Mayo Clinic offers these tips to help reduce or prevent their effects: Cool hot flashes. If you're experiencing hot flashes get regular exercise dress in layers and try to pinpoint what triggers your hot flashes. For many women triggers may include hot beverages spicy foods alcohol hot weather and even a warm room. Decrease vaginal discomforts. For vaginal dryness or discomfort with intercourse use over-the-counter water-based vaginal lubricants (Astroglide K-Y Jelly) or moisturizers (Replens Vagisil). Staying sexually active also helps minimize these problems. Optimize your sleep. If you have trouble sleeping avoid caffeinated beverages and exercise right before bedtime. Practicing relaxation techniques such as deep breathing guided imagery and progressive muscle relaxation can be very helpful. You can find a number of books and tapes on different relaxation exercises. Stay dry. If you experience night sweats wear cool cotton clothing to bed and keep an extra set handy. Strengthen your pelvic floor. Pelvic floor muscle exercises called Kegel exercises can improve some forms of urinary incontinence. Eat well. Eat a balanced diet that includes a variety of fruits vegetables and grains and that limits fats oils and sugars. In particular make sure your intake of calcium is at least 1200 to 1500 mg. If you're not taking estrogen ask your physician about additional calcium supplements. Don't smoke. Smoking increases your risk of heart disease stroke cancer and a range of other health problems. It may also increase hot flashes and bring on earlier menopause. Exercise regularly. Thirty minutes most days is a good goal to protect against cardiovascular disease diabetes and osteoporosis. It also can help reduce stress. Try a combination of weight-bearing aerobic activities such as walking jogging and dancing and strength-training exercises. Just staying physically active each day by taking stairs instead of an elevator or by parking farther away and walking to your destination also can make a difference. Schedule regular checkups. Talk with your doctor about how often you should have mammograms Pap tests and other screening tests. Additional Resources:Society of Obstetricians and Gynaecologists of Canada |