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Menopause: Symptoms, causes, complications, diagnosis and treatment

Post by on Sunday, August 21, 2022

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Menopauseis the natural biological process that marks the end of your Menstrual cycle. It is diagnosed after you have gone 12 months without a menstrual period. Menopause can happen in your 40's and 50's, but the average is 51 years in the United States.

Among the physical symptoms of menopause, the most common is hot flashes and emotional symptoms of menopause may disrupt your sleep, lower your energy or affect emotional health. There are many effective treatments available, from lifestyle adjustments to hormone therapy.

Symptoms

In the months or years leading up to menopause (perimenopause),you might experience these signs and symptoms:

1. Hot Flashes

2. Irregular Periods

3. Vaginal Dryness

4. Chills

5. Night sweats

6. Sleep problems

7. Mood changes

8. Weight gain and slowed metabolism

9. Thinning hair and dry skin

10. Loss of breast fullness

Signs and symptoms, including changes in menstruation can vary among women. Most likely, you'll experience some irregularity in your periods before they end. Skipping periods during Perimenopause is common and expected. Often, menstrual periods will skip a month and return, or skip several months and then start monthly cycles again for a few months. Periods also tend to happen on shorter cycles, so they are closer together. Despite irregular periods, pregnancy is possible. If you've skipped a period but aren't sure you've started the menopausal transition, consider a pregnancy test.

When to see a doctor?

Keep up with regular visits with your doctor for preventive health care and any medical concerns. Continue getting these appointments during and after menopause.

Preventive health care as you age may include recommended health screening tests,such as Mammography and Triglyceride screening. Your doctor might recommend other tests and exams, too including thyroid testing if suggested by your history, and breast and pelvic exams. Always seek medical advice if you have bleeding from your vagina after menopause.

Causes

Menopause can result from:

Naturally declining reproductive hormones: As you approach your late 30s, your ovaries start making less estrogen and progesterone — the hormones that regulate menstruation — and your fertility declines. In your 40s, your menstrual periods may become longer or shorter, heavier or lighter, and more or less frequent, until eventually—on average, by age 51 — your ovaries stop releasing eggs, and you have no more periods.

Surgery that removes the ovaries (oophorectomy): Your ovaries produce hormones, including estrogen and progesterone that regulate the menstrual cycle. Surgery to remove your ovaries causes immediate menopause.

Surgery that removes your uterus but not your ovaries (hysterectomy) usually doesn't cause immediate menopause. Although you no longer have periods, your ovaries still release eggs and produce estrogen and progesterone.

Chemotherapy and Radiation Therapy: These cancer therapies can induce menopause, causing symptoms such as hot flashes during or shortly after the course of treatment.

Primary ovarian insufficiency: About 1percent women experience menopause before age 40 (premature menopause). Premature menopause may result from the failure of your ovaries to produce normal levels of reproductive hormones (primary ovarian insufficiency), which can stem from genetic factors or autoimmune disease.

Complications

After menopause, your risk of certain medical conditions increases. Examples include:

·        Osteoporosis

·        Urinary incontinence

·        Sexual function

·        Weight gain

What Happens During Menopause?

Natural menopause isn’t caused by any type of medical or surgical treatment. It’s slow and has three stages:

Perimenopause: This phase usually begins several years before menopause, when your ovaries slowly make less estrogen.

Menopause: This is when it's been a year since you had a period. Your ovaries have stopped releasing eggs and making most of their estrogen.

Postmenopause: These are the years after menopause. Menopausal symptoms such as hot flashes usually ease. But health risks related to the loss of estrogen increase as you get older.

What Conditions Cause Premature Menopause?

Your genes, some immune system disorders, or medical procedures can cause premature menopause. Other causes include:

Premature ovarian failure: When your ovaries prematurely stop releasing eggs, for unknown reasons, your levels of estrogen and progesterone change. When this happens before you’re 40, it's called premature ovarian failure. Unlike premature menopause, premature ovarian failure isn’t always permanent.

Induced menopause: This happens when your doctor takes out your ovaries for medical reasons, such as uterine cancer or endometriosis. It can also happen when radiation or chemotherapy damages your ovaries.

Diagnosis

You might suspect that you’re going into menopause. Or your doctor will say something, based on symptoms you've told them about.

You can keep track of your periods and chart them as they become uneven. The pattern will be another clue to your doctor that you’re menopausal.

Your doctor might also test your blood for levels of:

·        Follicle-stimulating hormone (FSH)

·        Thyroid hormones

·        Anti-Mullerian hormone (AMH)

Treatment

Menopause is a natural process. Many symptoms will go away over time. But if they’re causing problems, treatments can help you feel better. Common ones include:

Hormone replacement therapy (HRT): This is also called menopausal hormone therapy. You take medications to replace the hormones that your body isn’t making anymore. 

Topical hormone therapy: This is an estrogen cream, insert, or gel that you put in your vagina to help with dryness.

Nonhormone medications: The anti-depression drug paroxetine (FDA-approved to treat hot flashes. The nerve drug gabapentin and the blood pressure drug clonidine might also ease them. Medicines called selective estrogen receptor modulators (SERMs) help your body use its estrogen to treat hot flashes and vaginal dryness.

Medications for osteoporosis: You might take medicines or vitamin D supplements to help keep your bones strong.

Lifestyle changes

Lifestyle changes help many women deal with menopause symptoms. Try these steps:

l  If you’re having hot flashes, drink cold water, sit or sleep near a fan, and dress in layers.

l  Use an over-the-counter vaginal moisturizer or lubricant for dryness.

l  Exercise regularly to sleep better and prevent conditions like heart disease, diabetes and osteoporosis.

l  Strengthen your pelvic floor muscles with Kegel exercises to prevent bladder leaks.

l  Stay socially and mentally active to prevent memory problems.

l  Don’t smoke. Tobacco might cause early menopause and increase hot flashes.

l  Limit how much alcohol you drink, to lower your chance of getting breast cancer and help you sleep better.

l  Eat a variety of foods and keep a healthy weight to help with hot flashes.

l  Practice things like yoga, deep breathing, or massage to help you relax.

Alternative and Complementary Menopause Treatments

Some studies have found that soy products relieve hot flashes, but researchers are still looking into it. There aren’t many large studies on whether other supplements such as black cohosh or “bioidentical” hormones work for menopause symptoms. Talk to your doctor before starting any herbal or dietary supplements.

Menopause Complications

The loss of estrogen linked with menopause is tied to a number of health problems that become more common as women age.After menopause, women are more likely to have:

l  Bone loss (osteoporosis)

l  Heart disease

l  Bladder and bowels that don’t work like they should

l  Higher risk of Alzheimer's disease

l  More wrinkles

l  Poor muscle power and tone

l  Weaker vision

It can be tough to manage the sexual changes that come along with menopause, like vaginal dryness and a loss of sex drive. You might also find that you don’t enjoy sex as much and have trouble reaching orgasm. As long as it isn’t painful, regular sexual activity may help keep your vagina healthy by promoting blood flow.

Your ovaries have stopped sending out eggs once you’re in menopause, so you can’t get pregnant. But you can still get a sexually transmitted disease. Use safer sex practices if you’re not in a relationship with one person.

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