Menopause refers to the time of life when the ovaries stop making the female hormones, estrogen and progesterone. While scientists once thought that this occurred suddenly, perhaps over a month or two, now we know that menopause occurs gradually. The term now used is the perimenopausal transition.

This process takes place over a 2-to-5 year period. During that time, the amount of estrogen made in the ovaries shifts back and forth, from normal amounts to high amounts to none at all. Thus the symptoms women have during this time, which occur when estrogen and progesterone levels fluctuate, vary widely.

Sometimes progesterone is made and a period occurs, and in other months the periods are skipped. Premenopausal women with breast cancer often enter menopause abruptly because chemotherapeutic drugs can destroy ovarian function. In this situation, menopausal symptoms occur suddenly and are often quite severe, since women don't have time to adapt slowly to them.

What problems result from lower estrogen and progesterone levels?

Most of the problems are related to the drastic fall in estrogen levels from 50-600 units (picograms per milliliter of blood) to 5-10 units (picograms per milliliter of blood). Women can have problems in five areas, described here:

1. The urogenital tract, which includes the bladder, uterus, and vagina, loses tissue (in a process called atrophy).

This causes symptoms of burning when urinating, pain when urinating, sudden loss of urine (incontinence), dryness and itching of the vagina, and often pain during sex.

2. The blood vessels become unstable in the amount of blood that they carry to the skin. This problem, called vasomotor instability causes hot flashes and frequent awakening.

3. The brain often responds to a lack of estrogen by functioning differently. This causes depression, memory loss, mood swings, irritability, or a general sense of not feeling well, a lack of well being. The medical term for these problems is neurocognitude dysfunction. The relationship between menopause and depression appears to have a biological and not exclusively psychological basis. The first link between depression and estrogen deficiency was seen in studies of depression occurring just after childbirth in some women when estrogen levels are very low.

4. The bones begin to break down more rapidly and lose calcium. This leads to loss of bone; a condition called osteopenia, and later to a more severe loss called osteoporosis. With osteoporosis, women lose height as bones in the spine break or shrink in height. Also their backs may begin to curve more, and what is called a "widow's hump" or "dowager's hump" develops. Finally, painful spine fractures or hip fractures may occur when an elderly woman falls. Hip fractures are a major cause of both hospitalization and death in elderly women.

5. Lack of estrogen speeds up the development of heart disease. Women begin to catch up to men in their risk of having a heart attack. This risk increases because of the lack of estrogen. Death from heart disease is about eight times more common than death from breast cancer in women. This is particularly true of older women, because heart disease affects women who are in their 60s to 90s, whereas breast cancer often occurs earlier in life.

Several other conditions are thought to occur more commonly after menopause in women who do not take estrogen. Alzheimer's disease and colon cancer are two conditions that are more common. These conditions have not yet been proven to be reduced in women who take estrogen, but the evidence is growing about the potential benefits of estrogen.Considering all of this, menopause is not just one set of symptoms that will go away, but is a process involving many parts of the body.

Some of the aspects of menopause cause symptoms such as hot flashes, which usually go away after a few months to one to two years without treatment. Others, such as urogenital atrophy, remain until some therapy is provided. Other aspects do not cause symptoms but make a woman more likely to have other conditions such as heart disease or osteoporosis.The medical terminology used by physicians to describe menopause conveys concepts that have been areas for discussion with informed women.

For example, the term estrogen deficiency implies an abnormality. Menopause is a natural event and estrogens naturally fall at the time of menopause. It is argued then that estrogen deficiency is not the correct term.

The implication is that hormone deficiency need not be treated at menopause if this is a natural process. Others point out that progesterone also falls at menopause and fluctuates during the perimenopausal transition.

Symptoms due to progesterone deficiency should then also be discussed as part of menopause. Male hormone levels, which are present but low in women, fall further as women age and drop rather suddenly after surgical removal of the ovary.

Many argue that this hormonal change be considered part of menopause.
(Courtesy of the National Women?s Health Info. Center)

Jacqui




		Menopause & Menstruation
	"Menopause: What is it?" (Courtesy of the National Women's Health Info. Center) Menopause refers to the time of life when the ovaries stop making the female hormones, estrogen and progesterone. While scientists once thought that this occurred suddenly, perhaps over a month or two, now we know that menopause occurs gradually. The term now used is the perimenopausal transition. This process takes place over a 2-to-5 year period. During that time, the amount of estrogen made in the ovaries shifts back and forth, from normal amounts to high amounts to none at all. Thus the symptoms women have during this time, which occur when estrogen and progesterone levels fluctuate, vary widely. Sometimes progesterone is made and a period occurs, and in other months the periods are skipped. Premenopausal women with breast cancer often enter menopause abruptly because chemotherapeutic drugs can destroy ovarian function. In this situation, menopausal symptoms occur suddenly and are often quite severe, since women don't have time to adapt slowly to them. What problems result from lower estrogen and progesterone levels? Most of the problems are related to the drastic fall in estrogen levels from 50-600 units (picograms per milliliter of blood) to 5-10 units (picograms per milliliter of blood). Women can have problems in five areas, described here: 1. The urogenital tract, which includes the bladder, uterus, and vagina, loses tissue (in a process called atrophy). This causes symptoms of burning when urinating, pain when urinating, sudden loss of urine (incontinence), dryness and itching of the vagina, and often pain during sex. 2. The blood vessels become unstable in the amount of blood that they carry to the skin. This problem, called vasomotor instability causes hot flashes and frequent awakening. 3. The brain often responds to a lack of estrogen by functioning differently. This causes depression, memory loss, mood swings, irritability, or a general sense of not feeling well, a lack of well being. The medical term for these problems is neurocognitude dysfunction. The relationship between menopause and depression appears to have a biological and not exclusively psychological basis. The first link between depression and estrogen deficiency was seen in studies of depression occurring just after childbirth in some women when estrogen levels are very low. 4. The bones begin to break down more rapidly and lose calcium. This leads to loss of bone; a condition called osteopenia, and later to a more severe loss called osteoporosis. With osteoporosis, women lose height as bones in the spine break or shrink in height. Also their backs may begin to curve more, and what is called a "widow's hump" or "dowager's hump" develops. Finally, painful spine fractures or hip fractures may occur when an elderly woman falls. Hip fractures are a major cause of both hospitalization and death in elderly women. 5. Lack of estrogen speeds up the development of heart disease. Women begin to catch up to men in their risk of having a heart attack. This risk increases because of the lack of estrogen. Death from heart disease is about eight times more common than death from breast cancer in women. This is particularly true of older women, because heart disease affects women who are in their 60s to 90s, whereas breast cancer often occurs earlier in life. Several other conditions are thought to occur more commonly after menopause in women who do not take estrogen. Alzheimer's disease and colon cancer are two conditions that are more common. These conditions have not yet been proven to be reduced in women who take estrogen, but the evidence is growing about the potential benefits of estrogen.Considering all of this, menopause is not just one set of symptoms that will go away, but is a process involving many parts of the body. Some of the aspects of menopause cause symptoms such as hot flashes, which usually go away after a few months to one to two years without treatment. Others, such as urogenital atrophy, remain until some therapy is provided. Other aspects do not cause symptoms but make a woman more likely to have other conditions such as heart disease or osteoporosis.The medical terminology used by physicians to describe menopause conveys concepts that have been areas for discussion with informed women. For example, the term estrogen deficiency implies an abnormality. Menopause is a natural event and estrogens naturally fall at the time of menopause. It is argued then that estrogen deficiency is not the correct term. The implication is that hormone deficiency need not be treated at menopause if this is a natural process. Others point out that progesterone also falls at menopause and fluctuates during the perimenopausal transition. Symptoms due to progesterone deficiency should then also be discussed as part of menopause. Male hormone levels, which are present but low in women, fall further as women age and drop rather suddenly after surgical removal of the ovary. Many argue that this hormonal change be considered part of menopause. (Courtesy of the National Women?s Health Info. Center) Jacqui Copyright 2002 Brandwynne Corporation. All rights reserved. Thank you for your trust.

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