Once ominously referred to as 'the change',
menopause is simply your body's adjustment to a downshift in hormones.
Because of recent concerns about HRT, now may be the time to consider
natural options such as soy foods, herbs and exercise.
Strictly speaking, a woman is in menopause when her ovaries stop producing the female harmones oestrogen and progesterone, and she hasn't had a menstrual period for a full year. This signifies the end of a naturally ability to bear children. The average age that most women experience menopause is 51 (although it can occur as early as your late 30s or as late as your 60s). Generally the loss of hormones is gradual, often beginning a decade earlier, a time frame now commonly known as perimenopause.
As oestrogen levels decline, many women begin to experience some decidely unpleasant symptoms: an intense heat, flushing and sweating known as hot flushes (felt by 75 percent of women), night sweats, insomnia, vaginal dryness, less interest in sex, mental fuzziness and/or mood changes. These symptoms may be subtle and short-lived, ending after a few months--or you may experience several years of sudden sweats, sleep loss and surliness. Once your body adjusts to the harmone reduction, however, symptoms do finally diminish.
Decreased hormone levels can also have long-term effects. After your final period, oestrogen declines rapidly and, along with it, your body's ability to absorb bone-building calcium. This leaves you more vulenerable to a thinning of the bones known as osteoporosis (see on shortly). Almost half of women over age 50 are at risk for this
condition. Left untreated, it can result in an annual 3 percent loss of bone during the first five postmenopausal years (after that, bone loss continues at a rate of 1 to 2 percent a year). Reduced oestrogen also raises levels of blood cholesterol, which may explain the increased risk for cardiovascular disease in postmenopausal women.
LIKELY FIRST STEPS
There's no doubt that the drop in female hormones during menopause profoundly affects your body, but don't make the mistake of thinking of menopause as a 'disease'. Menopause may actually bring about a feeling of freedom--namely, freedom from menstruation and concerns about contraception. Still, for many women menopause can be decidely uncomfortable and it can carry with it the potential for future health problems.
Until recently, the most widely prescribed treatment for women experiencing menopausal symptoms, such as unbearable hot flushes, irritability and insomnia, was harmone replacement. Doctors believed that resupplying a woman's body with oestrogen not only offered short-term symptom relief, but also provided lasting protection against osteoporosis and heart disease. New research, however, has put the safety of long-term use of harmones in question, and many women are opting for natural treatment approaches.
Whichever treatment you choose, your personal health profile must be a key factor in your decision. If you have a history of breast cancer or heart trouble, for instance, your treatment may well be different from another woman's. What works for your best friend, your neighbour--or even your sister--may not be right (or even safe) for you. Look to your doctor for help in reviewing the pros and cons of the treatments you're considering.
Treatment Options
MEDICATIONS
------------------------------------------------------------------------------------------------------------------------------------------
Hormone replacement HRT (short term) for severe symptoms; oestrogen-only replacement if
you've had a hysterectomy.
------------------------------------------------------------------------------------------------------------------------------------------
Bisphosphonates/SERMs Alternative to HRT for bone protection.
-------------------------------------------------------------------------------------------------------------------------------------------
Tibolone (Livial) For menopausal symptoms; protects against bone loss.
LIFESTYLE CHANGES
---------------------------------------------------------------------------------------------------------------------------------------------
Better diet Helps symptoms, strengthens bones; try soy.
----------------------------------------------------------------------------------------------------------------------------------------------
Exercise Protects bones; tones pelvic muscles
---------------------------------------------------------------------------------------------------------------------------------------------
Support group To improve self-esteem; combat depression.
NATURAL METHODS
-----------------------------------------------------------------------------------------------------------------------------------------------
Supplements Vitamins and herbs to lessen symptoms.
---------------------------------------------------------------------------------------------------------------------------------------------
Acupuncture Relieves symptoms in some women.
TAKING CONTROL
Medications
For more than 50 years, the first-line drug treatment for menopausal symptoms has been supplemental hormones. Oestrogen alone ('unopposed oestrogen'), known as oestrogen replacement therapy, was the earliest option; later, oestrogen in combination with progestin (a form of progesterone), known as hormone replacement therapy (HRT), became the choice for most women. Today the benefits of both are being re-evaluated. Because unopposed oestrogen has been found to increase the risk of cancer of the uterus, it is now recommeded for treating symptoms only in women who have had their uterus removed (hysterectomy). Its long-term risks are still being examied; a recent study showed that oestrogen alone increased a woman's chance of developing cancer of the ovaries.
HRT has suffered a recent setback. In July 2002, the Women's Health Initiative, a planned 81/2-year study in the US investigating the long-term effects of HRT in more than 16,000 postmenopausal women, was stopped abruptly after only five years.
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What is happening
Strictly speaking, a woman is in menopause when her ovaries stop producing the female harmones oestrogen and progesterone, and she hasn't had a menstrual period for a full year. This signifies the end of a naturally ability to bear children. The average age that most women experience menopause is 51 (although it can occur as early as your late 30s or as late as your 60s). Generally the loss of hormones is gradual, often beginning a decade earlier, a time frame now commonly known as perimenopause.
As oestrogen levels decline, many women begin to experience some decidely unpleasant symptoms: an intense heat, flushing and sweating known as hot flushes (felt by 75 percent of women), night sweats, insomnia, vaginal dryness, less interest in sex, mental fuzziness and/or mood changes. These symptoms may be subtle and short-lived, ending after a few months--or you may experience several years of sudden sweats, sleep loss and surliness. Once your body adjusts to the harmone reduction, however, symptoms do finally diminish.
Decreased hormone levels can also have long-term effects. After your final period, oestrogen declines rapidly and, along with it, your body's ability to absorb bone-building calcium. This leaves you more vulenerable to a thinning of the bones known as osteoporosis (see on shortly). Almost half of women over age 50 are at risk for this
condition. Left untreated, it can result in an annual 3 percent loss of bone during the first five postmenopausal years (after that, bone loss continues at a rate of 1 to 2 percent a year). Reduced oestrogen also raises levels of blood cholesterol, which may explain the increased risk for cardiovascular disease in postmenopausal women.
- Talk with your doctor to determine whether short-term HRT or other symptom-related medications are right for you.
- Make dietary changes (low-fat, high-fibre diet, rich in calicum and soy foods) to maintain a healthy weight, protect bones and control symptoms.
- Get regular exercise, with a focus on weight-bearing activities for stronger bones.
QUESTIONS TO ASK
- Could short-term HRT be good for me?
- Will using HRT after years of birth control increase may risk for breast cancer?
- Is my failing memory a symptom of menopause?
- Can I still get pregnant now that I'm going through menopause?
Treatments
There's no doubt that the drop in female hormones during menopause profoundly affects your body, but don't make the mistake of thinking of menopause as a 'disease'. Menopause may actually bring about a feeling of freedom--namely, freedom from menstruation and concerns about contraception. Still, for many women menopause can be decidely uncomfortable and it can carry with it the potential for future health problems.
Until recently, the most widely prescribed treatment for women experiencing menopausal symptoms, such as unbearable hot flushes, irritability and insomnia, was harmone replacement. Doctors believed that resupplying a woman's body with oestrogen not only offered short-term symptom relief, but also provided lasting protection against osteoporosis and heart disease. New research, however, has put the safety of long-term use of harmones in question, and many women are opting for natural treatment approaches.
Whichever treatment you choose, your personal health profile must be a key factor in your decision. If you have a history of breast cancer or heart trouble, for instance, your treatment may well be different from another woman's. What works for your best friend, your neighbour--or even your sister--may not be right (or even safe) for you. Look to your doctor for help in reviewing the pros and cons of the treatments you're considering.
Treatment Options
MEDICATIONS
------------------------------------------------------------------------------------------------------------------------------------------
Hormone replacement HRT (short term) for severe symptoms; oestrogen-only replacement if
you've had a hysterectomy.
------------------------------------------------------------------------------------------------------------------------------------------
Bisphosphonates/SERMs Alternative to HRT for bone protection.
-------------------------------------------------------------------------------------------------------------------------------------------
Tibolone (Livial) For menopausal symptoms; protects against bone loss.
LIFESTYLE CHANGES
---------------------------------------------------------------------------------------------------------------------------------------------
Better diet Helps symptoms, strengthens bones; try soy.
----------------------------------------------------------------------------------------------------------------------------------------------
Exercise Protects bones; tones pelvic muscles
---------------------------------------------------------------------------------------------------------------------------------------------
Support group To improve self-esteem; combat depression.
NATURAL METHODS
-----------------------------------------------------------------------------------------------------------------------------------------------
Supplements Vitamins and herbs to lessen symptoms.
---------------------------------------------------------------------------------------------------------------------------------------------
Acupuncture Relieves symptoms in some women.
TAKING CONTROL
- Dress for success. Pull on breathable cotton garments in layers--a tank top, a T-shirt, a cardigan--that can be easily removed when a hot flush hits. You also might want to sleep on cotton sheets, which absorb mositure better than polyester ones.
- Breathe from your belly. Deep-breathing exercises, such as inhaling slowly through your nose and down to your belly, have been shown to reduce hot flushes by 50%.
- Use drops for dry eyes. Women on HRT may be at greater risk for dry eye syndrome, according to a recent study of 25,000 postmenopausal women. The longer the therapy continued, the greater the risk.
- Stay sexually active. Regular intercouse increases the tone and lubrication of vaginal tissues. If necessary, use a vaginal cream containing a nonoestrogenic water-soluble lubricant for dryness--a popular choice is K-Y jelly. There are also oestrogen products without progestins that are minimally absorbed by the body. These include a tablet that dissolves in the vagina (Vagifem) and a vaginal cream (Ovestin).
- keep up with regular checkups. After menopause, continue with yearly Pap smears and pelvic examinations, along with other appropriate screenings, such as mammograms and lipid profiles to check cholesterol levels. And continue to carry out a montly breast self-examination (see on later).
For more than 50 years, the first-line drug treatment for menopausal symptoms has been supplemental hormones. Oestrogen alone ('unopposed oestrogen'), known as oestrogen replacement therapy, was the earliest option; later, oestrogen in combination with progestin (a form of progesterone), known as hormone replacement therapy (HRT), became the choice for most women. Today the benefits of both are being re-evaluated. Because unopposed oestrogen has been found to increase the risk of cancer of the uterus, it is now recommeded for treating symptoms only in women who have had their uterus removed (hysterectomy). Its long-term risks are still being examied; a recent study showed that oestrogen alone increased a woman's chance of developing cancer of the ovaries.
HRT has suffered a recent setback. In July 2002, the Women's Health Initiative, a planned 81/2-year study in the US investigating the long-term effects of HRT in more than 16,000 postmenopausal women, was stopped abruptly after only five years.
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