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Facts And Information About The Menopause And Female Sexuality

Menopause is the end of menstruation. The word comes from the Greek mens, meaning monthly, and pausis, meaning cessation. Menopause is part of a woman’s natural aging process when her ovaries produce lower levels of the hormones estrogen and progesterone and when she is no longer able to become pregnant.

The occurrence of menopause is different for each woman. It usually occurs between the ages of 40 and 55. The age of when menopause occurs is affected by several factors, including

Nutrition. Malnourished women begin menopause about 4 years earlier than well-nourished women. Early onset of menstruation. Women who begin menstruation at an early age are more likely to begin menopause later

Unlike a woman’s first menstruation, which starts on a single day, the changes leading up to menopause happen over several years. The average age for menopause is 52. But menopause commonly happens anytime between the ages of 42 and 56.

A woman can say she has begun her menopause when she has not had a period for a full year.

Perimenopause
‘Perimenopause’ refers to the several years before menopause when a woman may begin experiencing the first signs of her menopausal transition. But many people use the term ‘menopause’ for both the perimenopausal years as well as the few years following menopause.

The signs of menopause
Menopause is a natural process that happens to every woman as she grows older, and is not a medical problem, disease or illness. Still, some women may have a hard time because of the changes in hormone levels during menopause.

There are many possible signs of menopause and each woman feels them differently. Most women have no or few menopausal symptoms while some women have many moderate or severe symptoms.

The clearest signs of the start of menopause are irregular periods (when periods come closer together or further apart), and when blood flow becomes lighter or heavier.

Other signs may include some of the following:  

weight gain;  ·
hot flashes;  ·
insomnia;  ·
night sweats;  ·
vaginal dryness;  ·
joint pain;  ·
fatigue;  ·
short-term memory problems;  
bowel upset;  ·
dry eyes;  ·
itchy skin;  ·
mood swings; and  ·
urinary tract infections.  


Most of the time, these symptoms will lessen or go away after a woman has finished menopause.


Women experience the menopause in different ways
Menopause experiences are different among individual women, and also among women in different cultures and in different parts of the world. Research has shown that women’s experience of menopause can be related to many things, including genetics, diet, lifestyle and social and cultural attitudes toward older women.

For example:  ·
Japanese women report few hot flashes and other symptoms.  ·
Thai women record a high incidence of headaches.  ·
Scottish women record fewer severe symptoms.  ·
Greek women report a high rate of hot flashes.  ·
Mayan women report no symptoms.  


Some scholars wonder if the North American emphasis on youth and lack of respect for older people contributes to a more difficult menopausal transition here. The typical North American diet, high in saturated fats and sugars, along with our in-active lifestyle and low childbirth rate, may also contribute to the physical complaints common to many North American women at menopause.

Induced menopause
‘Induced’, ‘sudden’ or ‘surgical’ menopause happens when a woman goes through an immediate and premature menopause. This occurs when her ovaries no longer produce the hormones estrogen, progesterone and testosterone.

This may be caused by:  ·
surgery to remove your ovaries;  ·
chemotherapy;  ·
radiation treatment; or  ·
ovarian malfunction.  


Women going through induced menopause may have more severe menopausal symptoms, and are usually treated with hormone therapy.  


Preparing for the menopause
Menopause is one of women’s many important natural life-stages. For some, it is a challenging period of difficult physical and emotional changes. For others, it is a time of personal growth and renewal. And for many women, it is both at the same time. They don’t call it ‘Menopausal Zest’ for nothing!

Here are some suggestions to help you enjoy your menopausal years to their fullest:  ·
Learn about menopause through recent books, articles and other reading materials.  ·
Talk to friends and relatives who have already gone through menopause.  ·
Join a menopause or midlife support-group in your area.  ·
Have a nutritious diet and enjoy regular exercise.  ·
Manage your stress by balancing your work and social life.

Talk with your health care practitioner about your personal health concerns.  ·
Know that you have choices and can take charge of your health.   


The Symptoms of Menopause
The major symptoms of menopause are: missed periods, hot flashes, vaginal dryness, changes in mood and lack of sex drive.

Each of these symptoms are a result of hormonal changes. Hot flashes are caused by an increase of blood flow in the blood vessels of the face, neck, chest and back. Vaginal dryness is caused by thinning of the tissues of the vaginal wall, are the two side effects most frequently complained about. The mood changes and lack of sex drive may result partially from the hormone decrease, but may also result from having to deal with hot flashes and vaginal dryness.  


Hot Flashes
Hot flashes are caused by rapid decreases in estrogen levels. Unfortunately hot flashes cannot be prevented. However, they can be helped and made less uncomfortable. The herb Black Cohosh, used regularly, may help reduce the incidence and severity of hot flashes in menopause. Here are some techniques that can help you deal with them.

Wear loose clothing and dress in layers so you can peel off the top layers during a hot flash.
Wear fabrics that absorb moisture and dry quickly.
Avoid foods that may trigger hot flashes (hot drinks and spicy foods are common triggers)
Splash your face with cool water at the start of a flash.
Avoid Stress. It may contribute to the occurrence of hot flashes.
Menopause Statistics

After menopause, as a woman's body’s supply of the hormone estrogen declines the likelihood of developing heart disease increases.
About 75% of women experiencing menopause will have hot flashes.  


Vaginal Dryness
With the significant drop in estrogen after menopause, the membranes of the vagina thin, lose elasticity, and decrease their production of lubricating fluids. Sexual intercourse may be uncomfortable or even painful. Pain with intercourse may be largely a result of soreness of the vulva, the area right outside your vagina. Try avoiding harsh soaps or using a barrier cream like Eucerin or Bag Balm.

Lubrication
Many women find that Replens or other lubricants help ease vaginal dryness. Replens is designed to moisturize the walls of the vagina, but it may not in fact be the best lubricant. It's expensive, and it tends to drip out of the vagina. If you need a lubricant, you may want to try Astroglide or Moist Again.

Yeast infections
You can also get yeast infections—a common side effect of antibiotics, steroids, and some chemotherapies—inside the folds of the vagina and vulva that cause discomfort, thick white discharge, and odor. Clean the area gently. You may need to use yeast-fighting creams or pills, sold over the counter or by prescription (Monistat, Terazol, Diflucan). Lotrisone, a combination anti-yeast and steroid medication, can ease the vulvar burning that can go along with a yeast infection.

Discharge
Troubling vaginal discharge can also occur with menopause. Of the women taking tamoxifen, 80% will have no change in vaginal symptoms, 10% will have vaginal dryness, and 10% will have vaginal discharge. Describing your symptoms clearly and accurately to your gynecologist will make it a lot easier for you to get help.

Vaginal estrogen preparations
If you've had no improvement with your vaginal discomfort despite the use of these various remedies, talk to your doctor about using a low-dose vaginal estrogen cream or Estring (a plastic ring filled with estrogen that is inserted into the vagina). A vaginal estrogen treatment can help thicken and lubricate the walls of the vagina, but with some absorption through the walls into the blood.

Estradiol is thought to be readily absorbed, estrone less readily absorbed, and estriol minimally absorbed. There is little information about this, however. Some studies suggest that estriol may have less potent effects on breast tissue than estradiol.

If you and your doctor decide it's okay for you to use a vaginal estrogen cream for vaginal dryness and pain, you may need only a very small amount. Your doctor might start you with a dose as low as 0.1 milligram of estrogen per day, applying just a small dab inside the vagina, for up to three to four weeks, and then cutting back to once or twice a week.

WHEN DOES MENOPAUSE USUALLY BEGIN?
Menopause symptoms like hot flashes and irregular menstrual cycles can begin for women in their late 30s or early 40s during the perimenopause phase of a woman's life. Natural menopause is typically complete in the late 40s or early 50s.
WHAT IS SURGICAL MENOPAUSE?
Surgical menopause is the term used to describe menopause that happens as the result of hysterectomy and bilateral oophorectomy (where both ovaries are removed). Women who begin menopause as the result of surgical intervention often suffer the effects of menopause more drastically than women going through natural menopause. And, the younger the woman is, the more problems she will likely encounter.  
CAN A WOMEN BECOME PREGNANT DURING PERIMENOPAUSE?
Yes, though pregnancy is less likely since ovulation, when women can conceive, become more irregular. Until a women goes one full year without a period, she should consider herself fertile and continue using birth control methods.  
AT WHAT TIME DO I CONSIDER MYSELF POSTMENOPAUSAL?
Most clinicians place the postmenopausal phase at one full year after the last menstrual cycle. Postmenopause is a time when most of the distress of the menopausal changes have faded. At postmenopause, hot flashes and other symptoms of menopause are more mild and less frequent and energy and emotional levels stabilize.
WHAT ARE THE SYMPTOMS OF MENOPAUSE?
Symptoms of menopause may include hot flashes, night sweats, insomnia, vaginal dryness, aching joints and muscle problems, anxiety, irritability, depression and mental fatigue. Decreased libido, headaches, migraines, heart palpitations, urinary tract infections, weight gain, hair loss and incontinence are also symptoms of menopause. Not every woman will experience these symptoms or at the same severity. Women going through surgical menopause experience most of these symptoms in a more severe fashion than women going through menopause naturally.
WHAT HAPPENS DURING MENOPAUSE?
During menopause, the ovaries gradually produce lower levels of estrogen and progesterone. After menopause, the estrogen levels in woman are about one-tenth the level before menopause and progestin levels are near non-existent.
WHAT DO ESTROGEN AND PROGESTERONE DO IN THE BODY?
Estrogen is known as a 'female hormone’ and plays a key role in shaping the female body. One of estrogen's primary roles is to promote the growth of cells in the breast and uterus and estrogen affects many aspects of women's physical and emotional health. Progesterone is the second most important female hormone. Progesterone is primarily responsible for regulating the reproductive cycle.
IS HORMONE REPLACEMENT THERAPY SAFE?
No. The results of conclusive research prove that hormone replacement therapy is not safe. The use of synthetic estrogen and progestin is linked to increased risks of heart disease, breast cancer, uterine cancer and ovarian cancer, strokes and blood clots. Women should thoroughly investigate these risks and discuss all concerns with her physician before deciding to use a synthetic hormone replacement therapy.
WHY ARE SYNTHETIC HORMONES PRESCRIBED FOR MENOPAUSE?
Doctors often recommended hormone replacement therapy (either estrogen alone or in combination with progestin) to relieve menopause symptoms. Doctors also prescribed hormone replacement therapy to prevent long-term conditions such as osteoporosis and heart disease. With recent results from the Women's Health Initiative, a trial sponsored by the National Institutes of Health, showing elevated health risks of hormone replacement therapy, many doctors are not as inclined to place women on hormone replacement therapy.
WHAT WERE THE RESULTS OF THE WOMEN'S HEALTH INITIATIVE STUDY?
According to these results, estrogen used in combination with progestin increases the risk of both heart disease and breast cancer, strokes and blood clots. The Women's Health Initiative concluded definitively that hormone replacement therapy places women at a significantly elevated risk for breast cancer. The study found a 26 percent increase in breast cancer risk for women taking hormone replacement therapy. The study also showed that, contrary to prevailing belief, hormone replacement therapy also placed women using hormone replacement therapy at a higher risk - 29 percent - for heart disease. The Women's Health Initiative study on the combination of estrogen and progestin halted five years into the eight-year study because researchers determined that the risks to women in study outweighed any benefits. The arm of the trial studying estrogen alone continues and the results of that portion of the study are not yet known.
DOES HORMONE REPLACEMENT THERAPY PREVENT OSTEOPOROSIS?
Yes and no. Although hormone replacement therapy has shown to slow bone loss, those effects are not permanent and stop when women discontinue hormone replacement therapy. Because of the risks, hormone replacement therapy is no longer recommended for the prevention of osteoporosis.  
IS THERE A LINK BETWEEN OVARIAN CANCER AND HORMONE REPLACEMENT THERAPY?
Yes. A recent study following over 44,000 postmenopausal women during a 20-year span concluded that estrogen use increases the risk of ovarian cancer. In this study, women who used estrogen alone for 10-19 years were twice as likely to develop ovarian cancer than women who did not use postmenopausal hormones. For women who used estrogen for 20 or more years, the risk of ovarian cancer increased to three times that of women who did not use postmenopausal hormones. Because most studies have followed women using estrogen alone, there are currently not enough data to assess the potential effects of the estrogen-progestin combination on ovarian cancer. More data is needed to determine the estrogen-progestin risk for ovarian cancer.
ARE WOMEN USING HORMONE REPLACEMENT THERAPY AT RISK FOR OTHER HEALTH CONDITIONS?
Women who use estrogen combined with progestin are at increased risk for blood clots, gallbladder disease, stroke and inflammation of veins. Other studies show a link between hormone replacement therapy and endometrial cancer (cancer of the uterine lining).
SHOULD WOMEN TAKE HORMONE REPLACEMENT THERAPY IF THEY HAVE A HISTORY OF CANCER?
NO! One of estrogen's primary roles is to promote the growth of cells in the breast and uterus. There is concern that synthetic estrogen promote further tumor growth.  
WHAT NATURAL ALTERNATIVES TO HORMONE REPLACEMENT THERAPY ARE AVAILABLE?
There are many natural alternatives to help women as they go through menopause. Black cohosh and don quai are highly effective favorites among women choosing natural hormone replacement therapy. Estrogen-containing foods like soy products, whole-grain cereal, seeds, certain fruits and vegetables are also beneficial for reducing menopause symptoms. Healthy lifestyle - smoking cessation, regular exercise, and good nutrition - is also incredibly important for menopausal women to reduce the risks of heart disease, osteoporosis and certain types of cancer.  
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