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Menopause

Menopause can be a difficult medical condition that can lead to significant changes both physically and mentally for women. It often means the end of childbearing age and with it, comes several physical changes.

It occurs when a woman reaches a certain age (that is unique to the individual), and/or has certain medical conditions, and/or numerous of other factors. On a micro-level – this condition develops when a woman becomes unable to reproduce reproductive hormones.

The exact wording means “an end to monthly cycles“.

Often menopause occurs in women when their monthly cycles do stop. It is the opposite of menarche or the beginning of menses

The action results in a change in the Uterus – causing the stoppage of menses, but the real action takes place in the Ovaries

Classification:

1.)  Without Uterus –  When FSH levels become elevated

2.)  With Uterus  –  Stoppage of menses

Clarification

Example #1:

In a young women who has had her uterus removed (Hysterectomy) will often experience a loss of fertility and a loss of monthly menses.

Her ovaries and the release of reproductive hormones often will still occur. [This is assuming that she has at least 1 ovary remaining]. As long as those hormones continue – she has not reached menopause.

Example #2:

If a young women has both ovaries removed  (Oophorectomy) No additional reproductive hormones are produced. She has reached a “surgical menopause“.

Causes Often Seen:

–  Natural progression
–  Evolutionary adaptation
–  Surgical
–  Trauma
–  Medical Complication
–  Other

Age of Typical Occurrence

–  Often occurs naturally between ages 45 and 55
–  The average is different depending on country
–  If occurs prior to 40 – it is called premature ovarian failure

***  – Smokers may experience menopause at an earlier age

Associated Classifications

1.)  Perimenopause

–  The relative time around the transition to the final menses
–  There is a decrease in production of estrogen, progesterone, and testosterone.
–  Fertility decreases dramatically – but it is not at 0%
–  The age, where this most often occurs, is the mid to late 40s

2.)  Premenopause

–  Hormone level is very low
–  Just prior to menopause
–  Effects of hormone loss may be present

3.)  Postmenopause

–  Following menopause
–  Occurs 12 months following last period and spotting – at that point, she is 1 year into postmenopause
–  Women are infertile at this point
–  If not uterus – FSH levels will be very elevated

 Symptoms

–  Night Sweats
–  Hot flashes
–  Headaches
–  Back pain
–  Joint pain
–  Fatigue

Skin changes

–  Breast atrophy
–  Thinning of skin
–  Skin itching or burning

Vaginal changes

–  Vaginal Dryness
–  Itching
–  Bleeding
–  Discharge
–  Urinary changes
–  Increased risk for UTIs and vaginitis

Psychological changes

–  Irritability
–  Mood changes
–  Fatigue
–  Depression
–  Decreased Sleep

Sexual changes

–  Decreased sex drive
–  Vaginal dryness
–  Increased difficulty reaching orgasms
–  Painful intercourse

Treatment and Management

–  Since menopause is natural – often no treatment is required

When is the treatment needed?

–  This question can be answered by a medical provider but in cases of mental, emotional, and/or physical changes are severe, then an evaluation be necessary.

Hormone Replacement Therapy

–  Several risks are present

–  Symptoms should outweigh the risks

–  Replacement of estrogen and progesterone

–  May decrease sex drive in males
.  Medroxyprogesterone

Antidepressants

.  Paxil
.  Prozac
.  Effexor

Vaginal moisturizers

Vaginal lubricants

Vaginal Estrogen

Diet

Support groups