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Menopause - Dictionary Definition and Overview |
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Menopause : (noun)
1: the time in a woman's life in which the menstrual cycle ends
[syn: climacteric, change of life]
Based on WordNet 2.0
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Menopause : \Men"o*pause\, n. [Gr. ? month _ ? to cause to cease.
See Menses.] (Med.)
The period of natural cessation of menstruation. See Change
of life, under Change.
Based on Webster's Revised Unabridged Dictionary
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Menopause : What is menopause?
Menopause is the time in a woman's life when the function of the ovaries ceases. The ovary, or female gonad, is one of a pair of reproductive glands
in women. They are located in the pelvis, one on each side of the uterus. Each ovary is about the size and shape of an almond. The ovaries produce eggs (ova) and female hormones such as estrogen.
During each monthly menstrual cycle, an egg is released from one ovary. The egg travels from the ovary through a fallopian tube to the uterus.
The ovaries are the main source of female hormones, which control the development of female body characteristics such as the breasts, body shape, and body hair. The hormones also regulate the
menstrual cycle and pregnancy. { Estrogens also protect the bone. Therefore a woman can develop osteoporosis (thinning of bone) later in life when her ovaries do not produce adequate estrogen.
Menopause does not occur overnight, but rather is a gradual process of transition. This transition period (known as perimenopause) is different for each woman. Scientists are still trying to
identify all the factors that initiate and influence this transition. Women in perimenopause transition typically experience abnormal vaginal bleeding such as erratic periods or abnormal bleeding
patterns. Eventually a woman's periods will completely stop as she completes this transition into menopause.
The average age of onset of menopause process is 51 years old. But there is no single method to predict when a woman will enter menopause. The age at which a woman starts having menstrual periods is
also not related to the age of menopause onset. As a rough "rule of thumb" women tend to undergo menopause at an age similar to that of their mothers.
When does a woman know she is in menopause?
A woman is in menopause if she has had no menstrual periods (menses) for 12 months and has no other medical reason for her
menses to stop. That means she has to be evaluated by her doctor to exclude other medical causes of missed menses.
Are hormone levels or other blood tests helpful in detecting menopause?
Because hormone levels may fluctuate greatly in an individual woman, even from one day to the
next, hormone levels are not a reliable indicator for diagnosing menopause. Even if levels are low one day, they may be high the next day in the same woman. There is no single blood test that reliably
predicts when a woman is going through menopause, or menopausal transition. Therefore there is currently no proven role for blood testing regarding menopause except for tests to exclude medical causes
of erratic menstrual periods other than menopause. The only way to diagnose menopause is to observe lack of menstrual periods for 12 months in a woman in the expected age range.
What are the symptoms of menopause?
The symptoms of menopause can be divided into early and late onset symptoms. Early symptoms include abnormal vaginal bleeding, hot
flashes, and mood changes. Late symptoms include vaginal dryness and irritation, osteoporosis, and heart disease. These symptoms are discussed in detail below:
Early Onset Symptoms (Perimenopause)
Abnormal Vaginal Bleeding
Abnormal vaginal bleeding may occur during menopause. Some women have minimal problems with abnormal bleeding during perimenopause whereas
others have unpredictable, excessive bleeding. In general, menstrual periods (menses) at first occur more frequently (meaning the cycle shortens in duration), and subsequently get farther and farther
apart (meaning the cycle lengthens in duration) until they stop. It is also common for women in perimenopause to get a period after going for several months without one. There is also no set length of
time it takes for a woman to complete her menopausal transition, as all women are different. It is important to remember that all women who develop irregular menses should be evaluated by her doctor to
confirm that the irregular menses are due to menopause and not as a sign of another medical illness.
Hot Flashes
Hot flashes are common among women undergoing menopause. A hot flash is a feeling of warmth that spreads over the body. A hot flash is sometimes associated
with flushing and is sometimes followed by perspiration. The cause of hot flashes is not completely understood; they may be due to fluctuations in hormone levels. There is currently no method to
predict when hot flashes will begin and how long they will last in a given woman. Hot flashes can occur in menstruating women in their forty's. Hot flashes in some women can last decade(s). There is no
way to predict when hot flashes will cease in a given woman, though they tend to decrease in frequency over time. Hot flashes on average last about 5 years. For more, please read the Alternative
Treatments for Hot Flashes article.
Mood Symptoms
There is considerable controversy about exactly which behavior symptoms are due directly to menopause. Moodiness and irritability seem to be linked with
menopause, but other symptoms are less clear. The research has been difficult for many reasons. First, mood symptoms are so common to begin with that it is sometimes difficult in a given woman to know
if they are due to menopause. Also, to further complicate matters, women can suffer from significant fatigue that may aggravate moodiness. Many other symptoms that women associate with menopause, such
as mood swings, could actually be linked with the { depression .
Late Onset Symptoms (Postmenopause)
Vaginal Symptoms}
Vaginal symptoms tend to begin some years after the cessation of menses.
Postmenopausal women (the term for women who have completed their menopausal transition) may experience vaginal dryness, itching, or irritation due to the lack of estrogen. Dyspareunia, or pain with
intercourse, can also result from the loss of estrogen.
Osteoporosis
Osteoporosis is the deterioration of the quality of bone that causes an increased risk of fracture. Osteoporosis depletes both the calcium and the protein
from the bone, resulting in either abnormal bone quality or decreased bone density, or both. Estrogen loss over many years, such as after menopause, is the most firmly established and common cause of
osteoporosis.
The osteoporosis process can operate silently for decades. Some osteoporosis fractures may escape detection until years later. Patients may not thus be aware of their osteoporosis until suffering a
painful fracture. The symptoms are then related to the location of the fractures.
For an extensive review of osteoporosis, its treatment and prevention, please read the Osteoporosis article.
Heart disease
Heart disease is the number one killer of women after menopause. One out of two postmenopausal women will develop heart disease, and one out of three
will die from it. Although the onset of heart disease in women lags behind the onset in men by about a decade, the occurrence of heart disease increases after menopause. Furthermore, there are actually
more women than men who eventually die of heart disease. Being a female over the age of 55 is one of the many risk factors for heart disease.
What are the treatment options for menopause?
Treatments for menopause can be divided based on those symptoms that are present in a given woman at a specific time.
Treatment of Early Onset Symptoms
Abnormal Vaginal Bleeding}
Prior to treatment, a doctor excludes other causes of erratic vaginal
bleeding. Women in menopausal transition tend to have considerable breakthrough bleeding when given estrogen therapy. Therefore oral contraceptives are often given to women in menopause transition to
regulate their periods, relieve hot flashes, as well as to provide contraception. Oral contraceptives are considered safe in healthy, non-smoking women.
Hot Flashes
The choice of medication for treating hot flashes depends on whether a woman is still having periods or not. For women experiencing unpredictable bleeding
and hot flashes during menopause transition, oral contraceptives are commonly used (even up to 50 years of age) to control both erratic perimenopausal bleeding vaginal bleeding and hot flashes. For
women without periods, hot flashes can be treated with either oral (by mouth) or transdermal (patch) forms of estrogen. Both oral and transdermal estrogen therapies are available either as estrogen
alone, or estrogen combined with progesterone. For more, please read the Hormone Therapy article. All available prescription estrogen therapies, whether oral or transdermal, are effective in reducing
hot flash frequency and severity. Generally, available treatments decrease hot flash frequency by about 80 to 90%.
Mood Symptoms
Even though moodiness, irritability, and tearfulness are commonly attributed to menopause, studies are underway to determine which of these symptoms are
actually due to menopause versus other conditions such as medical depression. Even though many women experience improvement in irritability with oral hormone therapy, hormone therapy alone will not be
adequate treatment for a woman suffering from true medical depression (a true depression may require antidepressant medications that are different from medications for menopause). Accordingly, women
who are experiencing significant mood symptoms should be evaluated by their doctors to exclude depression and other medical illnesses.
Treatment of Late Onset Symptoms
Vaginal Symptoms}
Prior to being treated for vaginal irritation, burning, and itching, women should first
undergo an evaluation by a doctor, including a pelvic exam, to verify that the symptoms are due to estrogen deficiency.
There are local (meaning vaginal) and oral treatments for the symptoms of vaginal estrogen deficiency. Local treatments include the vaginal estrogen ring, vaginal estrogen cream, or vaginal estrogen
tablets. Oral treatments include multiple types of estrogen either alone, or estrogen given with progesterone (read the Hormone Therapy article). Local and oral estrogen treatments are both effective
in relieving vaginal symptoms and are sometimes combined for this purpose. In women for whom oral or vaginal estrogens are deemed inappropriate, such as breast cancer survivors, or women who do not
wish to take oral or vaginal estrogen, there are a variety of over-the-counter vaginal lubricants. However, they are probably not as effective in relieving vaginal symptoms as replacing the estrogen
deficiency with oral or local estrogen.
Osteoporosis
The goal of osteoporosis treatment is the prevention of bone fractures by stopping bone loss and increasing bone density and strength. Although early
detection and timely treatment of osteoporosis can substantially decrease the risk of future fracture, none of the available treatments for osteoporosis are complete cures. In other words, it is
difficult to completely rebuild bone that has been weakened by osteoporosis. Therefore, the prevention of osteoporosis is as important as treatment. Osteoporosis treatment and prevention measures
are: - Lifestyle changes including quitting cigarette smoking, curtailing alcohol intake, exercising regularly, and consuming a balanced diet with adequate calcium and vitamin D.
- Estrogen therapy for postmenopausal women and those with other low estrogen conditions. Women using HT for the short-term (less than 5 years) control of hot flashes will probably derive
protection against osteoporosis during the time they are using HT. Other safe and effective non-hormonal prescription medications can be used to address osteoporosis in women who stop taking HT when
hot flashes cease, and in women not taking HT.
- Medications that stop bone loss and increase bone strength, such as { calcitonin
(Calcimar).
For an extensive review of osteoporosis, its treatment and prevention, please read the Osteoporosis article, and for more on supplements, read the Vitamins and Calcium Supplements article.
Heart Disease
Although it was previously felt that oral estrogen decreases the risk of heart disease in postmenopausal women, research with a large enough number of
women in well-designed research (specifically, the Women's Health Initiative) has only just become available. The research suggests that estrogen does not protect against heart disease in women who do
not yet have heart disease, nor is it protective in women who are already known to have heart disease. In fact, women with heart disease who begin HT may be at increased risk of a heart attack in
the first year of starting oral HT. In the near future, we will have more research studies regarding this issue so we can know if the Women's Health Initiative results can be extended to other HT
brands and preparations, and whether the results apply to patches as well as oral HT. In summary, oral HT is not appropriate for heart disease protection, but is clearly appropriate for women with hot
flashes who intend short-term (less than 5 years) use and have no other contraindications. - Menopause is the time in a woman's life when the
function of the ovaries ceases. The ovary, or female gonad, is one of a pair of reproductive glands in women.
- The process of menopause does not occur overnight, but rather is a gradual
process. This so-called perimenopausal transition period is a different experience for each woman.
- The average age of menopause onset is 51 years old. There is no reliable lab test to predict
when a woman will experience menopause.
- The age at which a woman starts having menstrual periods is not related to the age of menopause onset.
- A women is in menopause when she has
had no menstrual periods (menses) for 12 months and has no other medical reason for her menses to stop.
- Symptoms of menopause can be divided into early and late onset symptoms. Early symptoms
include abnormal vaginal bleeding, hot flashes, and mood changes. Late symptoms include vaginal dryness and irritation, osteoporosis, and heart disease.
- Treatments for menopause are directed
toward alleviating the symptoms present in the particular woman affected.
Based on University of Miami School of Medicine [Medical_Dictionary]:
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Menopause : Menopause : The time in a woman's life when menstrual periods permanently stop; it is also called the "change of life." Menopause is the opposite of the menarche.
Menopause is defined as the time when there has been no menstrual periods for 12 consecutive months and no other biological or physiological cause can be identified. It is the end of fertility, the
end of the childbearing years. (A woman may still, however, be able to become pregnant unless 12 consecutive months have passed without a period.)
A woman can usually tell if she is approaching menopause because her menstrual periods starts changing. The medical terms used to describe this time are "perimenopause" and the "menopause
transition."
Natural menopause occurs when the ovaries naturally begin decreasing their production of the sex hormones estrogen and progesterone.
Induced menopause occurs if the ovaries are surgically removed (by bilateral oophorectomy) or damaged by radiation or drugs. Due to the abrupt cutoff of ovarian hormones, induced menopause causes
the sudden onset of hot flashes and other menopause-related symptoms such as a dry vagina and a decline in sex drive. Early menopause (before age 40), whether natural or induced, carries a greater risk
for heart disease and osteoporosis since there are more years spent beyond the protective cover of estrogen.
A "simple" hysterectomy (when the uterus but not the ovaries are removed) before natural menopause should not affect the production of sex hormones and so not cause menopause (unless the nerves or
blood supply to the ovaries is damaged during the hysterectomy).
The timing of natural menopause is variable. In the western world the average age is now 51. Natural menopause can, however, be in a woman's 30s or 60s. Factors influencing the time of menopause
include heredity (genetics) and cigarette smoking. Smokers (and former smokers) reach menopause an average of 2 years before women who have never smoked.
There is no relation between the time of a woman's first period and her age at menopause. The age at menopause is not influenced by a woman's race, height, number of children or use of oral
contraceptives.
The changes of the menopause transition (perimenopause) begin about 6 years before the natural menopause. This is a time when the levels of hormones produced by the aging ovaries fluctuate leading
to irregular menstrual patterns (irregularity in the length of the period, the time between periods, and the level of flow) and hot flashes (a sudden warm feeling with blushing). Other changes
associated with the perimenopause and menopause include night sweats, mood swings, vaginal dryness, fluctuations in sexual desire (libido), forgetfulness, trouble sleeping and fatigue (probably from
the loss of sleep).
Conditions that have not been proved due to the menopause include headache, dizziness, palpitations of the heart and depression .
Estrogen replacement therapy (ERT) is used to treat menopause. It reduces or stops the short-term changes of menopause such as hot flashes, disturbed sleep, and vaginal dryness. ERT can prevent
osteoporosis, a consequence of lowered estrogen levels. To keep bones strong, ERT should be taken from menopause throughout a woman's life. Stopping ERT allows bone loss to resume.
ERT reduces the risk of heart disease up to 50%. Vaginal ERT products help with vaginal dryness, more severe vaginal changes, and bladder effects but, since very little vaginal estrogen enters the
circulation, it may not help with hot flashes or prevent osteoporosis and heart disease.
The use of unopposed ERT (ERT alone) is associated with an increase in the risk of endometrial hormone replacement therapy (HRT).
Based on University of Miami School of Medicine [Medical_Dictionary]:
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Example Usage of Menopause |
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gn0sis: "I'm going through Menopause and I feel absolutely fabulous!". AM radio ads still make me laugh. |
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