In North America, menopause occurs in women at approximately 51 years of age.
With a life expectancy of about 81 years, a 50-year-old woman can expect to live
more than one third of her life after menopause. Scientific research is just
beginning to address some of the unanswered questions about these years and
about the poorly understood biology of menopause.
What is menopause? Known as the "change of life,"
menopause is the last stage of a gradual biological process in which the ovaries
reduce their production of female sex hormones—a process which begins about 3 to
5 years before the final menstrual period. This transitional phase is called the
perimenopause.
Perimenopause is the stage where ovulation periods become irregular and
ovaries produce less and less eggs. This is when the perimenopause signs start
to appear.
Decreasing number of eggs in the ovaries and
irregular ovulation;
Irregular and decreased estrogen and progesterone
production;
Endometrium is not regenerated (the endometrium is
the mucous membrane comprising the inner layer of the uterine wall);
Menstruation becomes irregular.
During that time, hormone levels (estrogen and progesterone) decrease and
vary greatly, causing irregular menstruation and menstruation to stop
eventually. This is when menopause starts.
Menopause is the point in a woman's life when menstruation stops permanently, signifying the end of her ability to
have children. Menopause is considered complete when a woman has stopped menstruating
for at least 1 year, although the timing varies from person to person, on
average, menopause occurs approximately at the age of 51. Smokers tend to
begin menopause earlier than non-smokers.
What are the symptoms? The symptoms of perimenopause
and menopause vary, but here are some of the most common ones:
Hot flushes (especially affecting the face, the neck
and the chest) and night sweats
Sleep problems
Mood swings
Vaginal dryness
Urinary problems
Change in libido
Fatigue
Headaches
What are the treatments? In order to help reduce
symptoms of menopause, many non-drug strategies may be beneficial to women
seeking relief. These include:
Smoking cessation
Healthy diet
Healthy weight
Regular exercise
Control of hypertension (high blood pressure)
Identification of triggers for hot flashes and night sweats (keep symptom
diary)
Hormones If the above symptom control strategies do not
help, then a physician may consider drug therapy. A physician will consider
efficacy, side effects and differential effects on metabolism before prescribing
any treatment to a menopausal woman.
In the 1940s when estrogen was first offered to menopausal women, it was
given alone and in high doses. Today, after 50 years of trial and error, it is
well known that estrogen stimulates growth of the inner lining of the uterus
(endometrium) that sheds during menstruation. This growth may continue
uncontrollably, resulting in cancer. Today, doctors typically prescribe a lower
dose of estrogen. For women who have a uterus, a progestogen is added to
counteract estrogen's dangerous effect on the uterus.
To combat the symptoms associated with falling estrogen levels, doctors have
turned to estrogen therapy (ET), which is the administration of the female
hormone estrogen. Estrogen can be administered in gel or pill form, skin
patches, vaginal creams or injectable preparations.
ET is also known to help prevent the devastating effects of osteoporosis, a difficult
and expensive condition to treat.
In consulting physicians about possible treatment options, patients should
discuss potential benefits and risks with hormone therapy (HT), both in the
short and long-term.
Progestogen therapy reduces the risk of endometrial cancer by causing monthly
shedding of the endometrium. Progestogens are available in two types: micronized
progesterone (natural) and synthetic progestins.
How to take the medication The two most common regimens
of HT are continuous and cyclic. Cyclic HT means estrogen is taken every day,
but progestogen is taken only for a certain number of days each month, such as
12 or 14 days of the month. Continuous combined dose means estrogen and smaller
amounts of progestogen are taken every day without a break in either. Some
methods of taking HT produce less bleeding than others and for many the bleeding
stops after several months of use. All options should be discussed with a
physician.
Reference: National
Institutes of Health. Menopause, February 15,
2001. [Online]
http://www.nia.nih.gov/health/pubs/ menopause/menopause.pdf
The information provided herein is of a general nature and is in no way
intended to replace the knowledge, assistance or diagnosis of your
physician or healthcare provider. All decisions regarding your health are
your sole responsibility and that of your physician or healthcare
provider, as the case may be. For specific guidance regarding your
personal health, we strongly advise that you consult your physician or
healthcare provider. Schering-Plough Canada cannot be held responsible
for any interpretation or misinterpretation you may make of the
information provided herein.
*Links to other sites are provided as a convenience
to the viewer. Schering-Plough accepts no responsibility for the content, or for
the accuracy or completeness of the information provided in linked sites.
Schering-Plough does not endorse the content of the sites provided by these
links.
