Menopausal Symptoms

Menopause starts as the ovaries begin to fail to be able to produce an egg or ovum every month. Since the process of producing and ripening the egg is also what produces several of the key hormones involved in the monthly cycle, this in turn interrupts the regular pattern of the hormone cycles, and gradually leads to the cessation of estrogen and progesterone production by the ovary and the symptoms of menopause. This process is a gradual one in which the ovaries lose their ability to respond to the brains chemical signals to release an egg every month. As this occurs, levels of pituitary hormone, Follicle Stimulating Hormone (FSH) and Luteinizing Hormone (LSH) rise, ovulation ceases and a woman transitions into the menopause.

The average age of menopause is 51 years. The normal age range for the occurrence of menopause is somewhere between the age of 45 and 55. Many women transition into the menopause with minimal if any symptoms. Others experience a range of symptoms that includes hot flashes, night sweats, mood swings, sleeping problems and fatigue. Many estrogen dependent tissues undergo changes including the vagina and bladder. These changes include thinning of the protective lining of the vagina resulting in vaginal atrophy leading to dryness, irritation and painful intercourse. Bone is also an estrogen dependent organ. The “thinning” of bone occurs during the menopause and may lead to osteopenia and/or osteoporosis, a condition that significantly increases the risk for fractures including those of the hip and vertebrae. Your doctor may recommend dietary and/or supplemental calcium, vitamin D and careful exercise for the prevention of osteoporosis and good bone health. A bone density or Dexa scan should be performed early in the menopause for an evaluation of bone health.

There are numerous approaches to treating menopausal symptoms and the risks of the available therapies must always be weighed against their benefit. Over the last few years there has been much knowledge gained from research on hormone therapy and the risks of cardiovascular disease, stroke and breast cancer. If symptoms are truly compromising then hormone replacement therapy is indicated and tailored to the individual. Many non hormonal therpies are available for bone loss and hot flashes.

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