Items Tagged With Menopause

In the U.S., the average age of onset for "natural" menopause is 51. However, because of genetics, illness, or medical procedures, some women go through menopause before the age of 40. Menopause that occurs before this age, whether natural or induced, is known as "premature" menopause.

In addition to dealing with hot flashes, mood swings and other symptoms that accompany menopause, many women undergoing premature menopause have to cope with additional physical and emotional concerns. For example, since menopause signals the end of a woman's fertile years, a woman who wishes to get pregnant is likely to have trouble.

What Are the Symptoms of Premature Menopause?

Symptoms of premature menopause are often the same as those experienced by women undergoing natural menopause and may include:

• Irregular or missed periods.
• Periods that are heavier or lighter than usual.
• Hot flashes (a sudden feeling of warmth that spreads over the upper body).

These symptoms are a sign that the ovaries are producing less estrogen.

Along with the above symptoms, some women may experience:

• Vaginal dryness (the vagina may also become thinner and less flexible)
• Bladder irritability and worsening of loss of bladder control (incontinence)
• Emotional changes (irritability, mood swings, mild depression)
• Dry skin, eyes, or mouth
• Sleeplessness
• Decreased sex drive

In addition to the symptoms listed above, if you are under the age of 40 and experience any of the following conditions, you should see your doctor to determine whether you are undergoing premature menopause:

• You have undergone chemotherapy or radiation.
• You or a family member has an autoimmune disorder such as hypothyroidism, Graves' disease or lupus.
• You have unsuccessfully tried to become pregnant for more than a year.
• Your mother or sister experienced premature menopause.

How Is Premature Menopause Diagnosed?

First, your doctor will most likely perform a physical exam and draw blood to rule out other conditions, such as pregnancy and thyroid disease. He or she may also order a test to measure your estradiol levels. Low levels of estradiol, a form of estrogen, can indicate that your ovaries are starting to fail. When estradiol levels are below 36, it may signal that you are in menopause.

However, the most important test used to diagnose premature menopause is a blood test that measures follicle stimulating hormone (FSH). FSH causes your ovaries to produce estrogen. When your ovaries slow down their production of estrogen, your levels of FSH increase. When your FSH levels rise above 30 or 40 mIU/mL, it usually indicates that you are in menopause.

What Types of Health Issues Affect Women Undergoing Premature Menopause?

Like all menopausal women, women in premature menopause experience lowered estrogen levels as the ovaries stop most of their production of this hormone. Low levels of estrogen can lead to changes in a woman's overall health and may increase her risk for certain medical conditions, such as osteoporosis. Other health risks associated with the loss of estrogen include increased risk for colon and ovarian cancer, periodontal (gum) disease and tooth loss and cataract formation.

However, compared with women who go through natural menopause, women undergoing premature menopause spend a greater portion of their lives without the protective benefits of their own estrogen. This puts them at an even greater risk for the above mentioned menopause-related health problems.

People seem to want and need to be close to others. As we grow older, many of us also want to continue an active, satisfying sex life. But the aging process may cause some changes.

What Are Normal Changes?

Normal aging brings physical changes in both men and women. These changes sometimes affect one's ability to have and enjoy sex with another person. Some women enjoy sex more as they grow older. After menopause or a hysterectomy, they may no longer fear an unwanted pregnancy. They may feel freer to enjoy sex.

Some women do not think things like gray hair and wrinkles make them less attractive to their sexual partner. But if a woman believes that looking young or being able to give birth makes her more feminine, she may begin to worry about how desirable she is no matter what her age is. That might make sex less enjoyable for her.

A woman may notice changes in her vagina. As she ages, her vagina shortens and narrows. The walls become thinner and also a little stiffer. These changes do not mean she can't enjoy having sex. However, most women will also have less vaginal lubrication. This could affect sexual pleasure.

As men get older, impotence becomes more common. Impotence is the loss of ability to have and keep an erection hard enough for sexual intercourse. By age 65, about 15 to 25% of men have this problem at least one out of every four times they are having sex. This may happen in men with heart disease, high blood pressure, or diabetes-either because of the disease or the medicines used to treat it.

A man may find it takes longer to get an erection. His erection may not be as firm or as large as it used to be. The amount of ejaculate may be smaller. The loss of erection after orgasm may happen more quickly, or it may take longer before an erection is again possible. Some men may find they need more foreplay.

What Causes Sexual Problems?

Illness, disability, or the drugs you take to treat a health problem can affect your ability to have and enjoy sex. But, even the most serious health problems usually don't have to stop you from having a satisfying sex life.

Arthritis. Joint pain due to arthritis can make sexual contact uncomfortable. Joint replacement surgery and drugs may relieve this pain. Exercise, rest, warm baths, and changing the position or timing of sexual activity can be helpful.

Chronic pain. In addition to arthritis, pain that continues for more than a month or comes back on and off over time can be caused by other bone and muscle conditions, shingles, poor blood circulation, or blood vessel problems. This discomfort can, in turn, lead to sleep problems, depression, isolation, and difficulty moving around. These can interfere with intimacy between older people. Chronic pain does not have to be part of growing older and can often be treated.

Menopause is a stage in a woman's life when her ovaries stop producing the hormones estrogen and progesterone and she stops having her monthly menstrual cycle (her period). It is a normal part of aging and marks the end of a woman's reproductive years. Menopause typically occurs in a woman's late 40's to early 50's. It can also lead to sleep problems.

When the ovaries no longer produce adequate amounts of estrogen and progesterone (as in menopause), the loss of these hormones can bring about various symptoms including hot flashes (a sudden feeling of warmth that spreads over the body) and sweating (which is related to hot flashes).

Approximately 75-85% of menopausal women experience hot flashes, which can last for five years. Hot flashes and sweating can make it difficult to sleep. According to the National Sleep Foundation, approximately 61% of menopausal women have sleep problems. Sleeping difficulties can lead to other problems, such as daytime drowsiness.

How Can I Treat Sleep Problems Related to Menopause?

The traditional treatment for the symptoms related to menopause has been hormone replacement therapy (HRT). HRT consists of estrogen given as a pill, patch, or vaginal cream, either alone or combined with progesterone (for women who still have their uterus). However, results from a large study, the Women's Health Initiative, showed that long term use of estrogen-progesterone combination therapy caused an increased risk of breast cancer, heart disease, blood clots, and stroke. Estrogen alone did not increase breast cancer or heart disease, but the study also found that therapy with estrogen alone increases the risk of blood clots and stroke.

The latest recommendation for use of HRT for severe menopause symptoms is to use the lowest possible dose for the shortest possible time, with regular follow-up with your doctor.

If you are not a candidate for HRT, if your symptoms are not severe, or if you simply decide not to use HRT, the following tips might keep you cooler at night and help you sleep better without the use of hormones.

• Wear loose clothing to bed.
• Keep your bedroom cool and well-ventilated.
• Avoid certain foods that may cause sweating (such as spicy foods), especially right before bed.

Other practices that may ease sleep problems include:

• Maintain a regular bedtime schedule, including going to bed at the same time every night
• Exercise regularly but not right before sleep
• Avoid excessive caffeine
• Avoid naps during the day, which can prevent you from sleeping well at night
• Talk to your doctor about prescription medications that can help you sleep

What Alternative Treatments Are Available to Treat Hot Flashes?

Alternative treatments for treating hot flashes have included soy products such as tofu and soybeans. Soy products contain a plant hormone called phytoestrogen that acts as a weak estrogen. Studies in general do not show significant hot flash reduction with soy products.

Black cohosh, a perennial plant that is a member of the buttercup family, has also been used to treat hot flashes. In several studies, menopausal women who took black cohosh experienced relief from hot flashes and sweating, although most of these studies have been short-term, and used varying amounts of black cohosh from different sources. More studies are underway to determine if black cohosh reduces the frequency of hot flashes and other menopausal symptoms.

Keep in mind that alternative treatment products are not regulated or controlled by the Food and Drug Administration, and the long-term benefits and risks of these therapies are unknown. Talk to your doctor before you take any of these products.

Reviewed by a doctor in The Department of Obstetrics and Gynecology at The Cleveland Clinic.

VitaDocs Medical Reference provided in collaboration with the Cleveland Clinic

'Portions of this page © The Cleveland Clinic 2000-2005

Menopause  Sleep and Menopause  Womens Health 

Some risk factors and symptoms associated with aging and menopause cannot be changed. However, healthy eating can help prevent or reduce certain conditions that may develop during and after menopause.

What Are Some Basic Dietary Guidelines?

Eat a variety of foods to get all the nutrients you need. Since women's diets are often low in iron and calcium, follow these guidelines:

• Get enough calcium. Eating and drinking 2 to 4 servings of dairy products and calcium-rich foods a day will help ensure that you are getting enough calcium in your daily diet. Calcium is found in dairy products, fish with bones such as sardines and canned salmon, broccoli and legumes.
• Pump up your iron intake. Eating at least 3 servings of iron-rich foods a day will help ensure that you are getting enough iron in your daily diet. Iron is found in lean red meat, poultry, fish, eggs, leafy green vegetables, nuts and enriched grain products
• Get enough fiber. Help yourself to foods high in fiber such as whole-grain breads, cereals, pasta, rice, fresh fruits and vegetables.
• Eat fruits and vegetables. Include at least 2-4 servings of fruits and 3-5 servings of vegetables in your daily diet.
• Read labels. Use the package label information to help you to make the best selections for a healthy lifestyle.
• Drink plenty of water. This will help you stay hydrated.
• Maintain a healthy weight. Lose weight if you are overweight by cutting down on portion sizes and reducing foods high in fat, not by skipping meals. A registered dietitian or your doctor can help you determine your ideal body weight.
• Reduce foods high in fat. Fat should provide 30% or less of your total daily calories. Also, limit saturated fat to less than 10% of your total daily calories. Saturated fat raises cholesterol and increases your risk of heart disease. Saturated fat is found in fatty meats, whole milk, ice cream and cheese. Limit cholesterol intake to 300 milligrams (mg) or less per day. Also try to limit your intake of trans fats, found in vegetable oils, many baked goods and some margarines. Trans fat also raises cholesterol and increases your risk of heart disease.
• Use sugar and salt in moderation. Too much sodium in the diet is linked to high blood pressure. Also, go easy on smoked, salt-cured and charbroiled foods -- these foods contain high levels of nitrates, which have been linked to cancer.
• Limit alcohol intake. Women should limit their consumption of alcohol to one or fewer drinks a day.

What Foods Can Reduce Menopausal Symptoms?

Plant-based foods that contain isoflavones (plant estrogens) work in the body like a weak form of estrogen and may help relieve menopausal symptoms. Some may help lower cholesterol levels and have been suggested to relieve hot flashes and night sweats. Isoflavones can be found in foods such as soy products like tofu and soymilk.

The time of a woman's life following menopause is called postmenopause. During this time, many of the symptoms of menopause ease for most women. But as a result of several factors including a lower level of estrogen, postmenopausal women are at increased risk for a number of health conditions, such as osteoporosis and heart disease.

How Will I Know When I am Postmenopausal?

A woman is considered to be postmenopausal when she has not had her period for an entire year. Having your doctor measure your follicle stimulating hormone (FSH) level is another way to determine if you are postmenopausal. FSH is a hormone produced by the pituitary gland (located at the base of the brain). Your FSH levels will dramatically rise as your ovaries begin to shut down; these levels are easily checked through one blood test.

What Changes Can I Expect During Postmenopause?

Once you hit the postmenopausal stage, you may regain your energy and feel emotionally normal once again, but you may also be at higher risk for certain conditions, such as osteoporosis and heart disease.

Medication and/or healthy lifestyle changes may reduce the risk of some of the conditions associated with menopause. Since every woman's risk is different, talk to your doctor to learn what steps you can take to reduce your individual risk.

Can I Get Pregnant Now That I am Postmenopausal?

The possibility of pregnancy usually disappears once you have been without your period for an entire year. But, continue using contraception until your doctor determines that you truly are postmenopausal, unless, of course, you are trying to get pregnant.

How Often Do I Need to See My Doctor?

Even if you are postmenopausal, getting regular check-ups and preventive screening tests such as pelvic exams, Pap smears and mammograms are among the most important things you can do for yourself. How often you need a check-up depends on your health history. Talk to your doctor to determine how often you should be seen.

Reviewed by the doctors at The Cleveland Clinic Women's Health Center (2006).

VitaDocs Medical Reference provided in collaboration with the Cleveland Clinic

Can I Get Pregnant Now That I am Postmenopausal?  How Will I Know When I am Postmenopausal?  Menopause  What Changes Can I Expect During Postmenopause?  Womens Health  Your Health After Menopause