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Coping up with Menopuse

Menopause is a normal part of life that every woman undergoes during her lifetime. The menopause is the natural process women go through as they reach a certain age and is a normal part of life. The word "menopause” is derived from Greek – men or menos meaning "month” and pausis meaning "to stop”. Menopause is defined as the time during which the function of the ovaries ceases and the monthly periods or menstruation finally stops. The average age of menopause is 51 years old, but menopause may occur as early as the 30s or as late as the 60s. However, the transition period may differ for each woman as one cannot 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.

Stages of Menopause:

The process of menopause does not occur overnight, but rather is a gradual process.Menopause occurs in a series of stages. While menopause is usually divided into two mainstages, perimenopause and postmenopause,

it is more accurately divided into the following

four stages:

 

1. Premenopause : A fertile or reproductive stage of woman’s life and it spans from the time of her first period to her last period.

 

2. Perimenopause : A stage that refers to the years immediately preceding menopause and is characterized by hormonal changes which often lead to menopause symptoms and usually occurs between 45 and 60 years of age. It usually lasts for a period of 2 to 6 years.

3. Menopause : Menopause occurs when a woman has her final period. Menopause is the permanent terminationof a woman’s period and her fertility. Menopause is confirmed when a woman does not have a period for twelve consecutive months. Most women experience natural menopause, but some may experience artificial or premature menopause. Natural menopause is caused by aging and occurs after a natural decline in estrogen and progesterone production.

Artificial menopause usually follows a medical intervention such as a hysterectomy, radiation treatment to the pelvic area or the removal of the ovaries. Premature menopause refers to when a woman stops menstruating before she is forty years old and can occur due to smoking,heredity or exposure to chemicals.

4. Postmenopause : Post menopause is a crucial stage in a women’s life as it many bring a new set of health concerns and most women may develop heart

disease and osteoporosis due to a decline in hormone levels.

Symptoms of the menopause:

The menopause usually happens gradually. Periods may become irregular and infrequent before they stop completely. Some women may also have other symptoms. Some of these can begin up to six years before the final menstrual period and can continue for several years after the last period.

Irregular vaginal bleeding may occur during menopause. There will be no "normal” pattern of bleeding during the perimenopause, and patterns vary from woman to woman. Some women have minimal problems with abnormal bleeding during perimenopause whereas others have unpredictable, excessive bleeding. Also, menstrual periods may occur more frequently in short duration or may happen after a lengthened duration. So, it is common for women in perimenopause to have a period after going for several months without one. There will also be no set length of time it takes for a woman to complete the menopausal transition. A woman can have irregular periods for years prior to reaching menopause. The menstrual abnormalities that begin in the perimenopause are also associated with a decrease in fertility, since ovulation has become irregular.

Symptoms of the menopause can include:

• Hot flushes and night sweats.
• Feeling heart racing (palpitations).
• Changes to the vagina, such as dryness, discomfort,itching and pain during sex.
• Difficulty sleeping (insomnia).
• Weight gain.
• Loss of interest in sex (libido).
• Changes in the mood, such as feeling tired, irritable, depressed or anxious.
•  Having difficulty concentrating or poor memory.
• urinary problems – such as recurrent urinary tract infections, loss of bladdercontrol (urinary incontinence).

The symptoms may be worse if the menopause happens suddenly (for example if one had the ovaries removed or underwent chemotherapy).

Common perimenopause and menopause symptoms Women may notice any of these symptoms

five to ten years before menopause.

•  Irregular periods
•  Insomnia
• Fatigue/ loss of energy
•  Hot flashes and night sweats
•  Forgetfulness or foggy thinking
•  Thinning hair or hair loss
•  Vaginal dryness
• Joint discomfort /stiffness
• Inflammation
•  Food cravings
•  Digestive symptoms 
• Pain with intercourse
• Anxiety and/or sadness
• Irritability and/or moodiness
• Weight gain around the waist and hips.

Treatments:

Treatments for menopause are customized for eachwoman as each woman may experience different levels of discomforts. Some women may experience few or no symptoms of menopause, while others experience multiple physical and psychological symptoms. The extent and severity of symptoms varies significantly among women. It is also important to remember that symptoms may come and go over an extended time period for some women.Treatments are directed by and large towards alleviating uncomfortable or distressing symptoms.

Osteoporosis:

Bone loss accelerates in the late menopausal transition and continues for the first few years after menopause. Postmenopausal women and elderly women should be treated early and on a longterm basis unless a contraindication to such treatment exists.

Current treatment options for preventing fractures among postmenopausal women with osteoporosis include the following:

• Bisphosphonates (alendronate, etidronate, ibandronate,risedronate, zoledronic acid)
• Selective estrogen receptor modulators (SERMs;eg, raloxifene)
•  Calcium
• Vitamin D
•  Calcitonin
• Monoclonal antibodies 
• Hormonal medications
• Estrogen therapy (considered a second-linetherapy for osteoporosis)

Heart Disease: 

With the fluctuating hormone levels and the loss of naturalestrogen, most women have some degree of weight gain during menopause. Changes in the walls of the blood vessels make it more likely for plaque and blood clots to form. With the changes in the level of fats in the blood,the "bad” cholesterol, increase and "good” cholesterol decrease.

These factors may contribute to the higher risks of heart disease Further, the distribution of body fat may change.More fat will be deposited more in the waist and abdominal area than in the hips and thighs. First and foremost, the risk factors for heart disease should be addressed during perimenopause and continues

after menopause.

To lower the risk of heart disease women must follow these:

•  Avoid or quit smoking.
• Lose weighand/or maintain their ideal body weight.
• Exercise for more than 30 minutes more than three times per week, with agoal of 150 minutes of moderate intensity exercise per week.
• Follow a diet low in saturated fat(<7% daily amount); low in trans-fat (partially hydrogenated fats such as margarine or shortening); and high in fiber, wholegrains, legumes (such as beans and peas),fruits, vegetables, and fish.
•  Treat and control medical conditions such as diabetes,high cholesterol, and high blood pressure that are know risk factors for heart disease.

Self Help:

Take practical steps to deal with hot flushes by keeping cool and avoiding possible triggers such as spicy foods, caffeine, smoking or stress.

Regular exercise may help improve some symptoms of the menopause, including hot flushes and night sweats, difficulty sleeping and mood changes. Pelvic floor exercises can help strengthen your pelvic muscles and improve your bladder control. Physical activity that stresses the bones,such as running and walking, can help strengthen your bones and reduce your risk of osteoporosis. Physical activity

can also help protect against heart disease and stroke.You should aim to do 30 minutes of moderate exercise fivedays a week.

A healthy diet can help protect your body against someof the long-term effects of the menopause. It’s importantto balance your diet with foods from each food group. Because the menopause causes you to lose calcium in your bones, the foods you eat can help protect you from osteoporosis.Try to include two to three portions of calcium-rich foods in your diet daily, such as 200ml of semi-skimmed

milk, or yoghurt. Your General Physician may advise you take a calcium supplement. It’s also important that you stay a healthy weight for your height.

Vitamin D is important for your bone health. Vitamin D is produced naturally by your body when your skin is exposed to sunlight and can also be obtained from some foods, such as oily fish. You may get enough vitamin D during summer by spending frequent short spells in the sun without wearing sunscreen (the exact time you need is different for everyone, but is typically only a few minutes in the

middle of the day). However, do not let your skin redden. If you don’t get much sun exposure and particularly during winter months, taking up to 25 micrograms of vitamin D (two high-strength 12.5 microgram capsules) can help tothe menopause causes you to lose calcium in your bones, the foods you eat can help protect you from osteoporosis.

Try to include two to three portions of calcium-rich foods in your diet daily, such as 200ml of semi-skimmed milk, or yoghurt. Your General Physician may advise you take a calcium supplement. It’s also important that you stay a healthy weight for your height.Vitamin D is important for your bone health. Vitamin D is produced naturally by your body when your skin is exposed to sunlight and can also be obtained from some foods,such as oily fish. You may get enough vitamin D during summer by spending frequent short spells in the sun without

wearing sunscreen (the exact time you need is different for everyone, but is typically only a few minutes in the middle of the day). However, do not let your skin redden. If you don’t get much sun exposure and particularly during

winter months, taking up to 25 micrograms of vitamin D (two high-strength 12.5 microgram capsules) can help to make sure you get enough.

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