Menopause 101

With record number of baby boomers now reaching mid-life, menopause has become the news hot flash of the 1990's. Yet much of what we hear or read about menopause is alarmist, misleading or downright confusing. Dr. Donnica explains that menopause is a transitional time characterized by the end of the menstrual cycle-and the beginning of the final third of a woman's life. She also discusses what menopause is, what its consequences are, and what is available to treat them.

Each day, nearly 5,000 women in the United States and Canada reach menopause, which is simply the end of a woman's menstrual cycle. During the perimenopausal period (up to 10 years before menopause), the ovaries decrease production of the "female hormones" estrogen and progesterone, the hormones which allow a woman to become pregnant and to menstruate. Yet these hormones also affect many other functions in a woman's body such as the circulatory system, urogenitary system, nervous system, skeletal system, memory, sexuality, skin, vision, and teeth.

The average age for menopause in American women is 51. However, when menopause begins and the length of time it lasts varies for every woman. Menopause means more than just losing your periods. This is a syndrome with clinical symptoms as well as long term consequences. Estrogen loss can have wide-ranging effects--from menopausal symptoms (such as hot flashes) to increased risk of heart disease and osteoporosis, which can be life threatening. Because most women will live a third of their life after menopause, it is important to be aware of the symptoms, systemic effects, and available treatment options associated with estrogen loss.

The term "menopausal" usually refers to the year preceding the end of menstruation and the five years following. "Postmenopausal" refers to the time thereafter. "Perimenopause" is the 2-10 year time period preceding menopause; it is this period we are now learning more about. "Premature menopause" is defined as menopause occurring for whatever reason before age 40. It is also called "premature ovarian failure".

An important definitional distinction here is that women who have had a hysterectomy (surgical removal of the uterus) but whose ovaries function normally won't have periods, but they are not "in menopause." They will go into menopause naturally when their ovaries cease functioning. Many women who have a hysterectomy also have their ovaries removed (ovariectomy or oophorectomy) at the same time; it's important to find out which category you are in if you have had either type of surgery.

Interestingly, up to a third of women report no disruptive menopausal symptoms; in others the symptoms may last several years, usually between ages 40 and 55. The most common symptom is that menstrual periods appear less and less frequently, or, in some cases, "irregularly irregular" until they stop altogether. Many women have the typical symptoms of menopause: hot flashes, night sweats, irritability, moodiness, sleep disturbances, vaginal dryness, decreased libido, and hair coarseness/loss.