Menopause is diagnosed by the presence of amenorrhea for six to twelve months, together with the occurrence of symptoms such as hot flashes, nausea, headache, flushed skin and palpitations (strong heartbeat). Menopause occurs at a mean age of 51 years in normal women. Menopause occurring after age 55 is defined as late menopause. The age of menopause is reduced by about two years in women who smoke.
High serum concentration of follicle-stimulatinghormone (FSH) can confirm the diagnosis of menopause.
Perimenopause is defined as the two to eight years preceding menopause and the one year after the last menstrual period. It is characterized by a normal ovulatory cycle interspersed with anovulatory cycles. Menses become irregular and heavy bleeding can occur. Some women complain of vaginal dryness and hot flashes. Irregular bleeding and menopausal symptoms during this perimenopausal transition may be treated by estrogen-progestin replacement therapy.
Menopause Symptoms
Hot flashes are the most common symptoms of menopause. Hot flashes may begin with headache or nausea and then it can be followed by flashed skin and strong heartbeat.
Irritability, Mood swings
Sudden tears
Insomnia (trouble with sleeping)
Urinary incontinention, especially after increasing intrabdominal pressure
(laughing, sneezing, coughing)
Vaginal dryness
Lost of libido
Irregular periods; shorter, lighter periods; heavier periods, flooding; phantom periods
Disorientation, difficulty concentrating
Increased abdominal fat
Breast changes (lost of fullness)
Depression
Hair loss or thinning
Osteoporosis
Treatment and drugs
Menopause itself requires no medical treatment. The treatment should be focused on reliving sings and symptoms and preventing some condition that may occur with aging. Treatments include:
Hormone therapy - Estrogen replacement therapy, the most effective for reliving the hot flashes.
Alternative therapies - phytoestrogens (estrogen-like substances from a plant)
Low-dose antidepressants
Vaginal estrogen ( decreased vaginal dryness)
Before deciding on any form of treatment, talk with your doctor about your options and the risks and benefits involved with each.
Almost two-thirds of the women may have had sexual difficulties at some time. Most of them experience pain with intercourse or difficulty to become aroused. But also a lot of women have a problem with reaching orgasm or are unorgasmic.
Sexual difficulties can be caused by insufficient stimulation, by a lack of communication, physical discomfort, fear of infection or fear of getting pregnant. Also same physical problems of childhood can be a reason for sexual dysfunction.
Treatment of sexual dysfunction
Lack of arousal can be caused by insufficient foreplay or if some of the partners is emotionally disturbed. Good communication and sensate focus exercises can solve these kinds of problems. In these exercise, two partners take turns caressing each other`s body, avoiding the genital area. When the caressing become pleasurable for both partners, they move on with manual stimulation and then with further sexual activity.
Some home methods of overcoming sexual difficulties are:
The patient should examine her body and her genital area and identify sensitive areas that produce pleasurable feelings. Also main accent should be put on psychological stimulation by sexual fantasy. If these methods did not give result, than maybe using the vibrator on or around the clitoris can be effective. And if once masturbation has resulted with orgasm, than the patient should continue doing that in presence with her partner and demonstrate sexual stimulation techniques.
If the problem is dyspareunia (pain during the intercourse) some tests related to hypostrogenism (reduced secretion of estrogenic hormones), endometriosis or maybe pelvic infections should be done.
Vaginismus is spasm of levator ani muscle. The penetration in vagina is painful or impossible. Treatment of vaginismus include putting vaginal dilator (the smallest one) into vagina by the woman. There is four available sizes of these dilators. As each dilator is replaced with the next larger size without pain, muscle relaxation occurs.
Also some medications have influence to the sexual function. The medications that interfere with sexual function are antihypertensive agents, antipsychotics and antidepressants.
Menorrhagia (excessive bleeding) is most often caused by anovulatory menstrual cycle. Sometimes it can by caused by infection, cancer or thyroid dysfunction.
Abnormal bleeding is defined as bleeding that occurs at interval less than 21 days or more than 36 days and lasts longer than 7 days.
Stress, exercise, weight changes and systemic diseases, particularly thyroid, renal or hepatic diseases or coagulopathies can be reason of some abnormality of the menstrual cycle.
Pregnancy complication such as ectopic pregnancy, placenta previa, abrupcio placentae and spontaneous abortion can cause heavy bleeding.
But the most commonly menorrhagia is caused by anovulatory menstrual cycle in girls at puberty and adolescence and in women at perimenopause. The reason for this is hormonally disbalance in this category of women. The first menstrual cycles in girls at puberty are anovulatory and followed with irregular bleeding because the hormonal function is not established in full. Also the perimenopause or menopause transition, the period when the ovaries gradually begin to produce less estrogen, is followed with anovulatory menstrual cycles and irregular bleedings.
The most serious and complicate reason of abnormal bleeding is cancer. It can be benign tumor as myoma , which is the most frequent. Myoma symptoms are: very heavy and prolonged menstrual periods, pelvic pain or pressure, pain during sexual intercourse, pressure on the bladder which leads to a constant need to urinate, incontinence, or the inability to empty the bladder, an enlarged abdomen which may be mistaken for weight gain or pregnancy.
Also the reason of abnormal bleeding can be endometrial (uterine) cancer, which is very serious diagnose and the surgery treatment (hysterectomy) is required. Uterine cancer usually occurs after menopause. The doctor’s care is necessary if the woman has some of the following symptoms: unusual vaginal bleeding, painful or difficult urination, pain in the pelvic area or pain during the intercourse.
Osteoporosis
Photo 1
A 19 year old with osteoporosis -- the result from never drinking milk.
Osteoporosis is characterized by low bone mass and it occurs when there is an imbalance between new bone formation and old bone resorption. It happens when the body isn`t able to form enough bone or the old bone resoption is increased. Two essential minerals for normal bone formation are calcium and phosphate. If the calcium intake is deficient or if the body does not absorb enough calcium, bone production may suffer and bones become weaker and fragile and can be broken easily.
Photo 2
Osteoporosis at a glance
The risk factors for osteoporosis are:
Personal history of fractures an adult
Family history of osteoporosis
Current cigarette smoking
Female sex (twice as common in woman as they are in men)
Estrogen deficiency (menopause before age 45 years or bilateral ovariectomy)
Low body weight
White race
Alcoholism
Lifelong low calcium intake
Lifetime exposure to estrogen (higher lifetime exposure to estrogen, the lower risk of osteoporosis)
Inadequate physical activity
Photo 3
This is a model of a second lumbar vertebra from a human.
Symptoms
In the early stages of osteoporosis usually there is no pain or other symptoms. Later it can cause severe back pain or neck pain if there is fractured or collapsed vertebra. Sometimes sharp pain can come suddenly. Spinal or vertebral fractures also have serious consequences, including loss of height or deformity. A hip fractures can cause prolonged or permanent person`s disability to walk and almost always requires hospitalization and major surgery.
Prevention:
There are several steps you can take to prevent osteoporosis.
Get your daily recommended amounts of calcium or vitamin D
Engage in regular weight-bearing exercise
Avoid smoking and excessive alcohol
Talk to your healthcare provider about bone health
When appropriate, have a bone density test and take medication
Breast cancer is the second most commonly diagnosed cancer among women, after skin cancer. White women are more likely to develop breast cancer than black women. The incidence of breast cancer increases with age.
Photo 1
Begin by looking at your breasts in the mirror with your shoulders straight and your arms on your hips.
I. The risk factor is anything that affects your chance of getting a disease, such as cancer. The risk factors of getting breast cancer are:
Prior history of breast cancer
Family history of breast cancer
Age greater than 50 years
Early menarche (first menstruation), before age of 12
Late menopause, after age of 50
Age greater than 30 at first birth
Obesity
High socioeconomic status
Exposition on ionizing radiation
Photo 2
Raise your arms and look for the same changes.
II. There are a number of ways in which breast cancer is detected:
First, every woman should perform Breast Self - Examination (BSE) every month. The doctor should examine both breasts and armpits every year. After age of 40, every woman should do mammography once in two years. If there is some abnormal area on mammogram than examination continues with breast ultrasound on suspicious area. Ultrasonography is useful to differentiate between solid and cystic breast masses when a palpable mass is not well seen on a mammogram.
Photo 3
Feel your breasts while lying down, using your right hand to feel your left breast and then your left hand to feel your right breast. Use a firm, smooth touch with the first few fingers of your hand, keeping the fingers flat and together.
Breast Self - Examination (BSE) should begin after the first period. BSE it can be done with breast palpation with round massaging moves around the nipple starting from lateral (axial) to the medial area(chest bone). If the woman regularly examines her breast, she will notice every difference or every appeasement of normal tissue. She will be more aware to notice changes like masses, lumps or nipple discharge which could be early sigh of cancer. A mass that is suspicious for breast cancer is usually solitary, discrete and hard. In some instances, it can be fixed to the skin or the muscle.
The woman should do BSE about a week after her period, when her breasts are not swollen or tender.
Photo 4
Finally, feel your breasts while you are standing or sitting. Many women find that the easiest way to feel their breasts is when their skin is wet and slippery, so they like to do this step in the shower.
