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Senior Health Week: Menopause
Health News You Can Use •

Latest Menopause News:

Women Who Produce Fewest Eggs Seen Entering Menopause Earlier: Researchers say women who produced few eggs were almost 12 times more likely to go through menopause early as compared with women who had a normal response.

Recent Menopause News:

HRT Via Skin Patch Results in Higher Estrogen Levels During Exercise: Researchers say women who get hormone replacement therapy (HRT) through a skin patch have higher levels of estrogen during exercise than women who take HRT orally, but in most instances it is not cause for concern.

Red Hot Mamas Provide Interactive Information on Menopause: A new Web developed by a national menopause educational organization is providing information for women and men on the multiple health and lifestyle implications of menopause.

Low Dose HRT Prevents Postmenopausal Osteoporosis: Researchers also reported in the Journal of the American Medical Association that calcium alone does not prevent bone loss during early menopause as was previously believed.

Women May Experience a Dramatic Loss of Sexual Function in Menopause: Australian researchers say the changes are primarily associated with a drop in the level of the hormone estradiol, and that use of hormone replacement therapy protects against the decline of sexual functioning.

Postmenopausal Women Can Regain Elasticity in Arteries: Researchers say that walking 40 minutes a day can help women decrease the risk of high blood pressure and heart disease.

Health Risks Linked to Obesity Seen as Problem Among Menopausal Women: Researchers say that with 70 percent of women age 45-54 either overweight or obese, diseases like diabetes and heart disease become major concerns.

Obesity Strongly Linked to Other Health Risks for Postmenopausal Women: Researchers say that postmenopausal women with higher levels of trunk fat were possibly at an increased risk of developing type 2 diabetes and cardiovascular disease.

Approval Delayed for New Lotion to Help Control Hot Flashes: Novavax Inc. has withdrawn its application for FDA approval for Estrasorb, an estrogen-replacement lotion.

Can Low-Dose Hormone Replacement Therapy Help Curb Skin Wrinkling: A study is testing an investigational, low-dose oral HRT as a possible means for controlling and improving age-related skin wrinkling.

Half of Women Beginning Menopause Do Not Understand What Is Happening: A national survey conducted by RoperASW also found that six out of 10 women do not understand the relationship between estrogen loss and menopausal conditions.

HRT After Menopause Creates Slightly Higher Risk of Ovarian Cancer: Researchers at Falu Hospital in Sweden say the risk is modest, but women taking the drug for more than 10 years are at higher risk for the disease.

Hormone Replacement Therapy May Not Benefit Heart: Hormone replacement therapy (HRT) should not be given to women solely for the purpose of preventing heart attacks and strokes, according to a new recommendation from the American Heart Association.

Hormone Replacement Therapy Appears to Reduce Risk of Cataracts: Researchers report that women who take hormone replacement therapy (HRT) after menopause appear to reduce their risks of cataracts.

Hormone Replacement Therapy Appears to Help Diabetics Control Glucose: California researchers report that diabetic women who take hormone replacement therapy (HRT) after menopause appear to be better able to keep their blood sugar levels under control.

Menopause Primer:

Menopause is the point in a woman's life when menstruation stops permanently, signifying the end of her ability to have children. Known as the "change of life," menopause is the last stage of a gradual biological process in which the ovaries reduce their production of female sex hormones--a process which begins about 3 to 5 years before the final menstrual period. This transitional phase is called the climacteric, or perimenopause.

Menopause is considered complete when a woman has been without periods for 1 year. On average, this occurs at about age 50. But like the beginning of menstruation in adolescence, timing varies from person to person. Cigarette smokers tend to reach menopause earlier than nonsmokers.

The ovaries contain structures called follicles that hold the egg cells. You are born with about 2 million egg cells and by puberty there are about 300,000 left. Only about 400 to 500 ever mature fully to be released during the menstrual cycle. The rest degenerate over the years.

During the reproductive years, the pituitary gland in the brain generates hormones that cause a new egg to be released from its follicle each month. The follicle also increases production of the sex hormones estrogen and progesterone, which thicken the lining of the uterus. This enriched lining is prepared to receive and nourish a fertilized egg following conception. If fertilization does not occur, estrogen and progesterone levels drop, the lining of the uterus breaks down, and menstruation occurs.

For unknown reasons, the ovaries begin to decline in hormone production during the mid-thirties. In the late forties, the process accelerates and hormones fluctuate more, causing irregular menstrual cycles and unpredictable episodes of heavy bleeding. By the early to mid-fifties, periods finally end altogether. However, estrogen production does not completely stop. The ovaries decrease their output significantly, but still may produce a small amount. Also, another form of estrogen is produced in fat tissue with help from the adrenal glands (near the kidney). Although this form of estrogen is weaker than that produced by the ovaries, it increases with age and with the amount of fat tissue.

Progesterone, the other female hormone, works during the second half of the menstrual cycle to create a lining in the uterus as a viable home for an egg, and to shed the lining if the egg is not fertilized. If you skip a period, your body may not be making enough progesterone to break down the uterine lining. However, your estrogen levels may remain high even though you are not menstruating.

At menopause, hormone levels don't always decline uniformly. They alternately rise and fall again. Changing ovarian hormone levels affect the other glands in the body, which together make up the endocrine system. The endocrine system controls growth, metabolism and reproduction. This system must constantly readjust itself to work effectively. Ovarian hormones also affect all other tissues, including the breasts, vagina, bones, blood vessels, gastrointestinal tract, urinary tract, and skin.

Menopause is an individualized experience. Some women notice little difference in their bodies or moods, while others find the change extremely bothersome and disruptive. Estrogen and progesterone affect virtually all tissues in the body, but everyone is influenced by them differently.

Hot Flashes. Hot flashes, or flushes, are the most common symptom of menopause, affecting more than 60 percent of menopausal women in the U.S. A hot flash is a sudden sensation of intense heat in the upper part or all of the body. The face and neck may become flushed, with red blotches appearing on the chest, back, and arms. This is often followed by profuse sweating and then cold shivering as body temperature readjusts. A hot flash can last a few moments or 30 minutes or longer. Hot flashes occur sporadically and often start several years before other signs of menopause. They gradually decline in frequency and intensity as you age. Eighty percent of all women with hot flashes have them for 2 years or less, while a small percentage have them for more than 5 years. Hot flashes can happen at any time. They can be as mild as a light blush, or severe enough to wake you from a deep sleep. Some women even develop insomnia. Others have experienced that caffeine, alcohol, hot drinks, spicy foods, and stressful or frightening events can sometimes trigger a hot flash. However, avoiding these triggers will not necessarily prevent all episodes. Hot flashes appear to be a direct result of decreasing estrogen levels. In response to falling estrogen levels, your glands release higher amounts of other hormones that affect the brain's thermostat, causing body temperatures to fluctuate. Hormone therapy relieves the discomfort of hot flashes in most cases.

Vaginal/Urinary Tract Changes. With advancing age, the walls of the vagina become thinner, dryer, less elastic and more vulnerable to infection. These changes can make sexual intercourse uncomfortable or painful. Most women find it helpful to lubricate the vagina. Water-soluble lubricants are preferable, as they help reduce the chance of infection. Try to avoid petroleum jelly; many women are allergic, and it damages condoms. Be sure to see your gynecologist if problems persist. Tissues in the urinary tract also change with age, sometimes leaving women more susceptible to involuntary loss of urine (incontinence), particularly if certain chronic illnesses or urinary infections are also present. Exercise, coughing, laughing, lifting heavy objects or similar movements that put pressure on the bladder may cause small amounts of urine to leak. Lack of regular physical exercise may contribute to this condition. It's important to know, however, that incontinence is not a normal part of aging, to be masked by using adult diapers. Rather, it is usually a treatable condition that warrants medical evaluation. Recent research has shown that bladder training is a simple and effective treatment for most cases of incontinence and is less expensive and safer than medication or surgery. Within 4 or 5 years after the final menstrual period, there is an increased chance of vaginal and urinary tract infections. If symptoms such as painful or overly frequent urination occur, consult your doctor. Infections are easily treated with antibiotics, but often tend to recur. To help prevent these infections, urinate before and after intercourse, be sure your bladder is not full for long periods, drink plenty of fluids, and keep your genital area clean. Douching is not thought to be effective in preventing infection.

Menopause and Mental Health. A popular myth pictures the menopausal woman shifting from raging, angry moods into depressive, doleful slumps with no apparent reason or warning. However, a study by psychologists at the University of Pittsburgh suggests that menopause does not cause unpredictable mood swings, depression, or even stress in most women. In fact, it may even improve mental health for some. This gives further support to the idea that menopause is not necessarily a negative experience.

Osteoporosis. One of the most important health issues for middle-aged women is the threat of osteoporosis. It is a condition in which bones become thin, fragile, and highly prone to fracture. Numerous studies over the past 10 years have linked estrogen insufficiency to this gradual, yet debilitating disease. In fact, osteoporosis is more closely related to menopause than to a woman's chronological age.

Cardiovascular Disease Most people picture an older, overweight man when they think of a likely candidate for cardiovascular disease (CVD). But men are only half the story. Heart disease is the number one killer of American women and is responsible for half of all the deaths of women over age 50. For reasons unknown, estrogen helps protect women against CVD during the childbearing years. After menopause, the incidence of CVD increases, with each passing year posing a greater risk.

Hormone Replacement Therapy To combat the symptoms associated with falling estrogen levels, doctors have turned to hormone replacement therapy (HRT). HRT is the administration of the female hormones estrogen and progesterone. Estrogen replacement therapy (ERT) refers to administration of estrogen alone. The hormones are usually given in pill form, though sometimes skin patches and vaginal creams (just estrogen) are used. ERT is thought to help prevent the devastating effects of heart disease and osteoporosis, conditions that are often difficult and expensive to treat once they appear. The cardiovascular effects of progesterone, however, are still unknown. Hormone treatment for menopause is still quite controversial. Its long-term safety and efficacy remain matters of great concern. There is not enough existing data for physicians to suggest that HRT is the right choice for all women. Each woman should make a decision about HRT based on her own family history and life experiences.

Good nutrition and regular physical exercise are thought to improve overall health. Some doctors feel these factors can also affect menopause. Although these areas have not been well studied in women, anecdotal evidence is strongly in favor of eating well and exercising to help lower risks for CVD and osteoporosis.

Clearly, no one has all the answers about menopause. The important thing to remember as you go through menopause is to be good to yourself. Take time to pursue your hobbies, be they gardening, painting or socializing with friends. Have a positive attitude toward life. Sharing concerns with friends, a spouse, relatives or a support group can help. Don't fight your body--allow the changes that are happening to become a part of you, a part that is natural and that you accept.

Background information provided by: National Institute on Aging, National Institutes of Health, Bethesda, MD 20892















































































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