An Overview of Menopause

The average age for menopause is approximately 52 years, though this may vary widely from individual to individual. Typically, the output of female hormones from the ovaries gradually declines during a woman's 30s and 40s.

Symptoms

The gradual decline of estrogen causes a wide variety of changes in the body. In the long term, a lack of estrogen may increase the risk of osteoporosis and heart disease. Menopause may be preceded by the following suggestive symptoms:

  • Hot flashes
  • Mood swings
  • Memory loss and/or difficulty concentrating
  • Depression
  • Fatigue
  • Night sweats and/or difficulty sleeping
  • Headaches
  • Heart palpitations
  • Weight gain
  • Vaginal dryness
  • Heavy and/or erratic bleeding
  • Reduced sex drive
  • Bone loss (osteoporosis)

Approximately one-third of women will enter menopause with very few or no symptoms other than cessation of menstrual flow. Another third will have moderate symptoms such as hot flashes, mood swings, memory loss, trouble sleeping or vaginal dryness. The remaining third will have severe symptoms; for these women, menopause can dramatically affect their quality of life.

Women should note especially symptoms of irregular and heavy bleeding. Both could be associated with an increased risk of cancer. Any abnormal bleeding should be immediately reported to a physician.

Treatment

Because menopausal symptoms can be complex, relief should be coordinated with a physician.

Hormone replacement therapy has been one of the most common treatments for menopausal symptoms. As of mid-2002, approximately 40 percent of menopausal women in the United States were using some form of hormone therapy, either HRT (a combination of estrogen and progestin) or ERT (estrogen alone).

In July 2002, however, the National Institutes of Health (NIH) announced that an increased risk of invasive breast cancer had been found among women using HRT. NIH also found that HRT may cause a higher incidence of coronary heart disease, stroke and blood clots in the lungs and legs. HRT also demonstrated some health benefits.

As a result of these findings, NIH halted a major clinical trial that was intended to measure the benefits and risks of HRT. What the study seemed to demonstrate is that HRT does not prevent or delay cardiovascular disease as once thought, so the benefits of effective symptom treatment (which in some women is considerable) need to be balanced with the possible slightly increased risks of some medical conditions (breast cancer and blood clots) and decreased risk of others (hip fractures and colon cancer).

The human body is complex, and so is menopause. There are many facets to consider before deciding on a form of therapy, and each woman's medical history and condition needs to be examined on a case-by-case basis. Many women have used botanical or other nontraditional medicines to treat menopause. Some treatments have reasonably well established benefits, while others are of no benefit or may carry risks that exceed their benefits. It's important to consult a physician before embarking on any type of symptom-management program.

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