Menopause Health

Menopause, also called the "change of life," is a normal, natural event that happens to every woman. It marks the end of your fertility and menstruation, and it is defined by a loss of menstrual periods for 12 consecutive months after your last menstrual cycle.

In the years leading up to menopause, you're in "perimenopause" or "menopause transition." During perimenopause, your ovaries slowly stop producing eggs and they produce lower levels of estrogen and other hormones. This decline of hormones is gradual, but often erratic. As a result, you may ovulate one month and not next. Missed periods are often a sign that your reproductive years are coming to an end.

The common symptoms of perimenopause include:

Irregular menstrual cycles and irregular bleeding. For some women, their menstrual cycles come to a sudden stop, and they don't have any problems with abnormal bleeding. However, in most women, their periods slowly stop over a number of years. Some women may have menstrual periods more frequently (even more than once a month); others have periods that get further apart. Your menstrual flow may also change during perimenopause. You may bleed more profusely, or your periods may become very light.

This irregularity in your menstrual cycles and bleeding patterns may last as between one and three years, before your menstruation completely stops.

Keep in mind that irregular bleeding may have other causes, such as uterine cancer. Please see your healthcare provider to rule out other causes, other than menopause.

Hot flashes and night sweats. Up to 75 percent of menopausal women experience hot flashes. Also called "hot flush," this perimenopause symptom is a sudden and intense feeling of warmth that spreads all over your body, but it's more noticeable on your face and upper body. It is sometimes accompanied with a pounding or racing heartbeat, nausea, dizziness, headache, and weakness. Hot flashes are followed by flush, which leaves you with a red, flushed face and sweating. Sometimes, you'll get a chill after the hot flash episode.

When hot flashes, accompanied with sweating, occur at night, they are called night sweats. These may interfere with your sleep. Night sweats may wake you up in the middle of the night, and you may feel like you've just had a bucket of water dumped on you.

Hot flashes and night sweats usually don't require treatment, and they will go away within one to five years after menopause. However, some women may experience hot flashes until age 70.

Mood swings. Another common symptom of perimenopause, mood swings are caused by hormonal changes during your "change of life." Some women may feel like they become a different person because of their mood swings. You may not be able to control your emotions as well as you used to. Menopausal women can be snappish, irritable, and have crying spells for no reason.

You are more prone to menopausal irritability, depression, and mood swings if you experienced PMS mood swings or had postpartum depression. These indicate that you may be sensitive to hormonal changes. Night sweats and difficulty sleeping (two other common perimenopause symptoms) can also contribute to your moodiness and irritability.

Vaginal dryness and pain during sex. During perimenopause, the decrease of estrogen in your body can thin the lining tissues of your vagina. As a result, you may experience vaginal dryness, itching, and pain during sexual intercourse. These vaginal changes may also lead to sexual dysfunction during the perimenopause years.

Decrease in Sexual Drive. In addition to causing vaginal dryness, the decrease in estrogen during the perimenopause years also decreases the blood flow to your vagina and vulva. This decreased blood flow can also decrease your vaginal lubrication. You may also have less sensation in these areas, so you may notice that you are not as easily aroused as you should be.

Not all women see a lowered sex drive during menopause. In fact, you may notice that you have an increase in libido due to the freedom that menopause gives you. You no longer have to be afraid of pregnancy! Plus, most menopausal and post-menopausal women have fewer parenting responsibilities, so they have more time to relax and enjoy intimacy.

These are just some of the many perimenopause symptoms that you may experience. The severity of menopausal symptoms varies with each individual woman. You may have mild symptoms, and your best friend of the same age may have moderate or severe symptoms. Once you hit that 12 months without a period, you are considered "postmenopausal" and you will no longer menstruate. Your reproductive years are now over.

Average Age of Menopause and Perimenopause
Related: Menopause Health Center at WebMD

The average age of menopause is around 51 years old. However, in 5 percent of women, menopause occurs after age 55. This is called "late menopause." Another 5 percent of women will have "early menopause," or menopause that occurs between age 40 and 45.

In some cases, menopause can occur before age 40. This is called "premature menopause." Premature menopause is not normal, and can be caused by premature ovarian failure, genetics, autoimmune diseases, chemotherapy for reproductive system cancers, surgical removal of both ovaries (called a bilateral oophorectomy), and other reasons.

Perimenopause symptoms can occur 4 to 7 years prior to your last menstrual cycle. The average age of the start of perimenopause is around 47.5 years. However, some women may experience this stage of their reproductive life as early as their 30s. There are certain factors that may predispose you to early perimenopause. Some of these include:

Genetics. Heredity may have something to do with whether you have menopause earlier than other women. You are at higher risk of earlier menopause if there's a family history of it.

Smoking. Women who are smokers tend to experience perimenopause two years earlier than non-smokers.

Ethnicity and Race. In two different studies, Hispanic and Japanese-American women had earlier natural menopause, than Caucasians.

Reproductive History. You are at higher risk of early menopause if you never had any children or if you had a shorter menstrual cycle length during your adolescence.

Whether you go through early menopause in your 40s, or you experience menopause at the same age as other women, you should embrace this stage in your reproductive life! There is life after menopause. Just remember that these symptoms won't last forever!

Plus, you may be surprised that your partner or husband also goes through a type of "menopause." Male menopause, also called "andropause," refers to a decrease in your male partner's testosterone levels as he ages.

Although men can continue to impregnate women in their later years, their fertility does decline with age. Testosterone (which is the hormone that makes men manly) levels decrease with age. An estimated 25 million men in the United States between 40 and 55 do experience some degree of andropause (male menopause.)

The drop in testosterone can occur to men as young as age 35, but the decrease in testosterone is gradual. Testosterone levels typically only drop one to 1.5 percent every year. Some hallmark signs of male menopause includes fatigue, depression, irritability, reduced libido, and even problems starting intimacy.

Hot Flashes
Related: Hot Flashes at Mayo Clinic

When you think of menopause, you may immediately think of hot flashes, also called "hot flushes" and "night sweats" when they occur at night. This is almost a universal menopause symptom. An estimated 75 percent of American menopausal women will experience hot flashes.

Most often, hot flashes start during your perimenopausal period - the years before menopause, when you start to experience menopausal symptoms. Perimenopause is what some women may call "going through the change."

Around 80 percent of menopausal women with hot flashes will experience them for over a year. For most women, hot flashes stop on their own within a few years without any treatment. Unfortunately, some women may experience hot flashes for many years after menopause. Around 12 to 15 percent of women in their 60s, and 9 percent of women in their 70s still experience hot flashes.

Hot flashes often start as a sudden rush of heat on your face and upper chest. Your face often looks red and flushed during a hot flash. Some women sweat heavily and have heart palpitations with a flash episode. It's often followed by chills and shivering. In some cases, hot flashes are accompanied with fatigue, feeling faint, and a sense of anxiety, panic, or fear. Some menopausal women also experience an aura beforehand, letting them know that a hot flash will soon occur. Hot flashes don't last long - typically between two to four minutes. However, they may last as long as ten minutes in some women.

Many menopausal women experience several hot flashes in a day. The frequency of hot flashes varies from woman to woman, depending on the level of estrogen in her body. Some women may experience as few as one or two each day; others may have as many as one every hour during the day and night.

When hot flashes occur when you're sleeping, these are called "night sweats." They may wake you up from sleep and lead to sleep disturbances. If you are suffering from insomnia (another common symptom of menopause), night sweats can make it hard for you to fall back asleep.

A Natural Approach to Treating Menopausal Symptoms: Herbs for The Menopause
Related: Herbal Remedies for Menopause at About.com Women's Health

“Natural” medicine has been around for centuries, and there are a variety of herbs and folk remedies that women have used since the dawn of time to treat the symptoms of menopause.

The following herbs are most commonly used to treat the symptoms of menopause:

Black Cohosh- this is an herb noted for its estrogenic properties. It helps the uterus contract and can relieve cramping and congestion in the uterus. It is also used to relieve hot flashes. Black cohosh may also help relieve muscular pain and reduce blood cholesterol levels.

Dandelion-this is a great herb for cleansing and tonifying the liver. In some women the liver becomes over stressed and doesn't function properly. This often results in hormonal imbalances.

Dong quai- this herb is high in plant estrogens and can relieve many of the symptoms associated with menopause including hot flashes.

False Unicorn root- this herb helps regulate estrogen and can be used to tone the uterus and help the ovaries function properly. It has been used among other things to treat ovarian cysts in women.

Shepherd's Pu rse- this herb helps regulate the pituitary gland. It has androgenic properties, and particularly is useful for regulating progesterone levels in the body. It can help alleviate irregular bleeding and spotting, and help regulate cycles until they cease.

Wild Yam- wild yam has been touted for centuries as an anti-inflammatory. It can provide relief for symptoms of arthritis due to menopause, and may also help minimize heavy menstrual bleeding. It is estrogenic in nature.

Eating Right During the Menopause
Related: Menopause Diet at MedicineNet.com

So how exactly does food related to menopausal symptoms? There are many nutrients in food that help nourish the body in ways that can lessen the severity of symptoms. In particular foods that are high in a substance called phytoestrogens (plant estrogens), healthy fats, vitamins and minerals are beneficial for menopausal women.

Eating the right combination of foods can also help combat osteoporosis and heart disease. Women are more at risk for both these diseases during menopause.

So what are the nutrients that you need to consume during menopause?

Calcium- calcium is number one on the list because it helps combat osteoporosis. Women between the ages of 30 and 50 should be getting at least 1,000 mg per day, and women over 50 should be getting 1,200 mg of calcium every day. There are many sources of calcium in the diet including: yogurt, cheese, low fat milk, broccoli and other leafy greens, salmon.

Lignans- lignans are a form of phytoestrogen, which your body can use to produce substances similar to estrogen. Hence, lignans can help combat hot flashes in some women. There are many foods jam packed full of lignans including fruits and vegetables, but your best source is flaxseeds. You can buy whole flaxseeds to add to meals or flaxseed oil at almost any store.

Magnesium- magnesium works together with calcium, enabling better absorption of calcium by the bones. Magnesium is also well noted for easing irritability and anxiety because it has a calming effect. It might even help you sleep better. You can get magnesium by eating almonds, cashews, kelp and wheat brand.

Omega 3 Fatty Acids- fatty acids can protect you from heart disease, and may even improve the symptoms of depression.; Fatty fish such as salmon and mackerel all provide adequate levels of fatty acids. You should try to eat fish at least twice per week, or consider taking a supplement.

Vitamin E- vitamin E is great for combating breast tenderness, hot flashes and even vaginal dryness. Vitamin E may also help improve the condition of your skin. The best sources include: asparagus, avocados, egg yolks, sweet potatoes and vegetable oils.

Exercise to Build Bone Mass during the Menopause
Related: Exercise to Build Bone Mass at National Institute of Arthritis and Musculoskeletal and Skin Diseases

While all forms of exercise are beneficial during menopause, resistance training is the best form of exercise to engage if you want to build bone mass. Now, you don't have to be a super athlete or a prize body builder to benefit from strength training. You should however lift weights to help build muscle, which will in turn help delay or prevent bone loss altogether.

How does resistance training help build bone mass during menopause? It stimulates the minerals in your body that help promote strong bones. Resistance training will also help improve your muscle mass, which also contributes to weight loss and helps maintain bone mass over time.

Of course, other forms of exercise including flexibility training and aerobic training are beneficial during menopause. Aerobic exercise will help relieve stress and anxiety, help boost your cardiovascular strength and help you maintain a healthy weight.

Likewise flexibility training will help keep your muscles and joints limber, which in turn will help prevent injury as you age.

Osteoporosis Prevention

Osteoporosis results in a condition where a woman's bones become thin, weak and more susceptible to factures, particularly those of the hip, spine and wrist.

Osteoporosis results when an imbalance occurs between the normal breakdown and formation of bone in the body. Much of the bone loss that occurs in women with the disease is largely the result of menopause, or age related.

Generally starting at about the age of 35 bone density in women beings to decline. Women are particularly at risk because the female hormone estrogen, which helps maintain bone mass, rapidly declines with age, particularly as a result of menopause.

Fortunately there are many therapies available that may help prevent bone loss and even promote new bone formation in women.

The first step however is prevention. Osteoporosis can be prevented if adequate levels of nutrition are ensured among women. Of particular importance is adequate consumption of calcium and vitamin D. Vitamin D works synergistically with calcium, aiding the body in metabolism and absorption.

Calcium Supplementation
The current guidelines recommended are a minimum of 1000 mg of calcium in pre-menopausal women, and 1500 mg in postmenopausal women who are not taking estrogen therapy.

The daily intake of calcium should not exceed 2000 mg however.

Calcium can be acquired through the diet in addition to supplementation. Foods that are high in calcium include dairy products such as milk, yogurt and cheese, certain vegetables including broccoli and fortified juices such as orange juice.

Most health care providers recommend routine supplementation in addition to dietary intake to ensure adequate absorption of calcium. Some forms of calcium are less easily absorbed in the body than others.

Preparations that contain calcium carbonate are less easily absorbed by the body than supplements containing calcium citrate or calcium lactate. Be sure to check the label on any supplement you purchase to determine the form of calcium the supplement is providing.

Studies also suggest that supplementation should be divided into 500 mg doses during the day, so that the body's absorption of calcium in a single sitting does not 'plateau' preventing the maximum benefit from supplementation.

Regular supplementation with calcium and a healthy lifestyle that includes adequate exercise and a well balanced diet can all reduce your risk for developing osteoporosis.

Vitamin D Supplementation
Vitamin D is important for strong bones. Calcium cannot be absorbed without vitamin D. Fortified milk is a good source for Vitamin D. Sunlight helps your skin produce vitamin D after being in the sun for just 15 minutes a day. If you don't wish to be exposed to the sun you can take a vitamin D supplement. However, a woman should not take more than 5-10 micrograms each day. Too much vitamin D can cause health problems.

Exercise to help Prevent Osteoporosis
Women who exercise prudently for at least 30 minutes three times per week will improve their bone mass. Premenopausal women who do exercise will increase bone mass and postmenopausal women who exercise will slow the loss of bone. Bones are strengthened by having the muscles pull on them while exercising. If you do not exercise bone loss will occur.

Most exercise programs that are good for the heart are also beneficial for preventing bone loss. It is never too late to start an exercise program; even walking a little is helpful.