Menopause

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Menopause

• Why is understanding menopause important?
• The basics Perimenopause
• The basics Menopause
• The change - A misunderstood period of life

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I. Why is understanding menopause important?
A. Numbers
Increase in US population aged over 55
Source US Bureau of the Census, International
Database
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B. Menopause is related to health

• increased risk for developing two significant
  diseases osteoporosis and heart disease

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II. The Basics Perimenopause

• Overview
• Years immediately preceding and following the
  last menstrual period -
• during this time the following processes are
  occurring within a woman's body
• ovaries release eggs less regularly
• ovaries gradually produce less estrogen and other
  hormones
• fertility decreases
• menstrual cycles shorten, there are fewer
  ovulations, and more cycle irregularity

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B. Perimenopausal symptoms

• mood changes
• changes in sexual desire
• difficulty in concentrating
• joint and muscle aches, frequent urination
• similar symptoms as experienced with premenstrual
  syndrome (PMS)
• Treatment of symptoms
• low-dose birth control pills

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III. The Basics Menopause

• Overview
• Cause?
• Decreasing of follicle cells
• Hypothalamatic changes in the brain cause ovaries
  to increase the of follicle cells recruited
  premenopausally, thereby rapidly depleting the
  follicle cells
• Result
• Most women enter complete menopause between the
  ages 45-55 (mean age 51),
• Premature menopause

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B. Modes of induction

• Natural menopause ovaries begin to fail to
  respond to the LH FSH which are still released
• Surgically induced menopause total
  hysterectomy, bilateral sapingo-oophorectomy,
  and/or chemotherapy
• Ovaries not present to respond to LH/FSH

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C. Symptoms of menopause

• Different for each woman!
• Hot Flashes a sensation of internally generated
  heat beginning in the chest and moving to the
  neck head or spreading throughout the body
• Accompanied by increased heart rate, temperature,
  shallow breathing, sweating followed by chills
• Early symptom of estrogen deficiency
• Treatment
• Deep breathing, reduced stress

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• Vaginal atrophy
• May impact sexual desire
• Vaginal lubricants can help this, sexual activity
  lessens the effect
• Atrophy of the urinary tract urinary
  incontinence diminished muscle tone
• Sleep disturbance,
• Increased weight
• Changes in hair growth skin (estrogen effects
  collagen)

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D. Menopause Management

1. Lifestyle changes

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• Non-prescription options
• Vitamins minerals
• Vaginal lubricants moisturizers
• Acupuncture
• Phytoestrogens (plant estrogens)
• Watch out for herbal alternatives that claim to
  cure cancer, prevent heart disease or reverse the
  effects of osteoporosis

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1. Hormone Replacement Therapy (HRT) medically
   supervised drug treatment of menopausal women
   which involves supplementing hormone levels

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Benefits of EPT and ET

• reduce the risk of osteoporosis.
• relieve hot flashes and night sweats.
• relieve vaginal urinary atrophy.
• improve cholesterol levels.
• reduce the risk of cancer of the colon.
• may reduce macular degeneration.

• Women's Health Initiative (WHI) clinical trial
  a turning point!
• Researchers found combination

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Risks of HRT

• EPT and ET modestly increase risk of breast
  cancer while they are being used long-term use
  may pose the greatest risk.
• EPT and ET may increase the risk for blood clots.
• EPT and ET can have unpleasant side effects, such
  as bloating and breast tenderness.
• EPT and ET in pill form can raise level of
  triglycerides (a type of fat in the blood).
• ET may increase the risk of dementia.
• ET increases the risk of stroke.
• ET increases the risk of cancer of the uterus.
• It's all in the timing Age is an important
  factor
• ET
• For some women such as those who experience
  moderate to severe hot flashes or other
  menopausal symptoms

http//www.nih.gov/PHTindex.htm
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IV. The change Currently, a misunderstood
period of life

• Cultural bias
• Neglected as a research area we still dont
  know what triggers menopause or how symptoms
  should be treated best

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B. Not simply the end of the road A time of
freedom empowerment

• Freed up energized
• To airbrush age off a womans face is to erase
  womans identity, power and history. Naomi Wolf
• My fantasy of aging is to age well enough so
  that younger women would think, Gee, I wish I
  were her age. I want the stigma of aging to be
  removed from women and for myself, I intend to do
  it with as much panache as I can. I am going to
  put everything Ive got into it. Claire
  Braz-Valentine
• In my fifties, I feel ripely quiet. Life seems
  simpler I am more appreciative. Ruth Zaporah

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For discussion

• Why has medical research been slower to
  understand the physiological dimensions of
  menopause than other reproductive health matters?
• What can be done to continue to change societal
  images of menopause, aging, and older women?
• How should menopause be viewed?