Department of Obstetrics, Gynecology and Reproductive Science
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Reproductive Endocrinology and Infertility: Menstrual Concerns
The period of time leading up to menopause is often characterized by irregular periods. In fact, changes such as shorter or longer periods, heavier or lighter menstrual bleeding, and varying lengths of time between periods may be a sign that menopause is near. Declining estrogen levels are linked to some uncomfortable symptoms in many women. About 75% of women report some troublesome symptoms during menopause. The most common and easy to recognize symptom is hot flashes - sudden intense waves of heat and sweating. Some women find that these hot flashes disrupt their sleep, and others report mood changes. Other symptoms may include irregular periods, vaginal or urinary tract infections, urinary incontinence (leakage of urine or inability to control urine flow), and inflammation of the vagina. Because of changes in the urinary tract and vagina, some women may have discomfort or pain during sexual intercourse. Many women also notice changes in their skin, digestive tract, and hair. In the long term, some women experience problems related to the low levels of estrogen found after menopause. These problems include osteoporosis - a loss of normal bone density - and increased risk for heart disease. Estrogen is also now known to be important in memory and the healthy functioning of nerve cells in the brain. Some studies have shown that estrogen replacement therapy can preserve brain activity and even improve memory. Treatment of menopausal women with replacement hormones can also slow the rate of bone thinning and may prevent bones from breaking. In addition, it is important that women take in enough calcium in their diet to strengthen the bones. Calcium is naturally found in many foods, including dairy products, and may also be added to a food (for instance, some orange juices now have calcium added). Calcium tablets are another good way to add calcium to your diet. The goal should be to reach a total daily intake of 1000 milligrams per day before menopause or 1500 milligrams per day after menopause. Regular weight-bearing exercise, like walking, may also help prevent osteoporosis. The rate of heart disease rises considerably in women after menopause, an increase that can be prevented by estrogen replacement. Some experts believe that estrogen replacement therapy may be the single most important factor in preventing heart disease in women. For more information on menopause, visit the North American Menopause Society's Web site at http://www.menopause.org. |
enopause is the medical term for the end of a woman's menstrual periods. It is a natural part of aging that occurs when the ovaries stop making hormones called estrogens. When estrogen levels subsequently drop, monthly menstrual periods end. The average age of menopause is 51, but younger women can undergo menopause when the ovaries are surgically removed or stop functioning earlier.