Most women think of menopause as the time of life when their menstrual periods end. This usually occurs during middle age, when women are also experiencing other hormonal and physical changes. For this reason, menopause is sometimes called the "change of life".

What doctors officially call menopause is an event - namely, the point at which you get your last menstrual period. This permanent cessation of menstruation is usually marked by 12 consecutive months of having no periods. Most women experience menopause from 40 to 58 years of age, with a median age of 51.4 years.

A woman is said to be in menopause after she has gone for one full year without periods. While most women in the United States go through menopause around the age of 51, a small number will experience menopause as early as age 40 or as late as their late 50s. Rarely, menopause occurs after age 60. When menopause is diagnosed before age 40, it is considered to be abnormal or premature menopause.

As hormone levels fall, a woman's pattern of menstrual bleeding usually becomes irregular. Many women experience light, skipped or late periods for several months to a year before their periods stop altogether. Some women may experience heavier-than-normal bleeding. It is important to realize that until menopause is complete, a woman still can become pregnant even when periods are light or missed.

For most women, menopause is a normal process of aging. If a woman has had her ovaries removed by surgery or has had damage to her ovaries for other reasons, such as radiation therapy, she may become menopausal from that process.

Some women don't have any symptoms during menopause or only have a few symptoms. Others develop disturbing and even severe, disabling symptoms. Studies of women around the world suggest that differences in lifestyle, diet and activity may play a role in the severity and type of symptoms women have during menopause. Symptoms can be noticed for several months to years before the last menstrual period and can continue for several years after.

A hot flash is a feeling described as suddenly being hot, flushed and uncomfortable, especially in the face and neck. Hot flashes come in bursts or flushes that usually last a few seconds to a few minutes. They are caused by changes in the way blood vessels relax and contract and are thought to be related to the changes in a woman's estrogen levels.

A woman can have irregular periods for several months to years before her periods finally stop. Any vaginal bleeding that develops after a year of no periods is abnormal and should be evaluated by a doctor.

As estrogen levels fall, the vagina's natural lubricants decrease. The lining of the vagina gradually becomes thinner and less elastic (less able to stretch). These changes can cause sex to be uncomfortable or painful. They can also lead to inflammation in the vagina known as atrophic vaginitis. These changes can make a woman more likely to develop vaginal infections from yeast or bacterial overgrowth and urinary tract infections.

Before menopause, women have lower rates of heart attack and stroke than men. After menopause, however, the rate of heart disease in women continues to rise and equals that of men after age 65.

For most women, the diagnosis of menopause is made based on a woman's description of her symptoms and the ending of her menstrual periods. Laboratory testing is not usually needed.

A number of medications are used to treat the symptoms of menopause. The type of medication needed is a complicated decision and each woman should discuss the issue with her doctor. The treatment will depend on what symptoms are most bothersome and how bothersome they are.

Estrogen taken as a pill or applied to the skin as a patch can reduce hot flashes, sleep disturbances, mood changes and vaginal dryness. Estrogen can be prescribed alone when a woman no longer has her uterus. A combination of estrogen and progesterone is used when a woman still has her uterus. Progesterone is necessary to balance estrogen's effect on the uterus and prevent changes that can lead to uterine cancer.

Medications such as venlafaxine (Effexor) and paroxetine (Paxil) are often the first choice for women with hot flashes who are not on hormone replacement therapy. They relieve the symptoms of hot flashes in 60% of women.

Etidronate (Didronel), alendronate (Fosamax) and other similar drugs are the most effective medicines that can be used to both prevent and treat osteoporosis. They increase bone density and decrease the risk of fractures.

The use of soy products in the diet such as tofu may have benefit for some women. Soy has small amounts of phytoestrogens (plant estrogens) that may help relieve hot flashes. Researchers speculate that the soy-based diet of Japanese women plays a role in preventing hot flashes. However, it's not clear whether Japanese women have fewer hot flashes or whether they report this problem less often.

There is no relation between the time of a woman's first period and her age at menopause. The age at menopause is not influenced by a woman's race, height, number of children or use of oral contraceptives.

Headaches, bloating, irritability, depression and fatigue are just a few of the unpleasant symptoms of premenstrual syndrome, which affects millions of women every month. But fortunately, PMS -- though widely believed to be a result of changes in hormone levels during a woman's menstrual cycle -- is not entirely beyond a woman's control.

Menstrual cycling in women results from a complex interplay of reproductive hormones that surge and ebb at various points during the course of an approximately lunar month (28 days).

Research shows that diet and nutrition play a significant role in the severity of PMS symptoms, and many women could ease their monthly bouts with discomfort simply by changing their diets or taking nutritional supplements.

Many women with premenstrual syndrome have high sugar and high dairy fat intakes, both of which lower magnesium values in the blood. Supplemental magnesium appears to be a necessity, particularly in persons who are getting little magnesium from their water.

PMS-sufferers are also frequently deficient in calcium, zinc and B-vitamins, particularly vitamin B6, and can often benefit greatly from supplementation.

Besides nutritional supplementation, women can help prevent PMS by making changes to their diets. Eating more foods rich in omega-3 fatty acids, like fatty fish and green leafy vegetables, is important since omega-3 deficiencies have also been linked to PMS.

Experts still aren't sure exactly what causes PMS. Some research shows that it's related to hormonal changes that occur during a woman's menstrual cycle. The symptoms may arise during ovulation or just before menses, or they may appear, disappear and reappear during the same cycle. For about one in 20 women, the combination is so bad that it creates a general depression that affects the daily course of their lives.

A deficiency of progesterone can exacerbate symptoms of premenstrual syndrome (PMS) and menopausal discomforts, and may increase the risk of osteoporosis.

It is caused by normal changes in breast tissue related to monthly fluctuations in levels of estrogen and progesterone, which cause the glands and ducts in the breast to enlarge. As a result, the breasts become swollen, painful, tender, and lumpy. For many women, these symptoms occur as part of the premenstrual syndrome and usually disappear during or after menstruation.

If you have menstrual problems, you may be able to alleviate them with diet. Scientists have long known that food can influence the female hormone estrogen, affecting menstruation, and that carbohydrates are strongly linked to premenstrual syndrome (PMS). Now research reveals surprising new clues about how certain foods and nutrients, including calcium, manganese, and especially dietary fat and cholesterol, may influence menstruation.

For prevention, we advise that a woman reduce her activities as much as possible for the first three days of her period each month, though this might be an unpopular suggestion to most busy women today. For exercise, we recommend a gentle walk rather than jarring aerobics classes at this time.

Although not everyone agrees on exactly why it happens, it is widely accepted that carbohydrates can act as mood elevators, particularly to relieve certain types of depression, such as the blues that come with premenstrual syndrome and the down moods of seasonal affective disorder.

Definitions

Anxiety

• A state of uneasiness and apprehension, as about future uncertainties.


• Worry or tension in response to real or imagined stress, danger, or dreaded situations. Physical reactions such as fast pulse, sweating, trembling, fatigue, and weakness may accompany anxiety.

Chlorella

• Chlorella is a genus of single-celled green algae, belonging to the phylum Chlorophyta. It is spherical in shape, about 2 to 10 nm in diameter, and is without flagella. Chlorella contains the green photosynthetic pigments chlorophyll-a and -b in its chloroplast. It depends on photosynthesis for growth and multiplies rapidly, requiring only carbon dioxide, water, sunlight, and a small amount of minerals..

Estrogen

• Any one of a group of hormones synthesized by the reproductive organs and adrenal glands in females and, in lesser quantities, in males. The estrogens cause the thickening of the lining of the uterus and vagina in the early phase of the ovulatory, or menstrual, cycle; in lower animals cyclical estrogen secretion also induces estrus, or "heat". The estrogens are also responsible for female secondary sex characteristics such as, in humans, pubic hair and breasts, and they affect other tissues including the genital organs, skin, hair, blood vessels, bone, and pelvic muscles..

Menopause

• The period marked by the natural and permanent cessation of menstruation, occurring usually between the ages of 45 and 55.

PMS

• Premenstrual syndrome.

Perimenopause

• The time period prior to menopause that may last 10 to 15 years, even beginning in one's 30s. It is associated with decreased ovarian function and decreasing estrogen levels.

Progesterone

• Steroid hormone secreted by the female reproductive system that functions mainly to regulate the condition of the endometrium (see uterus), preparing it to accept a fertilized egg. If the egg is not fertilized, the level of progesterone drops, the uterine lining breaks down, and menstruation ensues. If the egg is fertilized, the placenta produces progesterone, whose effects include preparing the mammary glands for lactation..

Biopsy

• Bone marrow aspiration, also called bone marrow sampling, is the removal by suction of fluid from the soft, spongy material that lines the inside of most bones. Bone marrow biopsy, or needle biopsy, is the removal of a small piece of bone marrow.

Climacteric

• A period of life characterized by physiological and psychic change that marks the end of the reproductive capacity of women and terminates with the completion of menopause.


• A corresponding period sometimes occurring in men that may be marked by a reduction in sexual activity, although fertility is retained.

Depression

• In psychiatry, a symptom of mood disorder characterized by intense feelings of loss, sadness, hopelessness, failure, and rejection.

Estrogen

• Any one of a group of hormones synthesized by the reproductive organs and adrenal glands in females and, in lesser quantities, in males.

Hormone

• A substance, usually a peptide or steroid, produced by one tissue and conveyed by the bloodstream to another to effect physiological activity, such as growth or metabolism.

Osteoporosis

• A disease in which the bones become extremely porous, are subject to fracture, and heal slowly, occurring especially in women following menopause and often leading to curvature of the spine from vertebral collapse.

Premenstrual syndrome

• The syndrome occurs in several distinct forms: emotional upheaval, including anxiety, irritability, insomnia, depression, forgetfulness, confusion, and lethargy; cravings for sweets, increased appetite, and intolerance to sugar (headache, heart palpitations, fatigue, and fainting); and fluid retention symptoms with weight gain, puffiness of hands and feet, breast swelling and tenderness, and abdominal bloating and tenderness. Some women suffer with symptoms of all these forms, others only a few..

Progesterone

• A drug prepared from natural or synthetic progesterone, used in the prevention of miscarriage, in the treatment of menstrual disorders, and as a constituent of some oral contraceptives.


• A female hormone that acts on the inner lining of the uterus and prepares it for implantation of the fertilized egg.

Stress

• A state of extreme difficulty, pressure, or strain.


• A physical and psychological response that results from being exposed to a demand or pressure.

Testosterone

• A white crystalline steroid hormone, C19H28O2, produced primarily in the testes and responsible for the development and maintenance of male secondary sex characteristics. It is also produced synthetically for use in medical treatment.

Job listings and descriptions here.