Menopause

Menopause is a condition all women go through at some time in their lives. It means the cessation of the production of eggs and the cessation of the menstrual cycle. Women can undergo menopause in their thirties but generally undergo it in their early to mid fifties. It is preceded by pre-menopause or perimenopause, where the ovaries are still somewhat functional.

Menopause is generally a natural process; however there are certain medical conditions that trigger menopause earlier than normal. For example, if a woman has a hysterectomy and her ovaries are removed, she goes into sudden and immediate menopause. There is no perimenopausal phase when there is a surgical menopause.

Women who have chemotherapy or radiation therapy for cancer can have the ovaries affected enough to go into menopause. A total of 1 percent of women undergo premature ovarian failure, which involves having menopause before the age of forty. This is often due to genetic factors or due to autoimmune diseases but can be idiopathic.

A woman is considered in menopause if she hasn’t had a menstrual period for a year. The symptoms and signs of menopause, though, can appear for years before the actual time of menopause. Symptoms include decreased fertility, hot flashes, irregular periods, mood swings, sleep problems, vaginal dryness, increased fat around the midsection, thinning hair and a loss of the fullness of the breasts. The symptoms can be mild and not need any treatment or they can be so severe that treatment is necessary in order to get through it.

One can tell a person is in menopause just by tracking the symptoms a person has or the doctor can check an FSH level to decide whether or not the person is in menopause. FSH stands for follicle stimulating hormone and is a brain chemical that is normally blocked by estrogen and progesterone release from the ovaries. When the ovaries fail to produce estrogen and progesterone, the FSH level increases and above a certain value can indicate a person is in menopause. Doctors also recommend checking a thyroid stimulating hormone or TSH because low thyroid conditions are common around the time of menopause.

The treatment of menopause depends on the symptoms and how severe they are. Menopause itself doesn’t require any treatment unless a woman desires treatment. The mainstay of treatment is hormonal therapy in the form of estrogen and progesterone, which are good treatments for hot flashes. In some cases, low dose antidepressants have been found to reduce hot flashes, particularly the SSRI class of antidepressants. They can also help with the mood swings of menopause.

Neurontin, also known as gabapentin, is an anti-seizure medication that has been found to improve hot flashes. Clonidine, given as a pill or a patch is a medication used to treat high blood pressure but also reduces hot flashes in menopausal women. Bisphosphonates are often used to treat osteoporosis that is at an increased risk during and after menopause. It is commonly prescribed to women going through menopause as a preventative. Medications like Evista can also be prescribed in menopause for osteoporosis. Some women get by on vaginal estrogen cream that reduces atrophic vaginitis or vaginal dryness so common around menopause.