MENOPAUSE

The active reproductive period in women lasts some thirty-five years. At about age 47, on the average it comes to an end in the so-called change-of-life climacteric. Climacteric is a broader term used to describe everything that happens during the change of life. In addition to the stoppage of menstruation, ovulation also ceases, therefore there are no eggs available for fertilization and the ovaries stop producing female hormones. Hormone production, in fact, may begin to decline ten or more years before a woman becomes completely menopausal. The adrenal gland continues to produce some estrogen after the menopause, but not enough. Therefore, some of the symptoms of the climacteric may occur while menstrual flow still goes on.

Technically, the term "menopause" refers only to the ceasing of menstrual flow, and a woman is said to be menopausal when she has not had a period for 12 consecutive months.

This discussion pertains to natural menopause. There is also surgical menopause – caused by surgical removal of the ovaries - which is not discussed here.

Manifestations of menopause vary greatly. A few women are barely aware of the transition, and the average healthy person experiences only moderate discomfort. In a certain proportion of women, however, the menopause is marked by such distressing discomfort as irritability, difficulty in concentration, headache, mental depression, restlessness and insomnia. The sympathetic nervous system shares in the heightened irritability of the transition period. Thus is explained a tendency of the blood pressure and the pulse rate to increase under relatively slight stimulation and of the skin to flush easily. This phenomenon is accompanied by subjective sensations of discomfort -the well known hot flashes.

At least two problems associated with menopause are definitely caused by estrogen deficiency: the notorious hot flashes and a condition known as vaginal atrophy ( the drying and shrinking of vaginal tissue).

Hot flashes – estrogen deficiency knocks the whole hormonal network temporarily out of balance. When this happens, blood vessels dilate abnormally, the sweat glands become over-active, and an unpleasant hot flash is experienced in a wave that sweeps the breasts upward. Then, after three or four minutes, the vessels contract rapidly, sweat gland activity ceases and skin becomes abnormally pale, cold and clammy. Some women have a series of flashes every few minutes, finding it impossible to sleep or carry on any sort of normal activity.

Estrogen – known for many years is important for the health of the vagina. When the estrogen supply is turned off, the vaginal tissues begin to atrophy, and its natural defense mechanisms are greatly reduced.

A large number of doctors believe that estrogen also has an important effect on bone metabolism, because in its absence bone mass begins to deteriorate in some women, resulting in a condition known as osteoporosis (a disease that afflicts far more women than men). Symptoms include backaches, brittle, easily fractured bones and loss of as much as six inches in height because of tissue breakdown between joints.

Medical science has made huge advances. Hormone therapy may make some of of the more serious symptoms of menopause, such as hot flashes and vaginal atrophy,  things of the past. New therapies may even retard some of the outward manifestations of aging, such as, wrinkling and sagging of the breast; help prevent obesity, heart disease and degeneration of bone. Some medical practitioners also believe that hormones act as psychological boosters on the female sex drive.

The truth is that a majority of women go through menopause without any major emotional difficulty.

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