Menopause Health Article

Menopause

Young girls start menstruating between the ages of eleven and thirteen, when their reproductive systems reach maturity. Women have regular menstrual cycles every twenty-eight days until about the age of fifty, at which time menstruation becomes irregular. This irregularity signals the start of menopause. The natural cessation of menstruation occurs due to reduced production of the female hormones estrogen and progesterone, which generally occurs between the ages of forty and fifty-five. The age at which a woman enters menopause is affected by genetics, race, and environmental factors. Women can also go into premature menopause, either naturally or due to oophorectomy (the surgical removal of the ovaries).

Stages of Menopause

Women go through different phases of menopause, including perimenopausal, menopausal, and postmenopausal periods. During the perimenopausal period, the regular cyclical occurrence of menstruation is disrupted and menstruation becomes irregular. This phase may last anywhere from six months to a year. During the perimenopausal period, production of estrogen is reduced, and eventually stops. Menopause is defined as the cessation of the menstrual period. Women are described as postmenopausal when they have gone one year without a menstrual period.

Physiological Changes

The lack of estrogen and progesterone causes many changes in women's physiology that affect their health and well-being. These changes include:

• Elevated levels of total cholesterol and LDL-cholesterol, which increases the risk of coronary heart disease (CHD) in women. During the reproductive years, estrogen prevents increased levels of blood cholesterol and maintains the activity of estrogen receptors in women, thus preventing the risk of CHD.
• Calcium loss from the bones is increased in the first five years after the onset of menopause, resulting in a loss of bone density. This bone loss then tapers off until about the age of seventy-five, when calcium loss accelerates again. This predisposes women to the risk of osteoporosis and bone fractures.
• The body composition of menopausal women also changes, with the percentage of body fat increasing and muscle mass decreasing. The increase in body-fat percentage is believed to be partly due to decreased physical activity.
• Decreased muscle mass reduces the rate of basal metabolism, which may be responsible for weight gain at this period of a woman's life.
• The abdominal-fat storage that occurs in women at this stage increases the risk for cardiovascular disease.
• The tissues in the urinary tract and reproductive organs atrophy.

Some other transient but unpleasant symptoms of menopause include hot flashes, fatigue, anxiety, sleep disturbance, and memory loss.

Treatments and Remedies

Menopausal women are faced with many choices in terms of treatment or remedies for these problems. Some of the treatment choices are experimentally proven to be effective and relatively harmless, while other options such as herbs, teas, and dietary supplements have not been subjected to scientific experimentation and have not been proven to be without harm.

Estrogen replacement therapy (ERT) is the often-used medically prescribed treatment for menopausal and postmenopausal women. Although some studies have indicated a decreased risk of CHD and osteoporosis with ERT use, others have indicated it may increase the risk of breast cancer. The Women's Health Initiative, which was designed to study the effects of ERT on the health of elderly women, stopped the ERT part of the research in July 2002. The preliminary result of that study showed the risk of CHD was, in fact, increased in women on ERT.

Scientific investigations have shown that physical activity, including aerobic and muscular strengthening exercises, not only prevent bone mineral loss, they also help alleviate many menopausal symptoms, including the increased percentage of body fat, abdominal-fat storage, hot flashes, fatigue, and sleep disturbances.

Phytoestrogens, which are present in foods such as soy, red clover, flaxseed, and other beans and legumes, are natural plant estrogen-type chemicals that can help replace human estrogen without some of the risk factors of ERT. Epidemiological observations indicate that in some cultures where soy is a staple food, women do not suffer from hot flashes during and after menopause. The results of human experiments designed to study the effect of soy products on alleviating symptoms during menopause are new and inconsistent, but promising. In addition, the isoflavones in soy products are strong antioxidants and may be effective in reducing the risk of CHD in women of menopausal age.

Herbal supplements promoted by the supplement industry to prevent hot flashes, anxiety, sleep disturbances, and other symptoms of menopause have not been scientifically studied, and since the chemical composition of these supplements is not always known, they may contain harmful substances. Thus, these kinds of supplements are not generally recommended for menopausal women.