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With
Childbearing Behind Her, and One-third Of Her Life
Ahead…
MENOPAUSE
SIGNALS MEANINGFUL
CHANGES
There is something about the word menopause that
conjures up all kinds of unpleasant images…shrouded in
mystery, and obscured by myths and grandmother’s
horror stories. After a woman reaches 40 or so, the
dreaded “change of life” gets blamed for everything
from a temporary mood swing to a decision to go back to
work.
There is no question that
over the years, menopause has gotten a bum wrap. Far too
many women approach this time in their lives with
fearful apprehension, half believing that their
productive years might truly be over. A recent opinion
survey revealed that only 27 percent of 500 women polled
by National Family Opinion felt that they had enough
prior information about menopause. Without knowledge,
menopause can indeed be a frustrating and frightening
experience.
Today, with Baby
Boomer’s approaching 50, there are an increasing
number of women entering the menopausal years who have a
voracious appetite for information about managing their
health during the middle years. Armed with the facts,
women are coming to view menopause as neither a
catastrophe nor the end to a happy and meaningful
existence. More and more women in their fifties and
beyond are proving that they can hold their own in the
boardroom and the bedroom.
BOTH A BIOLOGICAL AND
EMOTIONAL EVENT
Menopause, or the female
climateric - a term derived from the Greek word meaning
“top rung of the ladder” - is the stage in a
woman’s life during which ovulation and menstruation
cease. Somewhere between the ages of 45-55, women
typically experience a year or two of irregular periods,
fluctuations in body temperature, and some other
unfamiliar and vague physical or emotional symptoms.
About 1.5 million
American women enter menopause each year. While the age
at which this happens may vary widely, the “average”
age of menopause is 51 - in an expected life span of 78
years. The biological impact of the change does not
happen overnight; it is a gradual process that is
divided into three stages that may cover as much as ten
years.
The first is premenopause,
when the ovaries gradually decrease their function.
Periods become irregular- more infrequent in some cases,
or for other women two back to back and not another one
for six to eight weeks. Many women say that their
periods are lighter while others complain of a very
heavy flow for one or two days, followed by days of
spotting. All these are consistent with a decline in
ovarian function and changing hormonal levels.
The second stage is
menopause itself. There is a further decline in ovarian
function and periods cease completely. After a woman has
gone for an entire year without menstruating, she enters
the third-postmenopausal- stage of life. Ninety- five
percent of all women have gone through menopause by age
55.
THE SYMPTOMS VARY
Just as it is difficult
to predict with any certainty when menopause will occur,
knowing ahead of time how the process will affect a
woman is equally hard to accomplish. Some are virtually
unaware of it until they realize that several months
have elapsed between periods, but others find themselves
suffering from a full range of unpleasant and
frightening symptoms. The only thing that ALL women
experience is the marked change in hormonal status as
they proceed through menopause.
It is these hormonal
changes that are at least partly to blame for the wide
range of symptoms. As the ovaries cease to function,
they no longer produce estrogen. This causes the
pituitary gland to send out more luteinizing hormone (L.H.)
and follicle-stimulating hormone (FSH) in a last - ditch
effort to entice the ovaries into action again. Although
most menopausal symptoms are generally attributed to a
lack of estrogen, for many women it is the high levels
of LH and FSH that trigger the problems.
As all these hormones
begin to interact, it is not unusual for woman to feel
off balance and “strange”. When you consider that
there are 300 different tissues in a woman’s body that
respond either directly or indirectly to the estrogen,
it is not surprising that withdrawal from the hormone
could produce such a multitude of symptoms.
The classic symptom of
menopause is the “hot flash” - medically known as a
vasomotor instability - when the skin temperature rises,
then falls, and is accompanied by sweating and heart
palpitations, nausea and anxiety. There is a sudden rush
of heat to the upper body, starting in the chest area
and rapidly spreading upward to the face, neck and arms.
The skin reddens and breathing may also become more
shallow. In some women, the hot flash is accompanied by
an itching sensation. As the episode passes, the woman
may feel chilly and drained. It may last for only a few
minutes and may go totally unobserved by those around
her.
While the exact cause of
hot flashes is unknown, some researchers believe that
falling estrogen levels prompt an overreaction by the
hypothalamus, the region in the brain that regulates
body temperature. These hot flashes can occur only once
a month or several times in an hour; they may begin
months before menopause stats and continue for years
after periods end. A recent survey revealed that three
out of four women experience them. For some women, they
may be brought on by stress, exercise or entering a warm
or cool room. Caffeine and alcohol seem to aggravate
their symptoms.
Menopause does not send
women into full clinical depression as was once
believed. Estrogen withdrawal does, however, produce a
drop in the production of endorphins, the brain’s
“feel good” substances, so it is logical that there
would be some emotional adjustments as hormone levels
change.
There’s another reason
for women to feel irritable and stressed out. Falling
estrogen levels, scientists believe, may also produce a
decline in dream-rich REM sleep. Wakeful nights for
months on end, punctuated by occasional night sweats,
would ten to make anyone feel on edge.
Many women complain - if
they talk about the subject at all - about vaginal
itching and other troubling symptoms like dryness and
discomfort during intercourse. These symptoms, too, are
the direct result of lower estrogen levels but are
unfortunately interpreted by many women as an indication
that their sexuality is about to come to a screeching
halt.
While changes that often
occur in the urinary tract may be linked to falling
estrogen levels, some may also be related to muscle
weakness or damage from an earlier childbirth; either
can cause bladder control problems. Estrogen stimulates
collagen, the fibrous support tissue woven into the
walls of the bladder and other organs. As the amount of
collagen decreases, the bladder shrinks, and pelvic
floor muscles weaken causing incontinence.
The same vasomotor
irregularity that triggers hot flashes is also believed
to be the cause of rapid heartbeat or palpitations
during menopause. They are generally harmless, but can
be frightening and troubling nonetheless. Any
irregularities in heartbeat should be checked out with
your physician, who may prescribe medication such as a
low dose of beta-blocker.
While none of these
short-term symptoms can be considered life threatening,
they could certainly do damage to a woman’s quality of
life. The late 40’s and 50’s - often called Middle
Age - are years that involve change and reassessment for
both men and women. By this time, a couple’s children
are often grown and are leaving home (the empty nest
syndrome); the choice career opportunities may be going
to younger and more energetic employees; and there are
signs in the mirror that can no longer be ignored -
graying hair, new wrinkles and proof that gravity does
indeed exist. Coming to grips with these changes, and
the emotional upheaval that they sometimes produce, can
be a real challenge.
Just as the specter of
menopause haunted our mothers and grandmothers, the new
image of today’s “superwoman” sailing through
menopause undaunted can be equally damaging if it makes
some women feel like a failure. Every woman is different
and her experience will be unique, as well.
Today, there is
absolutely no reason for women to fear menopause and the
changes it will produce. Access to accurate and timely
information can help demystify the process and provide a
good foundation for women to discuss their concerns with
their doctor. Just knowing that they are not alone in
experiencing strange symptoms and that there are
medications and therapies available to assist them in
“getting through” menopause helps many women.
Ask your doctor how you
can minimize the symptoms of menopause and how to
protect your health during the middle years. You’ll be
glad you did.
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