Menopause

Menopause

 

Menopause is a natural physical transition that every woman experiences as she ages. It is often loosely defined as the final cessation of menstruation in a woman's life. This implies an abrupt and complete transition, although the actual process is typically quite gradual.

While most women undergo this change between the ages of 48 and 52, some women stop menstruating as young as their late thirties or early forties, and others continue to menstruate into their mid-fifties.

The process leading up to menopause begins with a slow-down in the function of the ovaries, generally about five years before the last menstrual period, and additional physical and emotional changes continue for several years after the last period.

What Happens during Menopause
During this time, there is a change in the hormonal balance, with a decrease in the amount of estrogen produced by the ovaries. Finally, there is such a low level of estrogen production that periods become irregular, eventually stopping altogether.

As the menstrual cycles cease, the level of progesterone also decreases. Together, these hormones influence and regulate a number of physical and emotional functions, and with changing levels of both, many women experience more than just the cessation of menstruation.

Menopause sets in motion a number of physiological changes that may impact a woman's sexual functioning. The decreased levels of estrogen and progesterone during and after menopause cause the lining of the vaginal walls to thin and become more rigid. In addition, the production of vaginal lubrication drops off, contributing to discomfort during intercourse.

Estrogen-replacement Therapy for Menopause
Helping to counter these changes for many women is estrogen-replacement therpay. But its risks may outweigh the benefits for women with cardiovascular disease, breast cancer, or uterine cancer in their histories. Estrogen suppositories or creams, which contain much lower doses of estrogen and are used over much shorter periods of time, are another option for maintaining the viability of the vagina.

For women who cannot, or prefer not to use estrogen treatments, water-based vaginal lubricants effectively alleviate vaginal dryness at the time of intercourse.

Menopause need not signal the end of a woman's sexual interest or activity, as was assumed to be true in the past. It is not the loss of estrogen, but the beliefs and attitudes about sex and menopause, or aging, that seem to be important to sexual desire and activity.

In recent years it has become clear that not only does interest in and capacity for sex continue well beyond menopause, but that many women report an increased enjoyment of sex because worries about unwanted pregnancy are no longer a concern.

Some women experience this as a smooth transition with little physical discomfort, while others experience many uncomfortable accompanying symptoms such as hot flashes, night sweats, mood swings, irregular heavy bleeding, osteoporosis, and vaginal dryness (which may lead to painful sexual intercourse).

Symptoms of Menopause
As many as 80 percent of women going through menopause experience some negative physical reactions. Women experience worse symptoms if they are undergoing severe emotional stress or have certain dietary habits that include excessive caffeine, sugar, or alcohol consumption.

Hot flashes are one of the most uncomfortable problems that menopausal women complain about. While most women experience hot flashes lasting two or three minutes, others last longer, even up to an hour. Roughly 80 percent of women going through menopause experience hot flashes, and for about 40 percent of those women the symptom is so distressing that they seek medical attention.

Some women have noticed that drinking coffee or alcohol can at times bring on hot flashes. Some women find relief from certain symptoms with the help of hormonal replacement therapy, in which various regimens of estrogen, progesterone and androgens are taken.

Other Helpful Remedies for Menopause
In addition to the hormonal treatments, other remedies that have been found helpful for the depression, irritability and anxiety experienced by some women include the use of tryptophan (an amino acid that has a calming effect, also naturally occurs in hot milk, beef, tuna, chicken, eggs and spinach), mild herbal teas (such as camomile and valerian root, taken at bedtime), regular exercise and relaxation.

As with any health issue, menopause is yet another life experience that is eased with good self-care, exercise and a healthy diet. Whole grains, legumes, vegetables, fruits, seeds and nuts, smaller portions of meat and unsaturated oils are all preferable to a diet laden in salt, sugar, caffeine, alcohol, dairy products (other good sources of calcium include green leafy vegetables, beans, peas, soybeans, fish, carob, and chicken stock made with bones), and fats.

Premature menopause can result from a variety of causes. One of these is the surgical removal of both ovaries as part of a hysterectomy to treat ovarian cancer or other cancers of the reproductive system, severe endometriosis, life-threatening infections, or to protect women from perceived risk of future cancer.

Early Menopause for a Small Few
About 5 percent of all women inherit a tendency toward early menopause from their mothers and are born with thousands fewer eggs than most women. Others inherit an autoimmune disorder in which their own immune system destroys healthy ovarian cells for as yet unknown reasons. These women tend to experience an earlier onset of menopause and range of symptoms than seen in the majority of other women.

The unpleasant side effects of going through menopause may be amplified by the meanings that menopause has for a woman. Some may see menopause as a sign of getting old; others may grieve the loss of their childbearing years. This phase of life may occur at the same time as other significant life changes: children may be entering college, parents may be getting older and may require more care, and women may begin to experience significant losses of relatives or spouses through death. The experience of menopause may be eased by viewing it in the context of other stresses that might be occurring in a woman's life.

Often allowing one to grieve the losses that are being experienced will paradoxically offer some relief to the adjustment to this normal phase of life. Finding someone supportive to talk to, such as someone older who has successfully made this transition, may be helpful. A holistic approach that addresses the physical, medical and emotional challenges that accompany menopause will ease the transition into what can continue to be a very enjoyable and rewarding time of life.

Male Menopause: A Recent Concept
Male menopause is a relatively recent concept referring to a kind of emotional or psychological crisis that occurs for some men during their 40s, 50s or early 60s. Because men do not menstruate, menopause is a somewhat inappropriate term for this male phenomenon. It is also referred to as mid-life crisis.

Male menopause or mid-life crisis typically manifests itself as symptoms of depression for no obvious reason, intense reflection on the direction one's life has taken as well as on what the future holds, and perhaps some personality and behavioral changes that may put a strain on relationships.

Just as estrogen production diminishes in women during menopause, so does testosterone production in males during this stage of life. The physical consequences are much less dramatic for men than for women, but some men do experience changes. These include taking longer to achieve an erection, less strongly felt ejaculation, and a longer refractory period (after ejaculation, the time it takes for a man to be able to ejaculate again).

Symptoms of Male Menopause
Most men also experience gradually declining levels of strength and endurance. On the other hand, ejaculatory control is likely to be increased, and the man remains fully able to cause a pregnancy. Furthermore, regular physical conditioning can combat much of the decline in strength and endurance.

For some men, the physical changes of mid-life signal a threat to their masculinity and virility, setting in motion psychological distress and behavioral changes. There are those men who experience mid-life as so threatening that they seek to prove their youthfulness, strength and virility by seeking out multiple sexual encounters, perhaps with younger partners, or by participating in strenuous physical activities.

Not all men experience male menopause, and of the men that do, only about 25 percent are profoundly affected. The duration of a mid-life crisis is highly variable. It may be concentrated into a few months, or it may last up to several years.

Generally, having a supportive and understanding family and being able to discuss the ongoing concerns of mid-life will help men negotiate this sometimes troubling time without major residual problems.