by Kimberly Allen, RN
Menopause is defined as the “permanent cessation of the primary function of the human ovaries”. This means both the release of the hormones and eggs responsible for reproduction are no longer being release by the ovaries. This in turn causes a woman’s menstrual cycle to stop. Perimenopause is the term for the period of time before menopause when a woman’s body is transitioning to menopause. The transitioning phase can vary from a few years to over 10 years.
During the perimenopausal phase the production of estrogen and progesterone is more erratic. The levels of these hormones fluctuate severely and unpredictably. A woman’s ability to reproduce during this time diminishes, however she can still conceive until the date of menopause. The date of menopause is determined after there has been 12 months since a woman’s last period. There is no way to predict the duration of the perimenopause phase or the severity of symptoms each woman will experience.
During the perimenopausal phase women experience many physical changes because of the hormonal fluctuations. The most commonly known change or symptom are the “hot flashes”. “Hot flashes” are the result of a sudden, but temporary, increase in body temperature. This increase usually reaches it’s peak very rapidly. However, it does not return to with in normal range nearly as fast. In fact it is very slow in returning to a normal range which is what causes the sensation of a “hot flash”. These changes in temperature can increas by multiple degrees in a very short period of time. This extreme temperature change can cause the woman to break out in heavy sweating. I can tell you from experience these “hot flashes” can be intense and last as long as 15-20 minutes each. There were times when I would sit outside in below zero weather in a T-shirt ans still be sweating I was so hot. Despite the fact that these extreme temperature changes may be very uncomfortable most Drs do not consider them to be harmful. In addition to the “hot flashes” many women experience other symptoms including mood swings, fatigue and insomnia as well as night sweats and memory problems. The night sweats can range from mild to heavy, personally there were many nights I had to get up and change my night shirt, sometimes ore than once.
There is no way to predict when a woman will begin menopause. There is on correlation between when a woman starts her period and when she starts menopause. The age for most women to begin menopause is usually between 45-55 years of age though it can start as early as 30-40 years of age. In some cases a woman may not begin menopause until in her 60’s. In many cases the age a woman begins menopause is close to the age her mother was when she started menopause. There are also certain medical conditions and surgical procedures that can alter the time a woman begins menopause. For example if the ovaries are removed surgically due to other medical conditions including ovarian cancer the woman would begin menopause immediately. Frequently the ovaries are also removed when a woman has a hysterectomy, which is the removal of the uterus. However, if the woman dies not have the ovaries removed during a hysterectomy the woman does not go into menopause. Even though the woman is unable to have their period the ovaries still produce their hormones until the time when menopause would naturally occur. Certain types of cancer as well as cancer treatments can cause the onset of menopause. Approximately 1% of women experience premature ovarian failure which is one of the causes of menopause before 40 years of age.
Treatments for menopause are focused of relieving the symptoms as well as preventing or managing certain chronic conditions that accompany aging. Estrogen therapy continues to be the most effective and most widely used treatment for relieving symptoms like the “hot flashes”. Other frequently used medications are the bisphosphonates like fosamax and boniva to help prevent or treat osteoporosis. There are a variety of medications available today to help relieve the various symptoms of menopause. Before you make any decisions on the type of treatment you are interested in research all the available options and discuss them with your Dr he/she will be able to help you weigh the risks and benefits of each so that you can make a choice based on your individual needs.