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Midlife and Menopause

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Midlife and Menopause
Tess Strickland
BHSH 371
September 4, 2012
Lisa Kirby

Midlife and Menopause
During a female’s midlife stage, one of the challenges that arise is menopause. According to the Animated Dissection of Anatomy for Medicine Journal or A.D.A.M., this is a natural event which typically occurs between the ages of 45 and 55 (2012). For some women this is easy process; for others it is quite difficult. How one copes with this process depends largely on their physical, emotional, and mental well being. Women usually ease into the process but some women, who have had a hysterectomy or have undergone chemotherapy for breast cancer, are thrust into it, and may experience menopause at a younger age (A.D.A.M. 2012).The following is an informational piece, which touches on the causes, symptoms, coping strategies, and suggested treatment methods of menopause.
Causes
The North American Menopause Society or NAMS (2011) defines menopause as “the reduced functioning of the ovaries due to aging, resulting in lower levels of estrogen and other hormones.” This marks the permanent end of fertility for women. Once a woman’s menstrual cycle has stopped for a period of 12 months or longer, they have entered menopause and are no longer able to bear children. According to NAMS (2011) there is a transitional phase called perimeopause; in which physical signs of menopause appear up to six years before and one year after the menstrual period ends. Postmenopause are the years following menopause. There is no actual calculation on how long menopause lasts, but most experts agree the average amount of time is five years (Wood, Mitchell 2005).
Symptoms
Although the symptoms vary from woman to woman; the most common ones are, according to A.D.A.M. (2012), menstrual periods that occur less often and eventually stop, heart pounding or racing, hot flashes, night sweats, skin flushing, and sleeping problems. Some women also experience decreased interest in sex, mood swings including irritability, depression, and anxiety, headaches, vaginal irritation or dryness, painful sexual intercourse, urine leakage, joint aches and pains, and possible irregular heartbeats (A.D.A.M. 2012). If a woman is experiencing these symptoms but unsure if they are menopause related, doctors can run various tests such as blood and urine tests to look for a loss in hormones. A pelvic exam can also be used to look for changes in the vaginal lining due to decreased levels of estrogen (A.D.A.M. 2012). There are certain risk factors associated with the reduction in estrogen such as possible vaginal bleeding after menopause, bone loss and/or osteoporosis, changes in cholesterol levels, and a greater risk of heart disease (National Institutes of Health 2010).
Coping Strategies
As mentioned earlier, how a woman copes with the symptoms and the process of menopause can depend on their physical, mental and emotional state. Dr Richard Lovett (2003) states, in an article for Psychology Today, that lifelong depression and economic stress can lead to early menopause. He also quotes Lauren Wise, a doctoral student at Harvard University, as saying “that stress, poor nutrition or toxins such as lead or tobacco smoke can lead to the acceleration rate at which eggs are depleted” (2003). Since midlife can already be filled with stressful events, with many demands, managing stress is vital to one’s overall being. Bracy (2007) points out that men and women handle stress differently. In her article Stress-Proofing Your Menopause, she mentions that women do not produce serotonin, an essential neurotransmitter for handling stress and regulating mood, as quickly as men; and that they use it faster. Therefore, when stress uses up the serotonin, women are more likely to suffer from mood disorders like anxiety or depression. She suggests certain stress management strategies such as getting involved in pleasurable activities, finding one’s creative side, talking with other women who are dealing with similar life issues, eating smart, exercising at least three times a week and maintaining a satisfying, relaxed sexual relationship with ones partner (Bracy 2007).
While menopause cannot be prevented, changing one’s lifestyle prior to the process can help minimize the symptoms. Experts suggest women avoid caffeine, alcohol, spicy foods; get plenty of calcium and vitamin D in either foods or supplements and exercise regularly. They also suggest trying yoga, tai chi, or meditation to reduce stress (National Institutes of Health 2010).
Treatments
As with the symptoms, treatment options vary from woman to woman. Some women find their symptoms are minimal and require no treatment. Others may feel they need assistance of some sort in dealing with their symptoms. Should one be considering treatment options, the best course of action is to consult one’s physician before trying anything. The doctor can discuss with the patient risk factors such as age, overall health risks based on ones medical history, and other health risk such as heart disease or cancer and possible natural alternatives (Women’sHealth.org 2012).
Menopausal Hormone Therapy, formally Hormone Replacement Therapy, is one such treatment that is offered. This treatment involves taking estrogen and progesterone; although women who have no uterus due to a hysterectomy do not take the progesterone (WomensHealth.gov 2012). This treatment has been studied and researched immensely since its introduction; experts in the field stopped recommending it as frequently after 2002, when studies revealed links to heart disease (National Institutes of Health 2010). Women who have certain types of cancer, liver disease, heart disease, or who have taken MHT should not use this treatment. However, should one decide to use MHT, the treatment does help with some of the symptoms such as hot flashes, night sweats, sleeping issues such as insomnia, bone loss, and vaginal issues. There are certain side affects when using MHT, such as headaches, bloating, nausea, breast swelling, and possible mood changes. MHT is not a depression medication; if depression is present, the female should seek outside professional help (WomensHealth.gov (2012).
There are alternative treatment methods for those who are concerned with the risks of MHT, such Bioidentical Hormone Therapy or BHT; manmade hormones that are the same hormones the body produces. There are several prescriptions available, through ones doctor, and the products have been tested by the Federal Drug Administration (WomensHealth.gov 2012). Other experts suggest taking soy internally through ones diet, as soy contains phytoestrogens, which may act like the estrogens a females body makes. Herbs such as black cohosh, dong quai, wild yam, and valerian root also contain phytoestrogens. It is important to discuss all medications taken with ones doctor prior to trying herbs (WomensHealth.gov).
Summary
There are options available to women to help them successfully ease through menopause. By keeping one’s self physically active, having healthy relationships, maintaining good mental and emotional health, eating healthy, and limiting toxic intakes, most women manage the symptoms quite well. For those that need additional help, treatment options are available. As with anything concerning ones health, taking preventive measures and being educated are coping strategies that have been proven through research, studies and over great lengths of time.

References
Animated Dissection of Anatomy for Medicine Journal (A.D.A.M.) (2012) Fact Sheet:
Menopause, Retrieved on September 1, 2012 from http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001896/ Bracy, K. RN (2007) Stress-proofing Your Menopause, Retrieved on September 3, 2012 from http://menopause.about.com/od/managingmenopausalstress/a/StssProof_Meno.htm Lovett, R. PhD (2003) “Research on Menopause: Economics, attitude and environment may bring menopause on earlier for some women”, Retrieved on September 2, 2012 from http://www.psychologytoday.com/articles/200305/research-menopause National Institutes of Health (2010) Menopause: Possible complications, Retrieved on
September 3, 2012 from http://www.nlm.nih.gov/medlineplus/ency/article/000894.htm
North American Menopause Society (2012) Menopause Basics, Retrieved on September 2, 2012 from http://www.menopause.org/for-women/expert-answers/faqs-menopause-basics
WomensHealth.gov (2012) Menopause symptom relief and treatment, Retrieved on September 3,
2012 from http://womenshealth.gov/publications/our-publications/fact-sheet/menopause-treatment.cfm#k
Woods, N., Mitchell, E. (2005) “Symptoms during the perimenopause: prevalence, severity, trajectory, and significance in women’s lives” American Medical Journal (ISSN: 1555-
7162), Retrieved on September 3, 2012 from http://menopause.about.com/od/menopausebasics/f/MenoDuration.htm

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