Body every woman has their own biological rhythm so installation time of menopause and its duration varies. There is a high probability that the time of the menopause to be identical to the mother. However some lifestyle and pharmaceutical treatments can cause or are correlated with early menopause:
-smoking. Middle-aged women, smokers reach menopause soon, 1 year and a half faster than those who do not smoke. As the period is longer cigarette consumption and the amount is higher as the stronger will be the effect
Ablation, radiotherapy or pituitary
-Chemotherapy
Radiotherapy or other treatment-abdominal or pelvic area that affects the ovaries
, And genetic diseases autoimmune
, Bilateral ablation of ovaries leading to sudden artificial menopause
, Living at high altitudes
-Vegetarian diet.
Although some women have few symptoms or no symptoms menopause announced, most shows a multitude of symptoms. Similarly, while some women have mild symptoms and others sleep, daily life and severely impaired general condition. It relieves symptoms when hormones is balanced. Changes in the postmenopausal period are normal and keep in time characteristic of the period.
Signs of perimenopause:
-Irregular menstrual cycles
and rare-light cycles
Unusual heavy-cycles.
Symptoms of menopause
Characteristic symptoms of menopause are due to changes in hormone levels or decrease and still remain one or two years after menopause. Some women have symptoms for other five or more years, postmenopausal. Symptoms are:
-Hot flashes (sudden and transient sensation of warmth felt on face, neck, chest, accompanied by sweating and shivering)
-Sleep disturbances (Insomnia)
-Emotional disorders, mood changes or irritability
Life-changes in sexual interest or sexual response
-Concentration or memory problems related to sleep disorders and hormonal changes
-Migraine (Headache)
-Tachycardia (palpitations)
-generalized pruritus (Itching).
Post-surgical artificial menopause by chemotherapy or radiotherapy may be associated with more severe symptoms than usual. Prodromal conditions (announcing the menopause) as depression, Anxiety, sleeping problems or irritability is accentuated during perimenopause transition.
Signs of menopause
Signs announcing that menopause are:
-Lack of menstrual periods (the woman does not need contraception)
-Dryness and thinning skin, due to the decrease of collagen production
-Vaginal and urinary changes as:
- Sensation of vaginal dryness, irritation and itching
- Increased risk of vaginal and urinary tract infections
- Pain during intercourse (dyspareunia)
Bone-loss (osteopenia).
Other conditions may cause changes in menstrual cycle or symptoms resembling those of perimenopause or menopause. Examples: load, significant variations in weight, depression, anxiety, disease, diseases of the uterus, thyroid or pituitary gland.
At the end of the third decade begins to decrease the number of ovulations quality and ovulation. Hormone production decreases as a result, we can see a shortened menstrual cycle and some premenstrual syndrome symptoms.
Perimenopause
As ovulation become irregular decreases in parallel with menstruation. This period can be installed no earlier than the end of the third decade or later to start the fifth decade and continue another 2 to 8 years before menstrual cycles end. During this period the ovaries produce estrogen and sometimes too much or too little progesterone and some other time. Progesterone vary more during this period leading to bleeding menstrual abundant. If the woman shows vaginal bleeding heavy and sudden see your specialist to rule out other more serious causes.
Menopause
Before 6 months to a year of continuous menstrual cycles stop estrogen begins to decrease. When you reach a certain level menstrual periods stop. After a year without menstruation is considered menopausal woman reached.
Postmenopausal
During the first year after menopause estrogen levels continue to drop. It is normal to have symptoms like hot flashes or insomnia during the first year after menopause. Once these symptoms gives balanced hormone levels. However, in some women the symptoms persist for years and an explanation would be very low estrogen level. After menopause, fat tissue continues to produce less estrogen and fat women have lower estrogen levels.
Low levels of estrogen are part of the post-menopause. Low level of estrogen decreases the risk of cancer (estrogen is linked with some types of cancer cells). However, because estrogen plays an important role in skin and bones, low levels cause health problems in postmenopausal women:
Bone-mineral loss (demineralization) - Low levels of estrogen after menopause accelerates mineral loss, increasing the risk of future osteoporosis
Skin-change them - the low level of estrogen leads to low production of estrogen which is support the skin and form bridges. Skin wrinkles, Thin and dry are normal after menopause. Lower urinary tract and vaginal mucosa thins and weakens also. These changes affect sexual activity becomes more difficult and increases the risk of vaginal and urinary infections.
-Changes of teeth and gums - low production of estrogen affect connective tissue which increases the risk of loss of teeth and gum disease.
Although not very well known reasons, a woman has high chances of developing heart disease after menopause. It is recommended to consider heart disease when making lifestyle changes and the treatment, because these diseases are treated on the spot death.
During perimenopause or menopause are turning to specialty examination in the following cases:
- Heavy menstrual cycles, irregular or prolonged (1 to 2 times longer than normal)
Vaginal bleeding between menstrual periods, when cycles were regular
-Swift resumption vaginal bleeding after a period of 6 months to break
-Unexplained bleeding during hormonal treatment
-Characteristic symptoms perimenopause insomnia, hot flashes or mood swings do not respond to treatment and affect sleep and daily activity
-Pain or vaginal dryness is not feeling better after treatment at home or shows signs of urinary tract infection
If she is worried about the risk osteoporosis can discuss this with your doctor.
Menopause is a physiological process of amending the panel and does not require hormone treatment. If symptoms can be easy to call a home treatment for improving the state. It is recommended to discuss with your doctor
The following medical specialists can help overcome menopausal and menstrual cycle changes in the assessment:
-GP
-Gynecology
-Physician
Women and their doctors can determine the cause premenopause, based on age, personal history physiological (genital activity), symptoms and results of pelvic examination. If possible, women need to keep a calendar with days of menstruation and the symptoms associated.
If women have severe symptoms before or after Menopause if your doctor suspects another condition or has a certain disease that is difficult diagnosis, the doctor may use one or more of these investigations:
A pregnancy test is done if there is likely to be pregnant woman
A stimulation test of follicle-stimulating hormone (FSH) can help confirm menopause. FSH increases during premenopause and remains increased after premenopause.
-Test for estrogen is to highlight the loss of estrogen after menopause.
A test of thyroid stimulating hormone is used to make differential diagnosis with a thyroid condition which can give irregular menstrual cycles or similar symptoms of the premenopause.
If she did not show menstrual cycles for a year reached menopause and are in menopause. It is time for a complete examination with particular attention to heart and risk factors for osteoporosis. Communication recommends any sudden vaginal bleeding treating physician.
Menstrual vaginal bleeding or sudden onset
If women have irregular bleeding during premenopause or following hormone treatment and shows vaginal bleeding after 6 to 12 months of treatment, doctors may resort to one or more additional investigation to eliminate the causes of severe bleeding. These investigations may include:
Transvaginal ultrasound, to highlight possible tumor or malformation of the uterus
-Endometrial biopsy to check the internal lining of the uterus (endometrial) Function normally during cycle and to check some signs of cancer.
Osteodensitometry as osteoporosis screening
All women 65 and over this age should be tested routinely to measure urinary density for osteoporosis screening. If the woman has risk factors for osteoporosis screening tests should be done early around age 60. If the person stopped hormone is very important to consider screening for osteoporosis due to lack of protection hormonal bone demineralization.
Experts say the decision to submit to a screening test for women 60 years or younger is individualized. This decision depends on the risk of developing osteoporosis and test results.
Menopause is a physiological change that does not require treatment. However, associated symptoms can be difficult to bear. If she has insomnia, mood disorders, hot flashes, incoherent, heavy menstrual periods or other symptoms of menopause treatment can help to overcome this period easier. During the review treatment options are recommended to consider the following:
A healthy lifestyle will help reduce symptoms of menopause. These habits include a balanced diet, without stress, regular exercise, avoid smoking, Caffeine and alcohol abuse. An unhealthy lifestyle can exacerbate the symptoms of menopause.
Low-dose hormone therapy or low-dose oral contraceptives may be an option if the woman shows cycles and have more symptoms or worse. Contraceptives Oral not used after menopause because they contain higher amounts of hormones than women need.
After menopause, hormone therapy can be used as short-term treatment for severe symptoms and lowest possible dose
-She may need some treatment for symptoms such as hot flashes or vaginal dryness
-Meditative breathing exercises and supplements as Black Cohosh or Cimicifuga racemosa (herb of North America - yarrow?) Or soy may help relieve symptoms.
Recent studies have led to a big change in the management of postmenopausal hormone therapy. For a long period of hormone replacement therapy or drugs with estrogen-progestin combination was found to protect against heart disease or dementia. However it was found that hormone replacement therapy can cause serious problems in case of women. After one or more years of HRT are a small number of women myocardial infarction, stroke or thrombophlebitis deep. After 4 years of therapy or a small number of women develop breast cancer or dementia. Similarly a small number of women following treatment with estrogen and are strokes of deep vein thrombosis. Only with estrogen therapy may cause breast cancer and ovarian cancer in some women.
Correlated with average hormone therapy risk is small compared with total population of women. However the individual risk for hormone therapy to stimulate the appearance of breast cancer, of cardiovascular disease, neurological thromboembolism or less or more depending on existing risk factors.
Treatment options for menopause symptoms
- Hot flashes. Mediated breathing exercises (paced respiration) have been shown to relieve hot flashes. Medicines that can relieve hot flashes include short-term therapies hormonal, selective serotonin inhibitors, antidepressants like fluoxetine and aroxetine treatment for hypertension (Clonidine) and an antiepileptic drug gabapentin.
Periods of heavy cycles. Progesterone can help relieve heavy menstrual cycle the progesterone level declined (after a thorough examination to make differential diagnosis). Other options would be anti-inflammatory drugs, or levonorgestrel contraceptives. For severe hemorrhage some women choose surgical and definitive. This method involves removing the uterus (hysterectomy) or using high temperatures to damage and scarring of the uterine wall (endometrial ablation).
- Vaginal dryness and irritation. A vaginal lubricant to assist with this. Estrogen-containing creams, rings or tablets may improve dry mucous membranes, irritated or thinned. The vaginal absorption assimilates a smaller amount of the hormone estrogen and decrease the risks associated with estrogen therapy.
Complex and severe symptoms. Hormone therapy can improve many symptoms of menopause period. For the treatment of premenopausal women are given pills with low doses Estrogen and progesterone hormone therapy with low dose estrogen-progestin to reduce heavy cycles and relieve other symptoms. In a low-dose hormone therapy is a treatment option. 6 months is recommended to control if they start hormone therapy in the short term.
Bioidentica Hormone replacement therapy is an alternative to hormone therapy. Hormones are synthesized in the laboratory from wild plants and soybean roots. This therapy is considered to be similar to hormones produced by humans to a greater extent than synthetic hormones used in hormone therapy. However bioidentici hormones have the same risk factors as traditional hormones, heart disease, stroke, thrombosis, breast cancer and dementia. Any form of hormone therapy, hormone therapy incusing bioidentici is indicated to follow for a period as short as possible after menopause.
Due to the risks of hormonal therapy, many women have turned to homeopathic therapy to relieve symptoms associated with menopause:
-Black cohosh (Remifermin) is an alternative to plant-based hormone therapy for hot flushes, mood changes and other symptoms. Still not quite well known mechanism of action of the plant. It is also not known whether black cohosh or accentuate risk for breast cancer uterine cancer.
-Soy diet is considered as improves symptoms while not enough evidence to support this claim. Dietary soy may also decrease the risk for heart disease but even this benefit has not been sufficiently demonstrated.
Hormone therapy - Hormone replacement modification therapy (HRT)
In recent decades HRT preserves and youth health in women after menopause. However, recent studies have led to a dramatic change of the concept.
A comprehensive study done by "women's health initiative" (Women's Health Initiative-WHI) showed that HRT does not protect against heart disease. In this group of women, short-term hormone therapy was linked to a greater number of myocardial infarctions, stroke and thromboembolism. Hormone therapy was administered for many years correlated with some cases of breast cancer or dementia. Most women in this study showed no adverse effects worrisome.
Normal hormone therapy is very low risks for most women. Individual risk but may be lower or higher than the average. It depends on risk factors for Breast Cancer, Cardiovascular disease, thromboembolism, or dementia.
Based on the WHI study, the Food and Drug Administration (FDA) has updated its recommendations so that estrogen-progestin hormone therapy is recommended:
-For short periods to treat symptoms of menopause. HRT effectively relieves symptoms in most women. HRT for women who are convinced that favors the above risks are advised to use the lowest dose for the shortest time possible. For most women menopause related symptoms improves in a few years, making long-term therapy dispensing
Osteoporosis prevention and treatment-specific. Most experts recommend only long-term hormone therapy for women with high risk of osteoporosis. In these cases the protective role of estrogen on bone exceeds other risks associated with HRT. Women are encouraged to explore all options for treatment of osteoporosis and to compare risks with benefits.
Changes in estrogen replacement therapy (ERT)
Young women who were artificially induced menopause post hysterectomy are advised to start treatment with estrogen to protect against bone demineralization. ERT helps relieve symptoms associated with menopause. ERT risks are known from studies on groups of women over 50 years. It can happen that the benefits exceed the adverse effects on a young woman following treatment with estrogen until age which had Menopause physiological. This statement requires extended research.
"Women's health Initiative (WHI) studied estrogen only therapy in older women and found that increased embolism risk in legs (deep thrombophlebitis) and lung (pulmonary embolism) and risk for stroke during the first year of treatment. ERT does not protect against heart disease risk but not promoted. Compared with women who are not hormone therapy, women with ERT have fewer hip fracture (Effect of estrogen on bone protection).
Some studies have found a possible link between ERT and breast cancer. ERT women in the WHI trial had increased risk for breast cancer during the 7 years as the study lasted. However, a recent study done in Britain on one million women aged between 50 and 64 suggest that ERT slightly increases the risk for breast cancer 10 years after treatment.
If a woman had breast cancer do not take ERT or HRT.
What are the hormonal treatment options now?
-HRT or short-term ERT relieves hot flashes and vaginal dryness for most women, although adverse effects are common. Side effects that cause women to stop treatment are unpredictable bleeding that mimics menstruation, breast tenderness and depression
-HRT or ERT in low doses or short courses it is hoped will provide a balance between benefits and risks of HRT. May be administered for 4 or 5 years with periodic inspections. It can work very well for many women who will benefit from improved symptoms during this period. As postmenopausal healthy women come to use increasingly more therapies in low doses for short periods of time, researchers will be able to assess the benefits and risks really.
If taken long-term HRT or ERT is recommended for control of specialized knowledge and benefits exceed risks tailored to individual needs, age and personal history pathological. Risk for myocardial infarction, stroke, thromboembolism, or dementia may be lower, depending on the person. If she has personal or family history of breast cancer or heart disease risks of HRT may outweigh the benefits.
Interruption of HRT or ERT. Before hormone therapy is recommended to discontinue a physician opinion. Can not know if the person who will interrupt treatment or symptoms of menopause. Approximately 70% of women who interrupt HRT have tolerable symptoms or shows any symptoms. The 30% who remain less tolerable symptoms or a longer period of time.
Tapering during the few months to prevent or reduce symptoms related to estrogen hormone sudden halt. Yet many women have symptoms after sudden discontinuation of HRT. If symptoms appear can delay and possibly resolve. If they continue to consider all treatment options with your doctor.
Because adverse effects of hormone replacement therapy (HRT) many women have turned to alternative medicine to relieve symptoms from menopause. As a step in addressing the symptoms is recommended to consider one or more of these options for preventing or treating symptoms before moving to prescription drugs or hormones
Meditation, breathing exercises have been shown to significantly reduce hot flashes or emotional disturbances. This approach has no known side effects, risks or costs outstanding and can be combined without any risk with additional treatment if needed
-Black cohosh may relieve a wide range of symptoms of menopause in women. Other studies showed no improvement of symptoms. It is unknown whether longer therapy presents a risk of 6 months (it is possible emergence of similar risk with estrogen therapy). If multiple checks are recommended following treatment with black cohosh and physician information about this treatment.
Soy-phytoestrogens found in complete form included in the daily diet. Regular diet with food or drink soy may help symptoms of menopause and beyond their effect on hot flashes and need to be studied. Soy protein also reduces cholesterol.
-Yoga (which usually includes meditative breathing) and / or Biofeedback are methods of reducing stress. Increased stress symptoms worse.
Alternative treatments to avoid!
Some therapies are not recommended for menopausal symptoms that are not effective or that can lead to dangerous side effects. These include:
-Herbs like kava, Evening Primrose, Dong Quai, Valerian, Angelica dehidroepiandrosteron or
Weeds or wild-natural progesterone cream
How to apply alternative treatments?
Before trying any treatment is recommended to check it by looking for studies that support the beneficial effects promoted and information about risks. If a person wants to buy herbs or supplements are recommended to find at least one known brands or suppliers because these products are not required to have the same purity and not up to the same standards or other to free prescriptions. Active substances in these products vary large. It may also be contaminated with metals or other hazardous substances.
If using an alternative therapy or natural remedy recommended physician information. Be served and the type and quantity that it manages and duration of use and motivation.
Years before menopause and premenopause menopause meaning are particularly important to omit appropriate treatment situation. If it was not until reaching an attitude this time is the time to act:
-If she is a smoker must stop and thus reduce hot flashes and long-term risks
-exercise regular physical and emotional health promotion
Is recommended meditative breathing exercises that reduce hot flashes and emotional state especially
Is recommending limited consumption of alcohol to relieve the symptoms and long-term risks
Healthy diet is recommended, reducing foods with simple sugar and caffeine which worsen menopause. Not only does this improve the condition but help prevent long-term health problems
-Emotional disorders in menopause can affect people but can fight with proper support.
If she shows symptoms of menopause can overcome by simple measures of care. Practical ways to overcome hot flashes include keeping a cool environment, a dress with more layers and stress control, especially with easy breathing exercises, rhythmic and relaxing. Measures to improve the sensation of vaginal dryness and muscle tone include a vaginal lubricant and regular Kegel exercises.
As the body ages the risk of developing heart disease, osteoporosis or other chronic diseases grow naturally. The most effective prevention and anti-aging therapy is a healthy life style:
-Can reduce risk of osteoporosis. Maintaining levels of calcium and vitamin D by eating calcium-rich foods and supplements
-Improving bladder control with regular Kegel exercises
Continuation of contraception is recommended to prevent unexpected pregnancies during premenopause.
Recent studies have changed the way the administration of hormonal therapy after menopause. For a while it was found that hormone replacement therapy (HRT) protects against heart disease and dementia. However it has been shown that HRT can cause serious health problems. After one or more years of HRT a small number of women are heart attack, stroke or deep thrombophlebitis. After 4 years of therapy or a small number of women develop breast cancer or dementia. Similarly a small number of women who are taking estrogen stroke and deep vein thrombosis. Only with estrogen therapy can cause breast and ovarian cancer in some women.
Experts do not yet know whether hormone therapy risks are the same for the older women and younger at menopause. HRT is still studied for its effects at a low dose and short time during menopause.
Risks of HRT and ERT Standard at women are rare. Personal risk for hormone therapy to stimulate breast cancer, cardiovascular problems, or neurological changes trombemboly can be higher or lower depending on risk factors.
Many medical specialists recommend no hormonal treatment for menopause symptoms before they consider hormone therapy (oral contraceptives, estrogen or estrogen-progestin, ERT-HRT). There are several treatments that may improve or nonhormonale relieve hot flashes and other symptoms of menopause. Women can try herb called Black Cohosh and soy diet.
Non-pharmaceutical treatments include hormones
Serotonin-selective inhibitors - are a type of antidepressant that can reduce the number and severity of hot flashes. Some women have side effects. Therapy term has not been sufficiently investigated
-Clonidine is an antihypertensive treatment can reduce the number and sever hot flushes. Some women have side effects related to low blood pressure
Is an antiepileptic drug, gabapentin, and may reduce the number and severity of hot flashes. Some possible side effects include drowsiness, vertigo and edema.
Hormone drugs
- Oral contraceptives (estrogen and progesterone) to regulate cycles and soothes menopause symptoms. Do not use after menopause. Women who smoke or have diabetes, hypertension untreated, heart disease or breast cancer history of oral contraceptives are not recommended. Contraceptives with lower doses of hormones are recommended for women over 35 years. Some women have side effects
- Pills or progestin levonorgestrel, which release a form of progesterone in the uterus reduced rainfall and irregular cycles during premenopause. Some women have side effects
- Low-dose vaginal estrogen (in the form of creams, tablets and vaginal rings) reduce the sensation of vaginal dryness and weakening of the vaginal wall and urethra without introduce high doses of estrogen in the body
- HRT (estrogen and progestin) in the form of tablets, patches or vaginal rings can be used to treat symptoms of menopause. Since recent studies have revealed adverse effects of HRT in some women, experts have changed the administration of HRT. To relieve symptoms of menopause experts recommend HRT in the lowest effective dose in the shortest time
- Hormone replacement therapy bioidentics synthesized in plants and is considered to be more like humans than synthetic hormones in HRT. However bioidentics HRT hormone has not been sufficiently investigated and could present the same side effects as standard HRT. Any form of hormone therapy is recommended in the shortest period possible.
Estrogen replacement therapy (ERT) is used by women who had sudden onset of early menopause. This situation usually occurs after ovarectomy bilateral (bilateral removal of ovaries) or ovarian failure after cancer therapy. ERT maintains bone density and prevent severe symptoms accompanying early menopause. However it is known that ERT slightly increases the risk of stroke and thromboembolism during the first year of treatment. Long-term ERT may slightly increase the risk of developing breast cancer or ovarian cancer.
HRT or ERT in small doses and short term it is hoped will provide a balance between HRT risks and benefits. It can reach 4, 5 years of therapy with regular checks. This method will work for many women will notice improvement of symptoms during this period. The more women following hormone treatment in small doses and for short periods after entering menopause, researchers will learn more about the benefits and real risks
- Progesterone creams. Progesterone creams without a prescription or with progestin prescription are made to correct low levels of progesterone. While some women tell improve symptoms with progesterone cream, there was a mixed reaction to the response to these creams. They raise issues regarding the use of progesterone without prescription
If well-absorbed - progesterone therapy involves some risk. Was correlated with breast cancer, migraines and thromboembolism in a small number of women. Thus progesterone is a hormone that is given on prescription, and no shortage risks in treating women who already has some risks
If not well-absorbed. If a woman taking estrogen (uterus is intact) needs enough progesterone to prevent endometrial cancer caused by estrogen. Using heavy cream that is absorbed during treatment with estrogen does not protect women from uterine cancer.
Doctor's consent is recommended for treatment with progesterone without a prescription.
- Testosterone. Testosterone therapy - estrogen is not recommended for flushing. There are studies indicating that it would be more effective than estrogen and has the same adverse effects as treatment with estrogen (embolism, stroke, breast cancer). Experts have studied long-term effects of treatment with testosterone and estrogen, but it is known that testosterone therapy may lead to hair loss, Acne, deepening of the voice and face hair growth (hirsute). Testosterone is sometimes used to increase sexual desire (libido) after menopause. Studies have observed effects of testosterone in postmenopausal women showed no benefit when treatment longer than 12 weeks. For testosterone decreased sexual desire disorder as an option but have known adverse effects.
Note!
HRT and osteoporosis. Researchers studying the effects of still very low doses of estrogen in women 65 years or more. But a recent study revealed that a small dose of 0.25 mg per day, representing about one third the standard dose of ERT can provide the same protection as a higher dose bone. In the same study approximately one third of women were still receiving uterus and estrogen along with progestin in HRT to eliminate the risk of developing uterine cancer. This group of women has gained increased bone density. However long-term risks of a low dose of estrogen (and progestin in one third) are not known yet.
