Menopause, sometimes referred to as the change of life, is not a disease, disability or medical condition. It is a normal, natural part of every woman’s life cycle. By definition occurring 12 months after a woman’s final menstrual period, it marks the end of her reproductive fertility. While menopause may signal a change of life, it may be viewed as a new beginning.
Female fertility begins at puberty when the egg follicles in the ovaries begin to develop into mature eggs. In ovulaton, hormone production controls the timing of the release of each egg, usually on a 28-day cycle. The egg travels through the fallopian tube and into the uterus. If it is fertilized, the egg will attach itself to the uterus and a baby will develop. If the egg is not fertilized, the uterus will slough off its lining and the unfertilized egg and the lining will be discharged as menstrual flow during the monthly period. Once all of the eggs in the ovaries have been depleted, the monthly menstrual cycle ceases. The woman’s fertile years are over and she enters menopause.
Most women enter menopause between the ages of 40 and 58. The average age of their final menstrual period is 51. Some women may experience natural, or spontaneous, menopause much earlier or much later than these averages. Women who experience menopause much later than age 55 may be at increased risk for some serious medical conditions including breast cancer, uterine cancer and ovarian cancer. All post-menopausal women experience diminished levels of the sex hormones estrogen and progesterone, which can contribute to the loss of bone density. Menopause typically begins around the same time women are experiencing other affects of aging, such as heart disease, cancer, diabetes and osteoporosis, which can make it difficult to determine whether a medical condition is related to menopause or the aging process. This makes menopause an ideal time to have a thorough medical checkup.
Every woman’s experience with menopause is unique and may be affected by genetic, cultural and ethnic factors. Some women may experience little physical change other than the cessation of their monthly period, while others experience significant physical issues related to altered hormone levels. Psychological factors can range from feelings of liberation from the need to practice birth control to sadness. The risk of heart disease increases dramatically for women after menopause, according to the North American Menopause Society. Heart disease is the number one killer of American women and should be of particular concern for women after menopause, as it accounts for half of all deaths in women over the age of 55. Post-menopausal women are up to three times as likely to have heart disease as pre-menopausal women.
Hormone Replacement Therapy
The female sex hormone, estrogen, is believed to play an important role in maintaining bone density and providing protection against heart disease. Diminished levels of estrogen that are common in women after menopause may contribute to their increased levels of osteoporosis and heart disease. Hormone replacement therapy (HRT) was commonly used in the past to treat symptoms of menopause, but this treatment fell out of favor when the 2002 Women’s Health Initiative found a connection between hormone use and increased rates of breast cancer. Some types of hormone therapy are approved in the United States for the treatment of osteoporosis, vaginal atrophy and severe hot flashes. Hormone treatment is highly individual and should be used only if deemed utterly necessary, at the lowest effective dose for the shortest period of time to reduce the associated risks.
Proper preparation for life after menopause during earlier stages of life may help make the transition easier. The North American Menopause Society recommends women who suspect they are entering menopause undergo a complete medical examination. This is an excellent time for those who smoke to quit. Women who smoke may enter menopause up to two years earlier than those who don’t, and smoking contributes to bone loss, which typically increases after menopause. A regular exercise routine can help control weight gain, which is common after menopause, and it may help to maintain bone mass and aid in sleeping. Mayo Clinic.com recommends menopausal women eat a healthy, sensible diet with a balanced range of foods from the food pyramid. Menopausal women should also add 1,200 to 1,500 milligrams of calcium along with 800 international units of vitamin D to their diet each day.