Women's Health

A Primer on Menopause What Every Woman Should Know. Part 3

Menopause
Menopause itself is a point in time, specifically 12 months after your last period, said Boggs. That’s when it’s clear that menstruation has stopped.

The average age of menopause in the United States is 51.2 years, Thomas said.

Post-Menopause
This is the condition that remains for the rest of a woman’s years, and given current life expectancies, most likely that means a full third of her lifespan. Hormones continue to be produced in the body, though at a reduced level.

What Are the Symptoms of Perimenopause/Menopause?
Symptoms, said Love, are what make you think “you’re going crazy.” One of the defining aspects of perimenopause and menopause is “change and unpredictability. Your body is reshuffling and rebalancing and, in doing so, you don’t know what it’s going to do when.”

About a third of women have no symptoms, she said, another third have some symptoms, though not badly enough to do much about them, and another third are suffering and need some form of treatment. The most common symptoms include: hot flashes, night sweats, insomnia, weight gain, vaginal dryness and mood swings. However, there are many different symptoms that a woman may experience. In her book on hormones, Love lists about 40 of them.

Treatment Options
Do Nothing
You don’t have to do anything different as you experience menopause. Some women have no symptoms. Some who do have symptoms can control them through their usual coping mechanisms. In fact, said, Thomas, about 75 percent of women choose not to treat menopause medically.

Hormone Treatment
This has become the hottest topic of menopause. In the past 60 years, medical science has created the capability to add hormones, such as estrogen and progesterone, to the body through medication. The questions include: Is it necessary? Is it risky? What are the benefits?

There are two reasons generally given to take hormones. One is to relieve the symptoms of perimenopause and menopause. The other is to add higher levels of estrogen with the intention of protecting the body from some of the diseases associated with aging.

To frame the discussion, Love said it’s important to understand that the ovaries continue to make hormones well into a woman’s 80s, but at a lower level than during the child-bearing years. And given the needs of an older woman’s body, “That lower level may well be adequate.”

Since the body naturally stops making high levels of estrogen, by taking hormone medication, you are not so much “replacing” hormones as adding them. The vast majority of women do just fine with the levels of hormones their body produces naturally, Love said. Some, however, may want hormones to get over the hump of symptoms that are too difficult to deal with and can’t be eliminated by other means. The ovaries of some women may not be making enough hormones to sustain their needs in the post-menopausal period, or they may not have ovaries if they were removed in a hysterectomy.

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