What is menopause?
When a woman has experienced no menstruation for 12 months, then she is considered menopausal. It is a natural physiologic process that results from the normal aging of the ovaries. It occurs when the ovaries can no longer perform the function of ovulation and estrogen production.
Menopause normally takes place between the ages of 35 and 58. About 25 percent of American women reach menopause by the age of 47, half by the age of 50, three-fourths by the age of 52 and 95 percent by the age of 55.
The perimenopause is that time when a woman begins to experience the symptoms related to the decrease of estrogen production. Chief complaints are related to menstrual irregularities. In the majority of women, bleeding decreases with each period and the periods are spaced farther apart. In some cases, there may be excessive bleeding during the regular periods. Other symptoms that a woman may complain of during the perimenopause are related to vasomotor changes, such as hot flashes or flushes of the face, neck and upper body; excessive perspiration, especially at night; vaginal dryness; urinary stress; incontinence or frequency; joint pain and backache; and insomnia, which is usually due to the night sweats.
Hormonal changes and psychosocial stress associated with adjustment to the aging process and perceived losses can lead to emotional instability, irritability and depression. The woman may associate cessation of menstruation with loss of femininity, sexual attractiveness or desire, and role of potential parent, even though she may not want to have more children.
Hormonal replacement therapy (HRT) with estrogen is prescribed with caution because of the possibility of complications. Alternatives to hormonal replacement include limitation of foods high in saturated fat and nitrites and avoiding red meat, coffee, tea, chocolate, colas and alcohol. Vitamins E and D, vitamins of the B complex, calcium and magnesium may be prescribed by some physicians. Regular exercise is especially important during the perimenopausal years and after. Exercise stimulates the production of endorphins which increase one's sense of well-being, improve circulation and help to prevent osteoporosis.
The manner in which a woman reacts to the changes taking place during the perimenopause depends to a great extent on her feelings of self-esteem. Knowing what to expect and being able to get some control over what is happening to her can significantly improve her physical and mental health during this time.