Most People Experience Symptoms
Menopause is not an illness, but the hormonal changes that occur can trigger symptoms.
These can range from mild to severe, leading, in some cases, to discomfort and distress. Treatment can help manage symptoms.
Common symptoms include:
Hot flashes: Sudden sensations of heat in the upper body affect up to 75% of people.
Night sweats: These are hot flashes that occur at night.
Difficulty sleeping: Night sweats, mood changes, and anxiety can make it hard to sleep.
Vaginal dryness: Sex can be painful as a result.
Reduced libido: Sexual desire can fall as hormone levels drop, but vaginal dryness can also make sex uncomfortable.
Mood changes: Fluctuating hormone levels and environmental factors can contribute to stress, anxiety, and depression.
Hormonal changes can also contribute to osteoporosis. When a person has osteoporosis, their bone density decreases, and bones are more likely to break. The risk of osteoporosis rises during and after menopause.
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The Sensitivity And Specificity Of Tests
The concepts of sensitivity and specificity help us to explore the relationship between a diagnostic test and the presence or absence of disease. The principles are outlined in Fig. 1 and discussed in Sackett and Haynes.1 Note that the total number of cases who truly have disease is , and truly without disease is . However, are test positive and are test negative.
The sensitivity is defined as the proportion of people with disease who have a positive test a/. A test which is very sensitive will rarely miss people with the disease. It is important to choose a sensitive test if there are serious consequences for missing the disease. Treatable malignancies should be found early thus sensitive tests should be used in their diagnostic work-up.
Specificity of a test is defined as the proportion of people without the disease who have a negative test result d/. A specific test will have few false positive results it will rarely misclassify people without the disease as being diseased. If a test is not specific, it may be necessary to order additional tests to rule in a diagnosis.
An example of this trade-off is the cut-point for abnormal blood sugar levels above which levels the diagnosis of diabetes becomes likely. Usually, we set a BSL of 8 mmol/L or 11 mmol/L , above which we suspect diabetes. At these cut-points, the sensitivity is about 57% and specificity 99%.
|Fig. 1Estimating the sensitivity and specificity of diagnostic tests|
Early Or Induced Menopause
There are additional concerns for those who have menopause at an early age or have sudden induced menopause due to surgery or injury.
- Premature menopause: If you go into menopause before age 40, it is considered to be abnormal. Autoimmune disorders are often associated with premature menopause.
- Induced menopause: If you have an injury to or removal of your ovaries, you can go into menopause abruptly. This often results in more intense menopausal symptoms.
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Increased Risk Of Some Health Conditions
After menopause, the risk of certain health issues appears to increase. Menopause does not cause these conditions, but the hormonal changes involved may play some role.
Osteoporosis: This is a long-term condition in which bone strength and density decrease. A doctor may recommend taking vitamin D supplements and eating more calcium-rich foods to maintain bone strength.
Cardiovascular disease: The American Heart Association note that, while a decline in estrogen due to menopause may increase the risk of cardiovascular disease, taking hormone therapy will not reduce this risk.
Breast cancer: Some types of breast cancer are more likely to develop after menopause. Menopause breast cancer, but hormonal changes involved appear to increase the risk.
Skin changes can also occur around the time of menopause. Find out more.
Hormone Therapy For Menopause
The risk of endometrial cancer is higher in women who have a uterus and are given unopposed estrogen therapy. Nevertheless, any vaginal bleeding in a woman on hormone therapy should immediately be evaluated to rule out endometrial cancer.
The risk of breast cancer begins to increase after 3 to 5 years of combination therapy when the standard dose is used. When estrogen is used alone, risk of breast cancer was slightly lower at 7 years in the Women’s Health Initiative study, but this benefit appears to disappear after 10 to 15 years of use. The risk of venous thromboembolism and stroke may be lower when low-dose transdermal estrogen is used. Older postmenopausal women are at higher risk of coronary artery disease and dementia when they are given combination therapy. Incidence of gallbladder disease and urinary incontinence may be increased with combination therapy or estrogen alone. Risk of all these disorders is very low in healthy women who take hormone therapy for a short time after menopause.
Estrogen therapy may be contraindicated in women who have had or are at high risk of breast cancer, stroke, coronary artery disease, or thrombosis.
Progestogens may have adverse effects ; micronized progesterone appears to have fewer adverse effects. Progestogens may increase the risk of thrombosis. There are no long-term safety data for progestogens.
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Are There Any Risks Related To Hormone Therapy
Like most prescribed medications, there are risks for hormone therapy. Some known health risks include:
- Endometrial cancer .
- Gallstones and gallbladder issues.
Going on hormone therapy is an individualized decision. Discuss all past medical conditions and your family history with your healthcare provider to understand the risks versus benefits of hormone therapy for you.
When To See A Gp
It’s worth talking to a GP if you have menopausal symptoms that are troubling you or if you’re experiencing symptoms of the menopause before 45 years of age.
They can usually confirm whether you’re menopausal based on your symptoms, but a blood test to measure your hormone levels may be carried out if you’re under 45.
When Does Menopause Begin And How Long Does It Last
Most women first begin developing menopause symptoms about four years before their last period. Symptoms often continue until about four years after a womans last period.
A small number of women experience menopause symptoms for up to a decade before menopause actually occurs, and 1 in 10 women experience menopausal symptoms for 12 years following their last period.
The median age for menopause is 51, though it may occur on average up to two years earlier for Black and Latina women. More studies are needed to understand the onset of menopause for women of color.
There are many factors that help determine when youll begin menopause, including genetics and ovary health. Perimenopause occurs before menopause. Perimenopause is a time when your hormones begin to change in preparation for menopause.
It can last anywhere from a few months to several years. Many women begin perimenopause some point after their mid-40s. Other women skip perimenopause and enter menopause suddenly.
About 1 percent of women begin menopause before the age of 40, which is called premature menopause or primary ovarian insufficiency. About 5 percent of women undergo menopause between the ages of 40 and 45. This is referred to as early menopause.
Can Postmenopausal Weakening Of Bones Be Postponed
Osteoporosis can not be cured. Nonetheless, certain procedures can delay its onset and also minimize the risk of crack. Thanks to the estrogens it includes, hormonal agent replacement therapy plays an essential duty in protecting against the condition. Even if osteoporosis depends much on genetic heritage, age, and also sex , a healthy way of living is essential. From early adulthood, it is advised that ladies consumeenough calcium, enough vitamin D, and regular physical activity.Dont be reluctant to have a check-up with your medical professional, who might prescribe bone densitometry, a medical checkup that gauges bone thickness. Which Of The Following Statements About Menopause Is False?
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Added Benefits Of Hrt
HRT reduces the risk of various chronic conditions that can affect postmenopausal women, including:
- diabetes taking HRT around the time of menopause reduces a womans risk of developing diabetes
- osteoporosis HRT prevents further bone density loss, preserving bone integrity and reducing the risk of fractures, but it is not usually recommended as the first choice of treatment for osteoporosis, except in younger postmenopausal women
- bowel cancer HRT slightly reduces the risk of colorectal cancer
- cardiovascular disease HRT has been shown to reduce cardiovascular disease markers when used around the time of menopause.
Let’s Look At 9 Of The More Unusual Symptoms Of Perimenopause And Menopause:
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Cultural Differences In Symptoms And Attitudes Toward Menopause
Nancy E. Avis, PhD Sybil Crawford, PhD
Menopause is a universal event in the biologic aging process of the human female. Every woman who lives long enough will eventually cease menstruating and end the reproductive phase of her life. However, cross-cultural studies find that womens menopausal experiences are far from universal; in fact, evidence shows that menopause is strongly shaped by social and cultural factors. The symptoms women experience, the meaning of menopause, their attitudes toward menopause, and whether or not they seek treatment all vary across cultures. Cross-cultural understanding of menopause comes from comparative population-based studies and anthropologic research from many countries and cultures.
Vasomotor Symptoms across Cultures TheWestern assumption that vasomotor symptoms are universally the most common symptoms associated with menopause is further challenged by data from crosscultural studies. Studies carried out in a wide range of countriessuch as Japan,2 rural Greece and Mexico, 9,11Newfoundland,12 Pakistan,13
The multiethnic/racial Study of WomensHealth Across theNation is studying the menopausal experience of five racial/ ethnic groups within the United States. SWAN investigators found that the prevalence of combined hot flashes and night sweats was lowest among women of Japanese and Chinese ethnicity , and higher among Hispanic and African-American women ;
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Hrt For Breast Cancer Survivors
It is advisable for women with a history of breast cancer to avoid HRT unless other treatments are ineffective, and their quality of life is made intolerable by menopausal symptoms. In these circumstances, HRT should only be prescribed in consultation with the womans breast surgeon or oncologist.
Evidence has not conclusively shown that HRT will increase the risk of breast cancer recurring in a woman with a history of the disease. However, oestrogen and progestogens may stimulate some types of cells in the breast and some types of HRT use have been associated with an increase in the risk of breast cancer in women without a history of breast cancer.
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How Long Does Perimenopause Last
The length of each stage of the menopause transition can vary for each individual. The average length of perimenopause is about four years. Some women may only be in this stage for a few months, while others will be in this transition phase for more than four years. If you have gone more than 12 months without having a period, you are no longer perimenopausal. However, if there are medications or medical conditions that may affect periods, it can be more difficult to know the specific stage of the menopause transition.
Understanding The Menopausal Transition
Menopause is a point in time 12 months after a womans last period. The years leading up to that point, when women may have changes in their monthly cycles, hot flashes, or other symptoms, are called the menopausal transition, or perimenopause.
The menopausal transition most often begins between ages 45 and 55. It usually lasts about 7 years but can last as long as 14 years. During the menopausal transition, the bodys production of estrogen and progesterone, two hormones made by the ovaries, varies greatly. Bones become less dense, making women more vulnerable to fractures. During this period, too, the body begins to use energy differently, fat cells change, and women may gain weight more easily.
Menopause may be triggered by a hysterectomy or surgical removal of the ovaries, which produce hormones. If you have surgery to remove your ovaries or uterus and are not taking hormones, you will experience the symptoms of menopause immediately.
This time in a womans life is often full of other transitionsnot just physical ones. Women may be caring for aging parents or relatives, supporting their children as they move into adulthood, or taking on new responsibilities at work.
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Can Menopause Cause Depression
Your body goes through a lot of changes during menopause. There are extreme shifts in your hormone levels, you may not be sleeping well because of hot flashes and you may be experiencing mood swings. Anxiety and fear could also be at play during this time. All of these factors can lead to depression.
If you are experiencing any of the symptoms of depression, talk to your healthcare provider. During your conversation, your provider will tell you about different types of treatment and check to make sure there isnt another medical condition causing your depression. Thyroid problems can sometimes be the cause of depression.
What Is Male Menopause
Testosterone is the male hormone that affects sexual function as well as energy, muscle mass and physical stamina. This hormone is produced in the testes. During male adolescence, testosterone levels elevate in order to allow the male body to undergo puberty.
After the age of 30, a mans level of testosterone typically decreases by about 1% each year. While female menopause happens relatively quickly , a mans testosterone levels decrease at a much more gradual rate. However, there are symptoms that many men may experience as the result of this decrease in testosterone that are similar to the symptoms that women experience during menopause.
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Bonding With Other Menopausal Women
When hot flashes have you peeling off layers of clothing or when you can’t remember what that one thing was that you came to the supermarket for, you’re likely to feel a kinship with any woman as sweaty or forgetful as yourself. Talking and often joking with other women about the menopausal symptoms you’re experiencing can be very helpful by reassuring you that you’re not alone. “Not only do women exchange coping strategies and sympathy and empathy, but sharing their stories gives women courage to face the world, knowing that they’re in good company and that unwelcome symptoms will not last forever,” says Dr. Richardson.
What Are Hot Flashes
Hot flashes can be a pretty unpleasant symptom of perimenopause and menopause. We dont totally understand the cause of hot flashes.
Most people describe a hot flash as a sudden hot feeling that spreads all over your body but mostly the upper body, like your arms, chest, and face. ;You may also get sweaty, and your fingers may tingle and your heart may beat faster. A typical hot flash usually lasts anywhere from 1 to 5 minutes.
Hot flashes at night are called night sweats. Sometimes they can get so severe that you soak your sheets with sweat.
Hot flashes are super common. More than 3 out of 4 people have them while going through perimenopause and menopause.
Nothing will make hot flashes stop completely, but there are some things you can do to help get some relief. Wearing light, loose clothes, keeping your room cool, drinking cold liquids, and avoiding alcohol and caffeine can help you stay cool.;
Prescription hot flash treatments can be helpful, too. Hormone therapy works best to treat hot flashes, but other medicines like SSRIs and SNRIs and clonidine may also help. Research shows that herbs, vitamins, acupuncture, and reflexology dont help with hot flashes.
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How To Detect Fibroids After Menopause Symptoms And Methods Of Diagnosis
The medical literature describes many symptoms of fibroids after menopause, but, most often they are talking about three of them:
- Increased profuse menstrual bleeding.;
- Large fibroids can put pressure on the bladder or rectum, leading to impaired urination, problems with stool.;
- Stomach enlargement. Many women ignore this symptom because they believe that they just gained weight.;
Other possible manifestations: pain in the lower abdomen, lower back, legs, pain during intercourse. Although you need to remember that these signs are nonspecific and can often indicate other diseases