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Menopause : Symptoms, Causes, Diagnosis and Treatment

What is Menopause?

Menopause is a transition into a new phase of life. It begins when the menstrual cycle finishes. Menopause is not a health problem, and some experience it as a time of liberation. However, hormonal changes and other factors involved can cause discomfort.

Menopause usually starts between the ages of 40 and 58 years in developed countries, where the average age is 51 years. For some, it will occur earlier due to a medical condition or treatment, such as the removal of the ovaries.

Around the time of menopause, many females experience physical symptoms such as hot flashes, night sweats, vaginal dryness, and a reduced sex drive. It can also lead to anxiety, changes in mood, and a reduced sex drive.

These symptoms may start before menstruation ends, and they can last for several years. The impact on a person?s quality of life can range from mild to severe. However, there are ways of managing these symptoms.

Each person will experience menopause differently. Many have full, active lives throughout the transition and afterward, and some feel relieved by no longer having to deal with menstruation or birth control.

Maintaining a healthful diet and getting regular exercise can help a person feel better and boost their overall health in the long term. For those who experience menopause symptoms, treatments and support are available.

Menopause is the stage of life that follows the end of the menstrual cycles. Each person may experience menopause differently.

It can last for several years, and there are three stages:

Perimenopause is the transitional time that starts before menopause and includes the 12 months that follow a person?s last period.

Menopause starts either 12 months after the last period or when menstruation has stopped for a clinical reason, such as the removal of the ovaries.

Postmenopause refers to the years after menopause, although it can be difficult to know when menopause finished and postmenopause starts.

Menopause belongs under the category of Sexual disease. Perimenopause, Menopause, Postmenopause are some common types of Menopause. Generally Female are the victim of the Menopause. Seriousness of this disease is Medium.

Symptoms of Menopause are :

  • Loss of breast fullness
  • Thinning hair
  • Hot flashes from vagina
  • Vaginal dryness
  • Irregular menstrual cycle or Irregular periods
  • On average, The normal length of a woman?s menstrual cycle is 24 to 38 days. A period usually lasts about 2 to 8 days. So this varies between individuals. When the length of the cycle is more than 35 days, or if the duration varies then it is called irregular menstruation or irregular periods.

  • mood swings
  • Weight gain
  • Weight gain can result from an increase in body fluid, muscle mass, or fat. An increase in body fluid can come from medications, fluid and salt retention, intravenous fluid infusion, kidney or heart failure. An increase in muscle mass is commonly seen with exercising. An increase in body fat is commonly seen as a result of diet or lack of exercise as the body converts muscle to fat. An excessive weight gain is referred to as obesity. Obesity is a function of environmental (diet, exercise, lifestyle, etc.), hormonal, and inherited (genetic) factors in varying degrees. Weight gain is a normal part of pregnancy.

  • Sleep problems
  • Night sweats
  • Night sweats are repeated episodes of extreme perspiration that may soak your nightclothes or bedding and are related to an underlying medical condition or illness.

    You may occasionally awaken after having perspired excessively, particularly if you are sleeping under too many blankets or if your bedroom is too warm. Although uncomfortable, these episodes are usually not labeled as night sweats and typically aren't a sign of a medical problem.

    In general, night sweats are also associated with fever, weight loss, localized pain, cough, diarrhea, or other symptoms of concern.

  • shaking chills
  • The shaking chills are sometimes referred to as rigors. They are kind of like shivering when you have an infection and fever, but much more intense. Teens usually get shaking chills from very bad infections, some drugs, and sometimes during blood transfusions. If you read the section on Fever, you will learn what causes your body to have a fever. Essentially, when your body senses a foreign substance ? germs, drugs, someone else?s blood ? it responds by increasing your body temperature, so it can fight off the perceived intruder. When your body temperature rises, the surface air feels cold and you begin to shiver. Sometimes the shivers are very intense and become shaking chills or rigors. One common anti-fungal medicine that often causes rigors is amphotericin (or sometimes referred to as ampho-terrible!). If this happens to you, your medical team may be able to switch you to a different type of amphotericin called liposomal amphotericin. You may also have the shaking chills when getting a blood transfusion. Even though the white blood cells (which often cause a reaction) have been filtered out of donated blood, a few remaining cells may cause you to have this reaction. Many teens describe this as one of the most frightening side effects of treatment. If you have this reaction, you will start feeling very cold. Soon, despite all efforts to get warm, you may begin shaking uncontrollably. The first time it happens you may think you are having some kind of seizure. Very scary! After a while, the chills and shaking will subside and you will feel very warm. Off come the blankets and heating pads and out come the cool washcloths! Read more about this in the Fever section.

    Causes

    Menopause can be caused due to:

    • **
      Natural decline of reproductive hormones.** As you approach your late 30s, your ovaries start making less estrogen and progesterone ? the hormones that regulate menstruation ? and your fertility declines. In your 40s, your menstrual periods may become longer or shorter, heavier or lighter, and more or less frequent, until eventually ? on average, by age 51 ? your ovaries stop producing eggs, and you have no more periods.
    • Hysterectomy. A hysterectomy that removes your uterus but not your ovaries usually doesn't cause immediate menopause. Although you no longer have periods, your ovaries still release eggs and produce estrogen and progesterone. But surgery that removes both your uterus and your ovaries (total hysterectomy and bilateral oophorectomy) does cause immediate menopause. Your periods stop immediately, and you're likely to have hot flashes and other menopausal signs and symptoms, which can be severe, as these hormonal changes occur abruptly rather than over several years.
    • Chemotherapy and radiation therapy. These cancer therapies can induce menopause, causing symptoms such as hot flashes during or shortly after the course of treatment. The halt to menstruation (and fertility) is not always permanent following chemotherapy, so birth control measures may still be desired.
    • Primary ovarian insufficiency. About 1 percent of women experience menopause before age 40 (premature menopause). Menopause may result from primary ovarian insufficiency ? when your ovaries fail to produce normal levels of reproductive hormones ? stemming from genetic factors or autoimmune disease. But often no cause can be found. For these women, hormone therapy is typically recommended at least until the natural age of menopause in order to protect the brain, heart and bones.

    What kind of precaution should be taken in Menopause?

    • Avoid triggers like spicy foods, caffeine, or alcohol. Smoking may also make hot flashes worse.
    • Dress in layers.
    • Use a fan at work or in your home to help cool you down.
    • Talk to your doctor about medications that may help reduce your hot flash symptoms.

    Treatment for the Menopause

    Diagnosis:

    Signs and symptoms of menopause are usually enough to tell most women that they've started the menopausal transition. If you have concerns about irregular periods or hot flashes, talk with your doctor. In some cases, further evaluation may be recommended.

    Tests typically aren't needed to diagnose menopause. But under certain circumstances, your doctor may recommend blood tests to check your level of:

    • Follicle-stimulating hormone (FSH) and estrogen (estradiol), because your FSH levels increase and estradiol levels decrease as menopause occurs
    • Thyroid-stimulating hormone (TSH), because an underactive thyroid (hypothyroidism) can cause symptoms similar to those of menopause

    Over-the-counter home tests to check FSH levels in your urine are available. The tests could tell you whether you have elevated FSH levels and might be in perimenopause or menopause. But, since FSH levels rise and fall during the course of your menstrual cycle, home FSH tests can't really tell you whether or not you're definitely in a stage of menopause.

    Additional blood tests commonly used to help confirm menopause include:

    • thyroid function tests
    • blood lipid profile
    • liver function tests
    • kidney function tests
    • testosterone, progesterone, prolactin, estradiol, and chorionic gonadotropin (hCG) tests

    Treatment:

    Menopause requires no medical treatment. Instead, treatments focus on relieving your signs and symptoms and preventing or managing chronic conditions that may occur with aging. Treatments may include:

    • Hormone therapy. Estrogen therapy is the most effective treatment option for relieving menopausal hot flashes. Depending on your personal and family medical history, your doctor may recommend estrogen in the lowest dose and the shortest time frame needed to provide symptom relief for you. If you still have your uterus, you'll need progestin in addition to estrogen. Estrogen also helps prevent bone loss. Long-term use of hormone therapy may have some cardiovascular and breast cancer risks, but starting hormones around the time of menopause has shown benefits for some women. You and your doctor will discuss the benefits and risks of hormone therapy and whether it's a safe choice for you.
    • Vaginal estrogen. To relieve vaginal dryness, estrogen can be administered directly to the vagina using a vaginal cream, tablet or ring. This treatment releases just a small amount of estrogen, which is absorbed by the vaginal tissues. It can help relieve vaginal dryness, discomfort with intercourse and some urinary symptoms.
    • Low-dose antidepressants. Certain antidepressants related to the class of drugs called selective serotonin reuptake inhibitors (SSRIs) may decrease menopausal hot flashes. A low-dose antidepressant for management of hot flashes may be useful for women who can't take estrogen for health reasons or for women who need an antidepressant for a mood disorder.
    • Gabapentin (Neurontin, Gralise, others). Gabapentin is approved to treat seizures, but it has also been shown to help reduce hot flashes. This drug is useful in women who can't use estrogen therapy and in those who also have nighttime hot flashes.
    • Clonidine (Catapres, Kapvay, others). Clonidine, a pill or patch typically used to treat high blood pressure, might provide some relief from hot flashes.
    • Medications to prevent or treat osteoporosis. Depending on individual needs, doctors may recommend medication to prevent or treat osteoporosis. Several medications are available that help reduce bone loss and risk of fractures. Your doctor might prescribe vitamin D supplements to help strengthen bones.

    Possible complication with Menopause

    After menopause, your risk of certain medical conditions increases. Examples include:

    • Heart and blood vessel (cardiovascular) disease. When your estrogen levels decline, your risk of cardiovascular disease increases. Heart disease is the leading cause of death in women as well as in men. So it's important to get regular exercise, eat a healthy diet and maintain a normal weight. Ask your doctor for advice on how to protect your heart, such as how to reduce your cholesterol or blood pressure if it's too high.

    • Osteoporosis. This condition causes bones to become brittle and weak, leading to an increased risk of fractures. During the first few years after menopause, you may lose bone density at a rapid rate, increasing your risk of osteoporosis. Postmenopausal women with osteoporosis are especially susceptible to fractures of their spine, hips and wrists.

    • Urinary incontinence. As the tissues of your vagina and urethra lose elasticity, you may experience frequent, sudden, strong urges to urinate, followed by an involuntary loss of urine (urge incontinence), or the loss of urine with coughing, laughing or lifting (stress incontinence). You may have urinary tract infections more often.

      Strengthening pelvic floor muscles with Kegel exercises and using a topical vaginal estrogen may help relieve symptoms of incontinence. Hormone therapy may also be an effective treatment option for menopausal urinary tract and vaginal changes which can result in urinary incontinence.

    • Sexual function. Vaginal dryness from decreased moisture production and loss of elasticity can cause discomfort and slight bleeding during sexual intercourse. Also, decreased sensation may reduce your desire for sexual activity (libido).

      Water-based vaginal moisturizers and lubricants may help. If a vaginal lubricant isn't enough, many women benefit from the use of local vaginal estrogen treatment, available as a vaginal cream, tablet or ring.

    • Weight gain. Many women gain weight during the menopausal transition and after menopause because metabolism slows. You may need to eat less and exercise more, just to maintain your current weight.

    References:

    1 https://www.mayoclinic.org/diseases-conditions/menopause/symptoms-causes/syc-20353397 2 https://www.healthline.com/health/menopause#treatments 3 https://www.medicalnewstoday.com/articles/155651#treatment 4 https://www.nia.nih.gov/health/what-menopause 5 https://www.webmd.com/menopause/guide/menopause-basics#1 6 https://www.healthline.com/health/menopause/menopause-facts#bone-loss 7 https://www.medicinenet.com/menopause/article.htm 8 https://my.clevelandclinic.org/health/diseases/15224-menopause-perimenopause-and-postmenopause

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