Menopause is feared by many women as the dreaded “Mid-life Change.” The loss of fertility associated with menopause is seen by some as a loss of purpose in life and as a sign of aging. Other women have decided to welcome menopause as a liberating time of life– when they finally don’t have to worry about unexpected pregnancies. Some women even participate in “croning” ceremonies that celebrate a woman’s arrival at that stage of life.
Menopause is defined as the time when a woman’s ovaries stop producing estrogen and her menstrual periods stop. For most women, there is a transition period called perimenopause, during which the hormone levels fluctuate. During perimenopause, the woman may experience symptoms such as hot flashes, mood swings, irregular or no menstrual periods. Perimenopause may start as early as thirty-five or as late as fifty-nine. The average age of menopause is fifty-one.
The reduced levels of estrogen at menopause may result in various symptoms: sleep problems; depression and mood swings; vaginal dryness, irritation or infections; urinary burning or pain; stress incontinence; memory loss; changes in sex drive and sexual response; weight gain; hair loss; or “spotting” and abnormal bleeding. The low estrogen levels also increase the risk of heart disease and osteoporosis, a disease of weakened bones.
Hormone replacement therapy (HRT) is a treatment chosen by many women. Usually a combination of estrogen and progestin, hormone replacement therapy is a way of preventing symptoms of menopause by replacing hormones no longer produced by the body. In addition to the benefit of relieving the menopausal symptoms, HRT may also reduce the risk of heart disease, stroke, osteoporosis, Alzheimer’s disease, colon cancer and may improve concentration and memory. However, this therapy may result in an increased risk of breast or endometrial cancer or side effects such as unusual vaginal bleeding, headaches, nausea, vaginal discharge, fluid retention, and swollen breasts. The decision to use hormone replacement therapy is an individual one that should be made on the advice of your health provider with consideration of your own medical history. For some, HRT is used on a short-term basis to relieve menopausal symptoms, for others it is used over a longer period both to relieve the menopausal symptoms and to prevent osteoporosis.