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Biological and psychosocial issues





The years leading up to menopause when ovulation and menstruation stop, are different from woman to woman. Some women menstruate regularly until their periods suddenly stop. Others may see changes in the amount of menstrual flow or the length of time between periods.

Still others have missed periods or bleeding between periods. Although irregular periods are often a normal part of the years leading up to menopause, irregular vaginal bleeding can also be a warning sign of other health problems. If your periods become irregular or you have bleeding between periods, keep a menstrual diary and check with your medical provider.

As many as 80 percent of women have hot flashes as they near menopause. So women may have them before periods stop. Hot flashes is nothing but a flushed feeling that usually begins around the chest and spreads to the neck, face, and arms and last 3 to 4 minutes and can occur often as once an hour.

Often hot flashes are followed by sweating and then chills. They can happen any time of day or night and may last for up to 5 years the womanís body adjusts to the ovaries much lower production of the hormones estrogen and progesterone. Hot flashes rarely last longer than 5 years.

Increasingly, researchers have come believe that a lack of adequate sleep as a result of nighttime hot flashes is to blame for much of the moodiness and other psychological symptoms linked with menopause. Scientific studies have yet prove a relationship between lower estrogen levels and depression, moodiness, irritability, fatigue, or other psychological symptoms commonly felt during menopause.

Lack of adequate sleep, how-ever can cause any number of these symptoms, making nighttime hot flashes. Other life issues happening along with menopause may also add to depression and or other symptoms.

Reduced estrogen levels in the body do, however, contribute to vaginal dryness and urinary problems, both of which can continue to be problems well beyond menopause. With much less estrogen in the body, the vaginal walls lose elasticity, become thinner, and secrete less fluid. A drier, less elastic vagina can mean discomfort or pain during or after intercourse. Surprisingly, avoiding intercourse can make the problem worse, while continued sexual activity improves blood circulation and suppleness of the vagina, thus reducing or stopping discomfort during intercourse.

Hormone replacement therapy (HRT) can relieve vaginal dryness, reduce or end hot flashes, help bladder symptoms, prevent osteoporosis, and may reduce cardiovascular disease risk. Combined estrogen and progesterone is recommended for women who have not had a hysterectomy. Estrogen alone is recommended for those who have had a hysterectomy.

Many women and medical providers worry that estrogen replacement therapy may increase the risk of breast cancer. The largest and most carefully done studies, however, show no absolute evidence that this is true. Furthermore, estrogen has been shown to lower the risk of cardiovascular disease and osteoporosis, Most experts today agree that the benefits of HRT far outweigh any potential risks.

About 10 percent of women receiving HRT have minor side effects, such as breast tenderness, nausea, headaches, fluid retention, or irregular vaginal bleeding. For most women, however, these side effects do not interfere with continuing the hormone therapy.

Some women should not use HRT (such as those with a history of breast cancer), but other drugs are available to help relieve menopausal symptoms.

Self Care

Dress in layers and wear loose clothing.

Set the thermostat at 68į F or lower.

Drink plenty of water. Six to eight glassesí a day is about right.

Exercise regularly Thirty minutes of moderate, weight-bearing exercise (such as walking) 3 days a Week can help reduce hot flashes and guard against osteoporosis by building stronger bones. Non-weight-bearing exercise, such as swimming or bicycling will also help with hot flashes that benefit you heart.

Avoid caffeine and alcohol, which can intensify hot flashes and cause insomnia.

Use a water soluble lubricant to relieve vaginal dryness. Donít use petroleum jelly products such as Vaseline.

Allow yourself time to become aroused before having intercourse. Menopause does not cause you to lose your sex drive. By savoring the moment, intercourse can be even more enjoyable, and less uncomfortable if you suffer from vaginal dryness.

Eat a balanced diet.

Signs that can be taken care of :

Irregular periods that donít return to normal within 3 months (i.e., periods less than 20 days from the start of one to the start of the next cycle; cycles more than 90 days apart; bleeding longer than 8 days).

Bleeding between periods or bleeding heavy enough to soak a pad or tampon an hour for 2 to 3 hours in a row.

Any vaginal bleeding after no periods for 6 months or longer.

Pain or burning during urination.

Vaginal bleeding after intercourse.

Symptoms not relieved by self-care.

Hot flashes, vaginal dryness, or irregular periods.


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