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Menopause and
HRT
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Symptoms of Menopause
- Physical Changes At Menopause
- Other Symptoms
- Hot Flashes
- Irregular periods
- Vaginal/Urinary Tract Changes
- Menopause and Sex
- Menopause and Mental Health
Menopause affects people differently. Some women notice little difference in their
bodies or moods, while others find the change extremely bothersome and disruptive.
Estrogen and progesterone affect virtually all tissues in the body, but everyone is
influenced by them differently.
A typical example of a menopausal woman is described by Joan Borysenko of Mind- Body
Clinic of Harvard Medical School and author of "A womans book of life:"
" At fifty-two, Cynthia is
still menstruating, but irregularly. She occasionally skips periods, sometimes has periods
barely two weeks apart, and occasionally she has very heavy bleeding, or flooding. Several
times daily she has hot flashes that last for two to three minutes, turning her face and
neck crimson and leaving her with an odd tingling sensation, but these are not as
disturbing as night sweats that cause her to throw off damp covers and often strip off her
nightgown. No sooner does she fall asleep, it seems, that she awakens chilled and puts her
nightgown back on, only to wake up a short time later hot and sweaty. The cycle often
repeats itself two or three times in the course of a night, and she sometimes wakes up for
good at four or four-thirty A.M., unable to doze off again.
Like many people whose sleep is interrupted, Cynthia suffers from two kinds of fatigue.
One stems from simple lack of sleep. The other has its roots in what she calls the
"three-A. M. horror show." In the quiet hours of the night, she finds herself at
the mercy of an anxious mind that seizes on potential problems and embroiders them into
catastrophic proportions. Her mind goes round and round considering the what-ifs. What if
her daughter Susan can't raise the money to go back to school to become an X-ray
technician? What if her husband's company downsizes and he loses his job? What if her
college-age son drinks too much and gets in an accident? What if the breast pain she has
been experiencing means that she has breast cancer?
Her nightly worry fests are increasing her stress level. As a result she is fatigued
during the day and experiencing more hot flashes than she would if she could relax.
Furthermore, she finds herself drawn to her typical "stress diet" including
plenty of sweet rolls, coffee, diet soda, and fatty meat, her traditional comfort foods.
The sweets, often eaten instead of a meal, are causing major fluctuations in blood sugar,
leading to hypoglycemia and fatigue. The caffeine is increasing blood pressure and heart
rate, making her hot flashes worse. More caffeine is present in the diet soda, as are
phosphates, which displace calcium from her bones, predisposing her to osteoporosis.
Furthermore, the caffeine is contributing to the fibrocystic condition of Cynthia's
breasts, causing mastodynia, or breast pain."
This gives in a nutshell, the common experience of women who undergo menopausal
symptoms.
Important: Some of the symptoms of
menopause may be actually signs of more serious conditions that require medical attention.
Please check Call or Contact Your Doctor section for more information.
The most common symptoms of menopause are:
Physical Changes At Menopause
 | Some shrinking of the vagina, cervix uterus, and ovaries |
 | Shortening of the vagina, with loss of muscle tone and thinning of the lining |
 | Changes in labia majora including possible thinning, paleness, and loss of elasticity |
 | Loss of muscle tone of supporting ligaments |
 | Reduction in vaginal and cervical secretions |
 | Changes in breast size, firmness, and shape |
 | Thinning of body hair in most women; possible increase of facial hair |
 | Wrinkling and loss of skin tone |
 | Loss of bone mass |
 | Slowing of metabolic rate |
Other Symptoms
 | Hot flashes |
 | Night sweats, often leading to sleep disturbance |
 | Nervousness. |
 | Dizziness. |
 | Depression. |
 | Mood swings. |
 | Thinning of the bones. |
 | Weight gain. |
 | An irregular or rapid heart beat. |
 | Difficulty holding the urine |
 | Vaginal dryness, itching or other discomfort which results in painful sexual intercourse |
 | More or less interest in sex. |
 | Skin changes such as dryness and increased moles. |
 | Brittle bones, leading to frequent fractures that may be slow to heal |
 | Varicose veins |
 | Rheumatic symptoms |
 | Constipation |
 | Irregular bleeding |
Hot Flashes
Hot flashes, or flushes, are the most common symptom of menopause, affecting more than
60 percent of menopausal women.
A hot flash is a sudden waves of heat that can start in the waist or chest and work
their way to the neck and face and sometimes the rest of the body. The face and neck may
become flushed, with red blotches. This is often followed by profuse sweating and then
cold shivering as body temperature readjusts. They are more common in the evening and
during hot weather. They can hit as often as every 90 minutes. Each one can last from 15
seconds to 30 minutes - 5 minutes is average. Seventy-five to eighty percent of women
going through menopause experience hot flashes. Hot flashes bother some women more than
others. Sometimes heart palpitations accompany hot flashes.
Hot flashes occur sporadically and often start several years before other signs of
menopause. They gradually decline in frequency and intensity with age. Eighty percent of
all women with hot flashes have them for 2 years or less, while a small percentage have
them for more than 5 years. Hot flashes can happen at any time. They can be as mild as a
light blush, or severe enough to wake you from a deep sleep. Some women even develop
insomnia. Others have experienced that caffeine, alcohol, hot drinks, spicy foods, and
stressful or frightening events can sometimes trigger a hot flash. However, avoiding these
triggers will not necessarily prevent all episodes.
Hot flashes appear to be a direct result of decreasing estrogen levels. If there is no
estrogen, your glands release other hormones that dilate blood vessels and destabilize
body temperature. Hormone therapy relieves the discomfort of hot flashes in most cases.
Vitamin E may offer minor relief.
Irregular periods
This varies and can include:
 | Periods that get shorter and lighter for 2 or more years |
 | Periods that stop for a few months and then start up again and are more widely spaced |
 | Periods that bring heavy bleeding and/or the passage of many or large blood clots. This
can lead to anemia. |
Vaginal/Urinary Tract Changes
With advancing age, the walls of the vagina become thinner, dryer, less elastic and
more vulnerable to infection. These changes can make sexual intercourse uncomfortable
or painful.
Lubricate the vagina with water-soluble lubricants. Avoid petroleum jelly; many women
are allergic, and it damages condoms.
Tissues in the urinary tract also change with age, sometimes leaving women more
susceptible to involuntary loss of urine (incontinence), particularly if certain
chronic illnesses or urinary infections are also present. Bladder training is a simple and
effective treatment for most cases of incontinence and is less expensive and safer than
medication or surgery.
Within 4 or 5 years after the final menstrual period, there is an increased chance
of vaginal and urinary tract infections. Infections are easily treated with
antibiotics, but often tend to recur. To help prevent these infections, urinate before and
after intercourse, be sure your bladder is not full for long periods, drink plenty of
fluids, and keep your genital area clean. Douching is not thought to be effective in
preventing infection.
Menopause and Mental Health
Despite the common myth to the contrary, menopause does not cause unpredictable mood
swings, depression, or stress in most women.
Studies showed that women already taking hormones who are experiencing mood or
behavioral problems sometimes respond well to a change in dosage or type of estrogen.
Also, women of childbearing age, particularly those with young children at home, tend
to report more emotional problems than women of other ages.
Menopausal women were no more depressed than the general population: about 10 percent
are occasionally depressed and 5 percent are persistently depressed. The exception is
women who undergo surgical menopause. Their depression rate is reportedly double that of
women who have a natural menopause.
Emotional changes associated with menopause:
 | Irritability |
 | Mood changes |
 | Lack of concentration, difficulty with memory |
 | Tension, anxiety, depression |
 | Insomnia, which may result from hot flashes that interrupt sleep |
Menopause and Sex
For some women menopause brings a decrease in sexual activity. Reduced hormone levels
cause subtle changes in the genital tissues. Lower estrogen levels decrease the blood
supply to the vagina and the nerves and glands surrounding it. This makes delicate tissues
thinner, drier, and less able to produce secretions to comfortably lubricate before and
during intercourse. So, some women show a lack of interest in sex. Estrogen creams and
oral estrogen can restore secretions and tissue elasticity. Water-soluble lubricants can
also help.
Some women actually feel liberated after menopause and report an increased interest in
sex. They feel relieved that the children are out of the house and pregnancy is no longer
a worry.
Next Topic: Long-Term
Effects Of Estrogen Deficiency
[Menopause and HRT
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