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Menopause

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Menopause

NIH – Menopause “Two common health problems can start to happen at menopause, and you might not even notice. Osteoporosis. Day in and day out, your body is busy breaking down old bone and replacing it with new healthy bone. Estrogen helps control bone loss, and losing estrogen around the time of menopause causes women to lose more bone than is replaced. In time, bones can become weak and break easily. This condition is called osteoporosis. Talk to your doctor to see if you should have a bone density test to find out if you are at risk. Your doctor can also suggest ways to prevent or treat osteoporosis. Heart disease. After menopause, women are more likely to have heart disease. Changes in estrogen levels may be part of the cause. But, so is getting older. As you age, you may gain weight and develop other problems, like high blood pressure. These could put you at greater risk for heart disease. Be sure to have your blood pressure and levels of triglycerides, fasting blood glucose, and LDL, HDL, and total cholesterol checked regularly. Talk to your health care provider to find out what you should do to protect your heart. How Can I Stay Healthy After Menopause? Staying healthy after menopause may mean making some changes in the way you live. • Don’t smoke. If you do use any type of tobacco, stop—it’s never too late to benefit from quitting smoking. • Eat a healthy diet, low in fat, high in fiber, with plenty of fruits, vegetables, and whole-grain foods, as well as all the important vitamins and minerals. • Make sure you get enough calcium and vitamin D—in your diet or with vitamin/mineral supplements. • Learn what your healthy weight is, and try to stay there. • Do weight-bearing exercise, such as walking, jogging, or dancing, at least 3 days each week for healthy bones. But try to be physically active in other ways for your general health. “

NIH – Menopause (Medical Encyclopedia) “Menopause is a natural event that normally occurs between the ages of 45 and 55. Once menopause is complete (called postmenopause), you can no longer become pregnant. The symptoms of menopause are caused by changes in estrogen and progesterone levels. As the ovaries become less functional, they produce less of these hormones and the body responds accordingly. The specific symptoms you experience and how significant (mild, moderate, or severe) varies from woman to woman. In some women, menstrual flow comes to a sudden halt. More commonly, it tapers off. During this time, your menstrual periods generally become either more closely or more widely spaced. This irregularity may last for 1 to 3 years before menstruation finally ends completely. A gradual decrease of estrogen generally allows your body to slowly adjust to the hormonal changes. When estrogen drops suddenly, as is seen when the ovaries are removed surgically (called surgical menopause), symptoms can be more severe. Because hormone levels fall, changes occur in the entire female reproductive system. The vaginal walls become less elastic and thinner. The vagina becomes shorter. Lubricating secretions from the vagina become watery. The outside genital tissue decreases. This is called atrophy of the labia.“

NHS – Menopause (Video)

NHS – Menopause “Menopause myths • You can’t get pregnant after the menopause FALSE. It can and does happen so carry on using contraception for two years after your last period if you're under 50 and for one year if you're over 50. • You're going to put on weight FALSE. Middle-age-spread is often linked to the hormonal changes at this time of life but as yet there's no proof. Those extra inches could just be part of growing older and being less active. • Your menopause will be difficult because your mum’s was FALSE. There's no evidence to suggest this, although the age at which your mum went through hers could give you a clue as to when to expect symptoms, as the age of menopause tends to be similar in mums and daughters.”

Highlighted Articles

Relationships between menopausal symptoms, depression, and exercise in middle-aged women: A cross-sectional survey (International Journal of Nursing Studies 2008) “Women who were depressed had more menopausal symptoms than women who were not depressed, and women who exercised regularly were less depressed and less symptomatic than women who did not exercise.”

Dietary and lifestyle predictors of age at natural menopause and reproductive span in the Shanghai Women's Health Study. (Menopause. 2008) “RESULTS:: Early menarche, younger age at first live birth, older age at last live birth, longer duration of breast-feeding, and higher parity were associated with longer reproductive years (Ptrend < 0.01 for all). Higher body mass index at age 20, mid-life weight gain, and leisure-time physical activity during adolescence and adulthood predicted later menopause and longer reproductive span (Ptrend < 0.01 for all). Total intake of calories, fruits, and protein was positively associated with later menopause (Ptrend < 0.05 for all) and longer reproductive span (Ptrend < 0.05), except for carbohydrates (Ptrend = 0.06), and long-term tea consumption predicted longer reproductive span (Ptrend = 0.03). Vegetable, fat, soy, and fiber intakes did not significantly affect reproductive span or age at menopause. Smoking was inversely associated with both early age at menopause and shorter reproductive span (Ptrend < 0.01). CONCLUSIONS:: In addition to reproductive factors, intake of fruits and protein, smoking, tea consumption, lifetime patterns of physical activity, and weight gain influenced the onset of menopause and/or reproductive span in Chinese women.”

Night sweats, sleep disturbance, and depression associated with diminished libido in late menopausal transition and early postmenopause: baseline data from the Herbal Alternatives for Menopause Trial (HALT). (Am J Obstet Gynecol. 2007) "RESULTS: Of 341 women, 64% had diminished libido, 18% had moderate to severe depression, and 43% had poor sleep quality. Women averaged 4.6 hot flashes and 1.9 night sweats per day. Depressive symptoms (P = .003), poor sleep (P = .02), and night sweats (P = .04) were significantly associated with diminished libido."

The timing of natural menopause in Poland and associated factors. (Maturitas. 2007) " RESULTS: The overall median age at natural menopause was 51.25 years; 25th percentile 49; 75th percentile 54 years."

Severe Hot Flashes May Be Linked to Chronic Insomnia (2007) "Hot flashes occurred in 12.5% of premenopausal women, 79.0% of perimenopausal women, and 39.3% of postmenopausal women. Chronic insomnia occurred in 36.5% of premenopausal women, 56.6% of perimenopausal women, and 50.7% of postmenopausal women (P < .001). Prevalence of symptoms of chronic insomnia increased with the severity of hot flashes. More than 80% of perimenopausal women and postmenopausal women who had severe hot flashes also had symptoms of chronic insomnia."

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Menopause

General Information

NEWS:

Abdominal Adiposity Linked to Hot Flashes in Menopausal Women

Cigarette Smoking Linked to Hot Flashes

Effect of natural early menopause on bone mineral density (Maturitas 2008)

Menopausal hot flashes worse for heavier women “Based on the findings, Thurston and her colleagues add, weight loss -- especially loss of fat -- may help women going through menopause to reduce hot flashes and night sweats.”

Menopause: Better late than early

Study Links Hot Flashes & Memory Loss

Sunnier mood for menopausal women: study “Menopause might sap energy and damage the sex drive of older women but the effect on mood and stress levels is positive, new studies show. Menopause is often blamed for increased emotional, physical and sexual dissatisfaction as women age, but researchers presenting findings at a women's mental health conference in Melbourne say the news is not all bad. "In fact it's quite good," said Professor Lorraine Dennerstein, a psychiatrist at the University of Melbourne, told delegates. "We found that women's overall mood actually lifts as they go through the transition, a fact that is really not widely known at all." … Post-menopausal women are not necessarily happier however. Research shows happiness in later life depends on each individual's attitude to ageing, feelings for their partner, the level of daily hassles they deal with and their general disposition earlier in life.“

Women Don't Notice 40% of Their Hot Flashes “"In other words, the hot flash-memory relationship is not all in a woman's head. It's actually a physiological relationship that you can pick up on, if you measure hot flashes objectively with a monitor." The researchers also noted a link between the total number of hours of sleep and memory performance the next day. "The total number of hours slept predicted worse memory performance, but also the total number of hot flashes during the night when a woman was sleeping predicted memory dysfunction," Maki said. "So, the two together worsen memory in women the next day." She said the findings suggest that treating vasomotor symptoms in women with hot flashes may improve their memory.”

ARTICLES:

Atrophic Vaginitis: An Undertreated Epidemic

Menopause: Time for a Change

JOURNAL ARTICLES:

Approach to the patient with menopausal symptoms. (J Clin Endocrinol Metab. 2008)

Association of age at menarche with cardiovascular risk factors, vascular structure, and function in adulthood: the Cardiovascular Risk in Young Finns study (Am J Clin Nutr 2008)

Blood pressure around the menopause: a population study. (J Hypertens. 2008)

Cycle and hormone changes during perimenopause: the key role of ovarian function. (Menopause. 2008)

Dietary and lifestyle predictors of age at natural menopause and reproductive span in the Shanghai Women's Health Study. (Menopause. 2008) “RESULTS:: Early menarche, younger age at first live birth, older age at last live birth, longer duration of breast-feeding, and higher parity were associated with longer reproductive years (Ptrend < 0.01 for all). Higher body mass index at age 20, mid-life weight gain, and leisure-time physical activity during adolescence and adulthood predicted later menopause and longer reproductive span (Ptrend < 0.01 for all). Total intake of calories, fruits, and protein was positively associated with later menopause (Ptrend < 0.05 for all) and longer reproductive span (Ptrend < 0.05), except for carbohydrates (Ptrend = 0.06), and long-term tea consumption predicted longer reproductive span (Ptrend = 0.03). Vegetable, fat, soy, and fiber intakes did not significantly affect reproductive span or age at menopause. Smoking was inversely associated with both early age at menopause and shorter reproductive span (Ptrend < 0.01). CONCLUSIONS:: In addition to reproductive factors, intake of fruits and protein, smoking, tea consumption, lifetime patterns of physical activity, and weight gain influenced the onset of menopause and/or reproductive span in Chinese women.”

Dyspareunia in postmenopausal women: A critical review (Pain Research and Management 2008) “CONCLUSIONS: Postmenopausal dyspareunia occurring concurrently with vaginal atrophy is strongly associated with a lack of estrogen in the genital tract. However, a significant percentage of postmenopausal women experience dyspareunic pain that is not caused by hypoestrogenism. It is likely that other types of dyspareunia that occur premenopausally are also occurring in postmenopausal women.”

Effect of dietary flaxseed on serum levels of estrogens and androgens in postmenopausal women. (Nutr Cancer. 2008)

Factors Associated With Worsening and Improving Urinary Incontinence Across the Menopausal Transition. (Obstet Gynecol. 2008) “CONCLUSION: In midlife incontinent women, worsening of incontinence symptoms was not attributable to the menopausal transition. Modifiable factors such as weight gain account for worsening of incontinence during this life stage.”

Hot Flashes and Subclinical Cardiovascular Disease. Findings From the Study of Women's Health Across the Nation Heart Study. (Circulation. 2008) “Conclusions-Women with hot flashes had reduced flow-mediated dilation and greater aortic calcification. Hot flashes may mark adverse underlying vascular changes among midlife women.”

Low dietary calcium in European postmenopausal osteoporotic women. (Public Health Nutr. 2008)

Identification of the risk factors for osteoporosis among postmenopausal women. (Maturitas. 2008)

Menopausal Complaints Are Associated With Cardiovascular Risk Factors. (Hypertension. 2008) “Results were similar for complaints of night sweating. The findings support the view that menopausal complaints are associated with a less favorable cardiovascular risk profile. These findings substantiate the view that differences in the presence of menopausal symptoms as a reason for using hormone therapy could explain discrepant findings between observational research and trials.”

Menopause and the Metabolic Syndrome (Arch Intern Med. 2008) “Conclusions As testosterone progressively dominates the hormonal milieu during the menopausal transition, the prevalence of MetS increases, independent of aging and other important covariates. This may be a pathway by which cardiovascular disease increases during menopause.”

Persistent Hot Flushes in Older Postmenopausal Women (Arch Intern Med. 2008)

Relationships between menopausal symptoms, depression, and exercise in middle-aged women: A cross-sectional survey (International Journal of Nursing Studies 2008) “Women who were depressed had more menopausal symptoms than women who were not depressed, and women who exercised regularly were less depressed and less symptomatic than women who did not exercise.”

Sleep and the menopause - do postmenopausal women experience worse sleep than premenopausal women? (Menopause Int. 2008)

The prevalence and pattern of gastroesophageal reflux symptoms in perimenopausal and menopausal women (Journal of the American Academy of Nurse Practitioners 2008)

Vulvovaginal atrophy is strongly associated with female sexual dysfunction among sexually active postmenopausal women. (Menopause. 2008)

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