Menopause
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Menopause
NIH - Menopause “Menopause is the time in a woman's life when her period stops. It usually occurs naturally, most often after age 45. Menopause happens because the woman's ovary stops producing the hormones estrogen and progesterone. A woman has reached menopause when she has not had a period for one year. Changes and symptoms can start several years earlier. They include • A change in periods - shorter or longer, lighter or heavier, with more or less time in between • Hot flashes and/or night sweats • Trouble sleeping • Vaginal dryness • Mood swings • Trouble focusing • Less hair on head, more on face Menopause is not a disorder. Most women do not need treatment for it. However, if symptoms are severe, medicines may help. After menopause, women are more vulnerable to bone loss and heart disease. Exercise and eating right can help keep women healthy as they age.“
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 “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:
A dip in sex drive is tied to menopause
BMD for all women at menopause
Hot flashes linked to lower bone density “The study, published in the journal Menopause, found postmenopausal women with vasomotor symptoms -- which include hot flashes and night sweats -- had lower bone mineral density.”
Increase in visceral fat during menopause linked with testosterone “"For many years, it was thought that estrogen protected premenopausal women against cardiovascular disease and that the increased cardiovascular risk after menopause was related only to the loss of estrogen's protective effect," said Janssen. "But our studies suggest that in women, it is the change in the hormonal balance – specifically, the increase in active testosterone – that is predominantly responsible for visceral fat, and for the increased risk of cardiovascular disease."”
Is rapid transition through menopause linked to earlier onset of heart disease? “Preliminary study detects a possible connection between shorter menopause and faster progression of atherosclerosis, pointing to the need for more definitive research.“
Memory Takes a Hit During Menopause “"The good news is that when women are finished with the menopause transition and in steady postmenopause, cognitive performance, memory, learning, all that comes back to premenopause levels," said Dr. Arun S. Karlamangla, an associate professor of medicine at UCLA's David Geffen School of Medicine and the study's senior author.”
Menopause, as Brought to You by Big Pharma
Postmenopausal women, too, reap cardiovascular benefits from endurance training “In a paper appearing in the September issue of the journal Metabolism - Clinical and Experimental, Brooks and Zarins report that participants increased their body's capacity to consume and use oxygen - their VO2 max - by an average of 16 percent and dropped their resting heart rates by an average of 4 beats per minute. Brooks said that after the age of 30, people lose the capacity to consume and use oxygen at about 1 percent per year. "So, in effect, the women in our study had the cardiovascular and metabolic capabilities of women 16 years younger," he said. By the end of the study, the women's blood pressure during exercise had dropped by 8 millimeters of mercury, while their heart rates were 19 beats per minute less when performing at the same intensity as early in the study. In addition, the women decreased their carbohydrate burning during exercise and increased their fat burning by about 10 percent. Women in the study maintained their body weight as a way to balance energy input and expenditures. "While men tend to burn carbohydrates first during exercise, women are better fat burners, and in our study, the women improved fat burning and decreased their reliance on carbohydrate after training," Brooks said. Because they burn fat more than carbohydrates during exercise, women, in general, are better than men at maintaining stable blood glucose levels - the glucose comes from stored carbohydrates - and maintaining their weight, even while undergoing vigorous training, he said. In fact, men continue to burn carbohydrates for several hours after exercise, while women's metabolism immediately returns to normal.”
Shorter Menopause May Speed Risk of Heart Disease “In a study of more than 200 middle-aged women, those who completed menopause within three years had more fatty plaque built up in their carotid arteries, putting them at risk for "preclinical atherosclerosis" narrowing of arteries caused by the thickening of their walls.”
Vaginal Health in Post-Menopausal Women: Part 1
What Causes Irritability In Menopause?
Watch for depression during and after menopause “The risk for major depression more than doubles while women are going through menopause and afterward, according to research presented this week at the annual meeting of the North American Menopause Society in San Diego. Recent studies have suggested that the risk for depressive symptoms in women increases in midlife, around the time of menopause, perhaps because of the effects of reduced estrogen on the mind, and the stress of hot flashes and other symptoms. However, less is known about the risk for major depression. … Women were more than twice as likely to have a major depressive episode as they were going through menopause, and almost four times as likely after menopause, compared to before menopause.”
ARTICLES:
Are You Perimenopausal–14 Signs
JOURNAL ARTICLES:
Accelerated postmenopausal cognitive decline is restricted to women with normal BMI: Longitudinal evidence from the Betula project. (Psychoneuroendocrinology. 2009)
Age at Natural Menopause and Risk of Ischemic Stroke. The Framingham Heart Study. (Stroke. 2009) “CONCLUSIONS: In this prospective study, age at natural menopause before age 42 was associated with increased ischemic stroke risk.”
Are Changes in Cardiovascular Disease Risk Factors in Midlife Women Due to Chronological Aging or to the Menopausal Transition? (J Am Coll Cardiol, 2009) “Results: Only total cholesterol, low-density lipoprotein cholesterol, and apolipoprotein B demonstrated substantial increases within the 1-year interval before and after the FMP, consistent with menopause-induced changes. This pattern was similar across ethnic groups. The other risk factors were consistent with a linear model, indicative of chronological aging. Conclusions: Women experience a unique increase in lipids at the time of the FMP. Monitoring lipids in perimenopausal women should enhance primary prevention of CHD.”
Aspirin Use, Dose, and Clinical Outcomes in Postmenopausal Women With Stable Cardiovascular Disease (Circulation: Cardiovascular Quality and Outcomes. 2009) “Conclusions: After multivariate adjustment, aspirin use was associated with significantly lower risk of all-cause mortality, specifically, cardiovascular mortality, among postmenopausal women with stable CVD. No significant difference was noted between 81 mg and 325 mg of aspirin. Overall, aspirin use was low in this cohort of women with stable CVD.”
Body mass index, urinary incontinence, and female sexual dysfunction: how they affect female postmenopausal health. (Menopause. 2009) “CONCLUSIONS:: Increased BMI early in menopause represents a risk both for UI and for sexual dysfunction. Weight control has an essential role in postmenopause and should be considered early in perimenopause to safeguard female quality of life as well as to prevent or improve UI and female sexual dysfunction symptoms.”
Iron and menopause: Does increased iron affect the health of postmenopausal women? (Antioxid Redox Signal. 2009)
Postmenopausal women, too, reap cardiovascular benefits from endurance training “In a paper appearing in the September issue of the journal Metabolism - Clinical and Experimental, Brooks and Zarins report that participants increased their body's capacity to consume and use oxygen - their VO2 max - by an average of 16 percent and dropped their resting heart rates by an average of 4 beats per minute. Brooks said that after the age of 30, people lose the capacity to consume and use oxygen at about 1 percent per year. "So, in effect, the women in our study had the cardiovascular and metabolic capabilities of women 16 years younger," he said. By the end of the study, the women's blood pressure during exercise had dropped by 8 millimeters of mercury, while their heart rates were 19 beats per minute less when performing at the same intensity as early in the study. In addition, the women decreased their carbohydrate burning during exercise and increased their fat burning by about 10 percent. Women in the study maintained their body weight as a way to balance energy input and expenditures. "While men tend to burn carbohydrates first during exercise, women are better fat burners, and in our study, the women improved fat burning and decreased their reliance on carbohydrate after training," Brooks said. Because they burn fat more than carbohydrates during exercise, women, in general, are better than men at maintaining stable blood glucose levels - the glucose comes from stored carbohydrates - and maintaining their weight, even while undergoing vigorous training, he said. In fact, men continue to burn carbohydrates for several hours after exercise, while women's metabolism immediately returns to normal.”
Premature menopause is associated with increased risk of cerebral infarction in Japanese women. (Menopause. 2009)
Sleep in post-menopausal women: Differences between early and late post-menopause (European Journal of Obstetrics & Gynecology and Reproductive Biology 2009) “Although early menopause is associated with several symptoms, complaints related to sleep were higher in the late post-menopausal group.”
Vaginal Dryness: A Comparison of Prevalence and Interventions in 11 Countries. (J Sex Med. 2009)
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