What is menopause?
When a woman has experienced no menstruation for 12 months, then
she is considered menopausal. It is a natural physiologic process that results
from the normal aging of the ovaries. It occurs when the ovaries can no longer
perform the function of ovulation and estrogen production.
Menopause normally takes place between the ages of 35 and 58.
About 25 percent of American women reach menopause by the age of 47, half by
the age of 50, three-fourths by the age of 52 and 95 percent by the age of
The perimenopause is that time when a woman begins to experience
the symptoms related to the decrease of estrogen production. Chief complaints
are related to menstrual irregularities. In the majority of women, bleeding
decreases with each period and the periods are spaced farther apart. In some
cases, there may be excessive bleeding during the regular periods. Other
symptoms that a woman may complain of during the perimenopause are related to
vasomotor changes, such as hot flashes or flushes of the face, neck and upper
body; excessive perspiration, especially at night; vaginal dryness; urinary
stress; incontinence or frequency; joint pain and backache; and insomnia, which
is usually due to the night sweats.
Hormonal changes and psychosocial stress associated with
adjustment to the aging process and perceived losses can lead to emotional
instability, irritability and depression. The woman may associate cessation of
menstruation with loss of femininity, sexual attractiveness or desire, and role
of potential parent, even though she may not want to have more
Hormonal replacement therapy (HRT) with estrogen is prescribed
with caution because of the possibility of complications. Alternatives to
hormonal replacement include limitation of foods high in saturated fat and
nitrites and avoiding red meat, coffee, tea, chocolate, colas and alcohol.
Vitamins E and D, vitamins of the B complex, calcium and magnesium may be
prescribed by some physicians. Regular exercise is especially important during
the perimenopausal years and after. Exercise stimulates the production of
endorphins which increase one's sense of well-being, improve circulation and
help to prevent osteoporosis.
The manner in which a woman reacts to the changes taking place
during the perimenopause depends to a great extent on her feelings of
self-esteem. Knowing what to expect and being able to get some control over
what is happening to her can significantly improve her physical and mental
health during this time.