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Menopause
| I
wasn't sure what to expect with menopause, although I certainly
looked forward to not having my period anymore. I have to
admit, I'm concerned about how my body will change. My mother
never talked about menopause. She says her mother never
did either, probably because then it was linked to old age
and poor health. Now, you hear about it all the time. The
"baby boom" generation is making menopause a big
issue because of their sheer numbers, and because they'll
live with it much longer than their grandmothers did. Back
then, menopause did come near the end of life. Now I'm going
through it, but I feel like I still have my whole life ahead
of me. |
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More than one third
of the women in the United States, about 36 million, have been
through menopause. With a life expectancy of about 81 years,
a 50-year-old woman can expect to live more than one third of
her life after menopause. Scientific research is just beginning
to address some of the unanswered questions about these years
and about the poorly understood biology of menopause.
Menopause is the
point in a woman's life when menstruation stops permanently,
signifying the end of her ability to have children. Known as
the "change of life," menopause is the last stage
of a gradual biological process in which the ovaries reduce
their production of female sex hormones--a process which begins
about 3 to 5 years before the final menstrual period. This transitional
phase is called the climacteric, or perimenopause. Menopause
is considered complete when a woman has been without periods
for 1 year. On average, this occurs at about age 50. But like
the beginning of menstruation in adolescence, timing varies
from person to person. Cigarette smokers tend to reach menopause
earlier than nonsmokers.
How Does It
Happen?
The ovaries contain
structures called follicles that hold the egg cells. You are
born with about 2 million egg cells and by puberty there are
about 300,000 left. Only about 400 to 500 ever mature fully
to be released during the menstrual cycle.
The rest degenerate
over the years. During the reproductive years, the pituitary
gland in the brain generates hormones that cause a new egg to
be released from its follicle each month. The follicle also
increases production of the sex hormones estrogen and progesterone,
which thicken the lining of the uterus. This enriched lining
is prepared to receive and nourish a fertilized egg following
conception. If fertilization does not occur, estrogen and progesterone
levels drop, the lining of the uterus breaks down, and menstruation
occurs.
For unknown reasons,
the ovaries begin to decline in hormone production during the
mid-thirties. In the late forties, the process accelerates and
hormones fluctuate more, causing irregular menstrual cycles
and unpredictable episodes of heavy bleeding. By the early to
mid-fifties, periods finally end altogether. However, estrogen
production does not completely stop. The ovaries decrease their
output significantly, but still may produce a small amount.
Also, another form of estrogen is produced in fat tissue with
help from the adrenal glands (near the kidney). Although this
form of estrogen is weaker than that produced by the ovaries,
it increases with age and with the amount of fat tissue.
Progesterone, the
other female hormone, works during the second half of the menstrual
cycle to create a lining in the uterus as a viable home for
an egg, and to shed the lining if the egg is not fertilized.
If you skip a period, your body may not be making enough progesterone
to break down the uterine lining. However, your estrogen levels
may remain high even though you are not menstruating.
At menopause, hormone
levels don't always decline uniformly. They alternately rise
and fall again. Changing ovarian hormone levels affect the other
glands in the body, which together make up the endocrine system.
The endocrine system controls growth, metabolism and reproduction.
This system must constantly readjust itself to work effectively.
Ovarian hormones also affect all other tissues, including the
breasts, vagina, bones, blood vessels, gastrointestinal tract,
urinary tract, and skin.
Surgical Menopause
Premenopausal women
who have both their ovaries removed surgically experience an
abrupt menopause. They may be hit harder by menopausal symptoms
than are those who experience it naturally. Their hot flashes
may be more severe, more frequent, and last longer. They may
have a greater risk of heart disease and osteoporosis, and may
be more likely to become depressed. The reasons for this are
unknown. When only one ovary is removed, menopause usually occurs
naturally. When the uterus is removed (hysterectomy) and the
ovaries remain, menstrual periods stop but other menopausal
symptoms (if any) usually occur at the same age that they would
naturally. However, some women who have a hysterectomy may experience
menopausal symptoms at a younger age.
| I had hot flashes,
but they were fairly mild. Sometimes at night I'd suddenly
start to sweat and have to throw all my covers off. But
they never lasted long and I could usually get right back
to sleep. During the day I noticed they tended to come
whenever I had a big decision to make or when I felt a
little tense. But they only lasted about 2 years. I feel
blessed. I've had no other problems. |
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