CPhT CONNECT™ Magazine - Jan/Feb 2021

Women’s health



Aside from menstruation changes that signal their arrival, perimenopause, menopause, and postmenopause are generally quite similar. The most common symptoms of perimenopause are: • Less frequent or highly irregular menstruation • Heavier or lighter periods (in relation to what was usually experienced before perimenopause) • Vasomotor symptoms, including hot flashes, night sweats, and flushing

take place during this time as well. One of the most notable is the loss of active ovarian follicles. These structures within the ovaries are responsible for pro- ducing and releasing eggs, allowing for menstruation and fertility. As perimenopause and menopause progress, the ovarian follicles become significantly less active, and therefore menstruation ceases for a period. Most women first notice their cycles become less consistent and their flows become heavier and longer. This typically occurs at some point in the mid- to late-40s; however, by the age of 52, most women have started or completed menopause. For some women, menopause is induced or caused by injury or surgical removal of the ovaries and related reproductive organs. This is most common when women undergo a hysterectomy at an early age. Known as induced menopause, this process can be caused by pelvic surgery that damages or destroys the ovaries, pelvic radiation (as would be used to treat ovarian or uterine cancer), hormone therapies that shut down a variant function, or removal of the ovaries through a hysterectomy. Diagnosing and Treating Menopause: If you are experiencing symptoms that you believe may be related to menopause (especially if you are younger than the age of 45), it may be worth talking to your OBGYN or your primary health care provider. Several new means of testing can determine if a woman has entered menopause, including a new blood test recently approved by the Federal Food and Drug Administration. This test may help those who show symptoms of early menopause, especially those with associated higher risks of osteoporosis or other chronic health con- ditions that can be exacerbated by menopause. These tests, combined with other menopausal symptoms, are typically significant enough to diag - nose menopause. Depending on your symptoms and your health history, your medical provider may also order additional tests to help rule out other underlying medical conditions that could contrib- ute to your symptoms yet be completely unrelated to menopause. Depending on the severity of your symptoms, available treatments can help reduce symptomatic impacts and improve your qual- ity of life. Hormone therapy has shown to be an effective treatment for women under the age of 60. It can help reduce hot flashes, flushing, night sweats, and the risk of osteoporosis. Other med- ications are available to treat specific symptoms, including vaginal dryness, sleeping difficulties, fre - quent urinary tract infections, and hair loss. Your provider may also recommend lifestyle changes, including exercise, dietary changes, weight manage- ment, and quitting smoking (if you are a smoker). While menopause is unavoidable, it is manageable if you understand the symptoms and how to manage them best. If you are experiencing symptoms of menopause, whether early-onset or otherwise, talk to your primary care provider to see what options are available for symptom management.

As many women begin to approach their late 40s and 50s, they begin to consider the arrival of menopause. For most women, menopause starts between the ages of 45 and 55; however, cer- tain circumstances can result in its development well before or years after this typical age range. Menopause is something every woman will experience to some extent. For some, it brings about a host of unpleasant symptoms. But for others, it comes and goes relatively unnoticed. For many women, treatment is not necessary; how- ever, treatments are available for those with severe or unmanageable symptoms to help reduce symp- tomatic effects throughout the menopausal process. When Women Can Expect Menopause to Come and Go? Many women will begin to develop menopause symptoms approximately 4 years before they stop menstruating (or have their last period). These symptoms will often remain for 4 to 5 years, depending on the individual. A minimal number of women experience meno- pause symptoms for up to 10 years before menopause (the actual cessation of a monthly period) occurs. Approximately one out of every ten women will experience menopause symp- toms for 10 to 12 years after their last period. The onset of menopause and the symptoms each woman will experience are unique to the indi- vidual. Many factors, including race, genetics, and reproductive health, will determine when women begin menopause. The first stage of menopause is called perimenopause. This starts well before menopause when hormones start to change in preparation for the onset of menopause. Perimenopause can last anywhere froma fewmonths to several years, again, depending on various factors. Some women may even skip perimenopause and suddenly enter menopause as they reach their mid- 40s. A small percentage of women (approximately 1%) who will naturally (menopause that occurs unrelated to surgical intervention or disease process) begin menopause before the age of 40. This is often referred to as premature menopause or primary ovarian insufficiency. Another 5% of women will naturally go throughmenopause between the ages of 40 and 45, which is referred to as early menopause. What Are the Symptoms of Menopause? As each woman is unique, so are her menopause symptoms. Inmost cases, awomanwill experience the most severe symptoms when her menopause comes on suddenly or lasts for a brief time. Certain medical conditions, including ovarian health problems like cancer, surgical procedures such as hysterectomy, and lifestyle choices such as smoking, often increase the severity and duration of menopausal symptoms.

Hot flashes are the most common symptom associated with menopause. An estimated 75% of women experience hot flashes through - out menopause. Other symptoms of menopause that may or may not occur include: • Changes in sleeping patterns including insomnia • Vaginal dryness and reduced libido • Sore or tender breast tissue • Frequent urinary tract infections and increased urination • Reduced bone mass and increased risk for osteoporosis • Thinning hair or hair loss While this list is not exhaustive, it provides insight into some of the more common symptoms women may expect to experience between the onset of perimenopause and through postmenopause. • Weight gain • Depression • Anxiety • Memory and concentration difficulties Why Does Menopause Occur? Menopause is a naturally occurring process as women’s ovaries age and consequently produce less reproductive hor- mones. This happens as the reproductive system and associated hormones prepare the body to no longer carry children. As the body begins to undergo changes in response to lower hormone levels, including estrogen, progesterone, testosterone, and other hormones pertinent to the reproductive pro- cess, symptoms pertaining to menopause typically begin. Specific changes to the reproductive organs

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