Menopausal and Postmenopausal Symptoms
Date Added: September 09, 2008 07:56:50 PM
The need is urgent for women to understand the facts about menopause before they experience it. Correct, present information is equally vital to postmenopausal women. Steps can and should be taken to promote good health and prevent the serious complications that can arise. Menopause need not be troublesome.
Approximately 10 to 15 percent of women have discomfort sufficient to send them for medical treatment. The troubling symptom is almost always hot flushes; between 65 and 85 percent of menopausal women experience them to some degree.
In reviewing the list of symptoms, it should be noted that some are rare, and others are unlikely to develop until five to ten years or more after menopause.
Depression: Psychiatrists once believed that menopausal women were particularly prone to a serious form of depression they called "involutional melancholia." This dictum has all but disappeared from the literature because studies found that neither major depression nor other serious psychiatric problems are more frequent during menopause.
Hot flushes: The opening of small blood vessels in the skin produces sensations of extreme heat with reddening, "flushing" of the body, sometimes followed by drenching sweats. Doctors describe them as a disorder of uncertain origin involving the brain's temperature control center.
The average flush does not come and go in a "flash." It generally lasts five minutes and can persist up to an hour. In most cases, the occurrence of flushes gradually diminishes over the course of a year. While flushes are minimal in most women, some are long lasting or repeat every few minutes and may interrupt sleep.
Thinning of the linings of the vagina and urinary tract: Symptoms generally don't occur until five or more years after menopause. In nearly all women over 60, lack of estrogens hampers the restoration of tissues lining these areas. They become fragile, lose their tone and are easily torn or infected. Pain on intercourse and virginities (vaginal inflammation, itching and discharge) are fairly common, but treatable. The good news is that regular intercourse actually enhances growth of the vaginal lining and, thus, has a protective effect.
With the use of lubricants to overcome vaginal dryness, sex should continue to be pleasurable. In fact, libido (sex drive) may increase. Some experts theorize that until menopause, estrogens actually have some suppressant effect on sex drive.
Thinning of the lining of the urinary tract can lead to "stress-incontinence" — loss of urine when coughing or sneezing. For some women, daily "puckering" exercises — repeated tightening of muscles around the bladder and in the vaginal area such as might be done to stop the flow of urine — may help solve the problem. Failing this, surgery can correct it.
Osteoporosis: This loss of bone calcium results in bone thinning — actual loss of bone. The marrow cavities enlarge. Bones become so brittle and fragile, they can break spontaneously during bending, lifting or even walking. Falls frequently result in breaks. Bones of the wrist, hip and spine are most susceptible.
Osteoporosis is the most serious and widespread consequence of menopause. One-quarter of all postmenopausal women develop an unhealthy degree of bone loss. A very large number of elderly women, bedridden with hip fractures, die from complications.
Bone can erode at up to three percent a year in the two or three years after menopause occurs. Then the rate slows. Women with severe osteoporosis lose up to 30 percent of their bone mass by age 70.
Bone loss, while preventable, is largely irreversible. For this reason, early diagnosis, though not a usual assessment in a physical exam, is desirable. A woman loses a considerable proportion of bone before she has any symptoms. Early osteoporosis does not bring women to their doctors. It is essentially symptom-free. Diagnosis by computed tomography (CAT scan) or photon (light) absorption is expensive and may be done primarily in hospitals.
Some experts believe that low back pain and periodontal disease (bone erosion under the gums) are early signs. Noticeable loss of height occurs only once osteoporosis is severe.
In light of the advantages of early diagnosis, physicians are paying special attention to women at high risk: These postmenopausal women are thin-boned, thin, inactive, heavy drinkers and smokers, who ingest too little protein, calcium and vitamins, particularly vitamin D.
