Help For Menopause.

What is Menopause?

Menopause is the medical term for when a woman stops having menstrual periods. Some people call menopause "change of life," or "the change."

Menopause causes changes to a woman's body. Some of the changes are unpleasant or painful. Other changes involve risks to the woman's health. But there are medicines that a woman can take to help relieve these problems and protect against the health risks.

Natural menopause occurs when a woman's ovaries stop releasing eggs and the lining of the womb no longer sheds every month during a menstrual period.

When a woman has gone a year without having a period when she isn't pregnant, she has gone through menopause. The date of the last period is considered the date of menopause. In the United States, the average age of menopause is 51. But this is only an average. Some women go through menopause much later in their 50s, some in their 40s, and a few in their 30s.

When a woman has surgery that removes her ovaries, it is called surgical menopause. This operation is often done at the same time as a hysterectomy--surgery that removes the womb, or uterus.

Signs of Menopause

A woman's body changes around the time of menopause, often before periods have actually stopped. One change is that periods become very irregular. Sometimes bleeding is very heavy or very light. Some women skip periods, or have more than one period a month. It's still possible for you to get pregnant during this time. If you don't want to get pregnant, keep using birth control even if your periods are irregular. Some women have irregular periods for several years before their periods stop. Others have regular periods right up to the time of their last period.

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Hot Flashes

The hot flash is probably the best known sign of menopause. Some women start getting hot flashes several years before their periods stop. During a hot flash or "flush" you suddenly feel hot. It may begin with a sudden tingling in the fingers, toes, cheeks, or ears. Sometimes only certain parts of your body, get red or flushed. The most common parts of the body to get fully flushed are the face and the neck. Each hot flash can last from 30 seconds to five minutes. Some women go from feeling hot to feeling cold. You may also get very warm and sweaty as you sleep. Sometimes these "night sweats" are uncomfortable enough to wake you up. Hot flashes happen because your body is making less estrogen, a female hormone.

About 85 out of every 100 women approaching or going through menopause have hot flashes. About one out of 10 women still have hot flashes 10 years after their last period. Overweight women are less likely to have hot flashes than thin women because their bodies continue to produce more estrogen from stored fat.

Other Problems

Another menopause discomfort is vaginal dryness. This is also due to decreased estrogen. Vaginal dryness can make sex painful for women and can also lead to vaginal and urinary infections and other problems.

Some women get osteoporosis after menopause. With osteoporosis, your bones get weak and can break more easily. It is probably related to the loss of estrogen. Heavier women are less likely to get osteoporosis than thin women. Smoking adds to your risk of osteoporosis.

About Hormones

Hormone Replacement Therapy, sometimes called HRT, can help with many of the problems of menopause. But, HRT has good effects and bad effects. So, you should discuss HRT with your doctor to find out if it is right for you.

With HRT, two hormones are usually given to women who still have their wombs. They are estrogen and progestin. Estrogen relieves hot flashes, vaginal dryness, irregular bleeding, and helps prevent osteoporosis. But women who take estrogen have a higher risk of getting cancer of the lining of the womb (endometrial cancer). So, women who still have their wombs usually also take progestin to protect against this cancer. When you take progestin with estrogen, you have monthly bleeding like a menstrual period, but usually lighter. Often this bleeding gets even lighter over time. Women who have had hysterectomies don't need to take progestin.

Besides protecting against osteoporosis, researchers think that estrogen also lowers the risk of heart disease. It may also lower the chance of getting Alzheimer's disease.

HRT does have some risks. These include gallbladder disease, blood clots, and maybe breast cancer. There are also less serious side effects. You should discuss all these risks with your doctor before starting hormone therapy.

Types of Hormone Replacement Therapy

Estrogen creams and vaginal estrogen rings. These can help relieve vaginal dryness and urinary problems. They do not prevent hot flashes, irregular bleeding, osteoporosis or heart disease. You place estrogen cream in your vagina with an applicator, usually several times a week. You or a doctor inserts a vaginal estrogen ring into the upper part of the vagina. It stays there for 90 days and slowly releases estrogen.

If you want protection against hot flashes, osteoporosis, and heart disease, you need to use hormone pills or patches.

Pills. If you still have your womb, the doctor will probably recommend that you take pills with estrogen and progestin. If your womb has been removed through a hysterectomy, you only need to take estrogen.

Patches. Patches are worn on the skin. They slowly and steadily release hormones. Some patches only have estrogen. Others have estrogen and progestin.

Relief Without Hormones

If you do not want to take hormones or you cannot take them for medical reasons, there are other ways to relieve some of the problems brought on by menopause.

For hot flashes:

* Try dressing in layers of clothes so you can take off some of them to get cool quick.

* Drink cold drinks instead of hot ones.

* Drink less coffee, tea, colas and other drinks that have caffeine.

* Drink fewer alcoholic drinks.

* Sleep under lighter covers or no covers.

For vaginal dryness, try ointments that you can buy without a prescription such as KY Jelly or Replens.

Vitamins

Some scientists think that vitamin E may help prevent hot flashes, but this has not been proven. If you can't take estrogen and these other tips don't keep you from having hot flashes, ask your doctor about other prescription drugs that might help you.

Osteoporosis can sometimes be prevented by eating foods that have lots of calcium and Vitamin D, and by exercise. This works best if you do this for many years before menopause. Most people get enough Vitamin D from sunlight. Read the labels of milk and cereal to see if they have Vitamin D added. Salmon and sardines are other sources of Vitamin D. If you're not in the sun much, or if you live far north, ask your doctor if you should take a vitamin supplement.

Calcium

You can get calcium from foods such as milk, cheese and yogurt. If you are allergic to milk products, other foods with lots of calcium are broccoli, kale and other dark green leafy vegetables, and canned fish with bones, such as sardines. Some foods have calcium added. These include some breads, cereals and orange juice. Read the label to see if calcium has been added. Ask your doctor if you should take calcium supplements to prevent osteoporosis.

Ask Your Doctor

FDA has approved prescription drugs besides estrogen to prevent and treat osteoporosis. They include:

* Miacalcin--a nasal spray that contains the hormone calcitonin

* Fosamax--a drug without hormones

* Evista--a drug that acts like estrogen in preventing osteoporosis but does not have some of the other good and bad effects of estrogen.

Not all women should take these drugs. Ask your doctor what is best for you.

Not every woman has discomfort during menopause that needs to be treated. Some women go through menopause with few problems. Before you begin any treatment, talk with your doctor.

For More Information

North American
Menopause Society
P.O. Box 94527
Cleveland, OH 44101
www.menopause.org

National Women's Health
Information Center
1-800-994-WOMAN
(1-800-994-9662)
www.4woman.gov

National Women's Health
Resource Center
120 Albany St., Suite 820
New Brunswick, NJ 08901
1-877-986-9472 (a toll-free
number)
www.healthywomen.org/

National Institute on
Aging Information Center
P.O. Box 8057
Gaithersburg, MD 20898-8057
1-800-222-2225
www.nih.gov/nia/health/

American College of
Obstetricians and
Gynecologists
P.O. Box 96920
Washington, DC 20090-6920
1-800-762-2264
www.acog.org

American Menopause
Foundation
350 Fifth Avenue
New York, NY 10118
www.americanmenopause.org

National Osteoporosis
Foundation
1232 22nd St., N.W.
Washington, DC 20037
www.nof.org

The Power Surge Reading
Room
www.power-surge.com/

Do You Have More
Questions About
Menopause?

Ask your doctor. And ask
FDA. There may be an
office near you. Look for
their number in the blue
pages of the phone book.

You can also contact
FDA through its
toll-free number,
1-888-INFO-FDA
(1-888-463-6332).

Or, on the
World Wide Web
at www.fda.gov.