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Menopause - RCJ
Menopause---A time in a woman’s life
that marks the end of her reproductive years. It is a
natural part of aging, and occurs when the ovaries stop
making hormones. Estrogen levels start to drop, resulting in
the end of menstrual periods. This usually happens between
the ages of 45 and 60, with the most common age being 51.
Most women will experience a sudden intense wave of heat
and sweating called hot flashes. Low levels of the hormone
estrogen cause the brain to release a hormone, GNRH, in
surges. The sudden release of this hormone causes the hot
flashes. The periodic release of GNRH is generally worse at
night, resulting in a disruptive sleep and constant
tiredness through-out the day. Others report mood changes,
irregular periods, vaginal or urinary tract infections,
urinary incontinence (leakage of urine) and inflammation of
the vagina, causing pain during sexual intercourse.
Fortunately, replacing the estrogen can relieve these
annoying and uncomfortable problems.
Women who are over weight are less likely to develop hot
flashes and other post-menopausal symptoms because some
estrogen is available from fatty tissue. Very thin women
tend to have more problems.
Estrogen is important not only to the
reproductive cycle, but it is also vital in maintaining
cardiovascular health and bone strength. When the ovaries
fail and estrogen starts to decline, we start to see an
average bone loss of 2 percent per year for the first five
years, then 1 percent per year after that.
Preventing bone loss is more practical
than treating bone loss. All women are candidates for some
measure of bone loss prevention, whether it is in the form
of replacing the hormone estrogen or supplementing their
diet with calcium and Vitamin D. Taking estrogen can reduce
the risk of fractures due to osteoporosis by as much as 50
percent.
Using estrogen may also fight heart
disease by lowering your bad cholesterol, LDL and raising
the good cholesterol, HDL. Some research also suggests that
estrogen may help prevent memory loss and Alzheimer’s
disease.
Most of the studies on the effects of
estrogen on heart disease and mental function have been
retrospective studies. Currently, A Women’s Health
Initiative Study will be prospective, or future-oriented,
and it will observe a number of women both with and without
therapy. These women will be observed over a number of years
to see if they develop symptoms of heart disease or memory
loss.
Estrogen replacement is not
risk-free. When given alone, it can lead to endometrial
cancer. Therefore, a woman who still has a uterus is
usually prescribed progestin in addition to estrogen to
reduce this risk.
Endometrial cancer is not the only risk
from estrogen use. Gallbladder disease is another. Women who
use estrogens after menopause are more likely to develop
gallbladder disease and needing surgery than women who don't
use estrogens.
Estrogen can produce uncomfortable side
effects such as nausea and vomiting. It can enlarge breasts
and make them tender. Women who use it can retain excess
fluid, which can aggravate conditions like asthma, epilepsy,
migraines, and heart and kidney disease. For women who take
progestin along with estrogen, menstrual-like bleeding and
premenstrual symptoms can occur.
Is there a link between estrogen and
breast cancer? In recent years, there have been many studies
on breast cancer and estrogen. Some studies suggest the
possible increase in risk of developing breast cancer when
taking estrogens for prolonged periods of time. However, the
majority of studies have not shown a higher risk of
developing breast cancer. Physicians urge women who receive
estrogen therapy to have regular breast examinations by a
health professional, perform monthly self-exams, and have
yearly mammograms.
Estrogen replacement is not for
everyone, and as with all medications, it may work better in
some people than others.
It also may carry with it some degree
of risk. By understanding the benefits and risks of estrogen
use, you and your doctor can determine the best treatment
for you.
As advances in medicine continue and
the ability to treat disease improves, we are seeing the
population over the age of 50 grow in numbers. When a woman
reaches age 50, she typically has another 30 years to live.
As physicians, we are not only interested in the quantity of
her life, but the quality of it.
Content
of articles can only be used with writer attribution to Dr.
Kevin Weiland.
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