Menopause is part of every woman's natural aging process. During this time, ovulation (egg production) stops and menstruation becomes less frequent, eventually stopping altogether. The symptoms of menopause are caused by changes in estrogen and progesterone levels. As the ovaries become less functional, they produce less of these hormones and the body responds accordingly. The specific symptoms experienced and how significant (mild, moderate, or severe) varies from woman to woman.
In perimenopause, the amount and duration of flow tapers off. Menstrual periods generally become either more closely or more widely spaced. This irregularity may last for 1 to 3 years before menstruation finally ends completely (postmenopause). A gradual decrease of estrogen generally allows the body to slowly adjust to the hormonal changes. When estrogen drops suddenly, as is seen when the ovaries are removed surgically (called surgical menopause), symptoms can be more severe.
Health concerns associated with menopause include:
Heart diseases and hypertension
Commonly Prescribed Drugs
Hormone replacement therapy. Combinations of estrogen and progestin (female hormones) are used to treat certain symptoms of menopause. Hormone replacement therapy (HRT) works by replacing estrogen hormone that is no longer being made by the body.
Estrogen reduces feelings of warmth in the upper body and periods of sweating and heat (hot flashes), vaginal symptoms (itching, burning, and dryness) and difficulty with urination, thinning of the bones (osteoporosis) but it does not relieve other symptoms of menopause such as nervousness or depression. Progestin is added to estrogen in hormone replacement therapy to reduce the risk of endometrial hyperplasia, estrogen-induced bleeding in women who still have their uterus.
From many observational studies, there has been optimism that HRT might offer protection against certain aging processes, including heart disease, osteoporosis, Alzheimer's disease, colon cancer, tooth loss, and macular degeneration, which is the leading cause of blindness in the elderly. Other studies have pointed to the risks associated with HRT, especially the possibility of an increase in the risk of breast and endometrial cancer. The risks and benefits must be thoroughly discussed with a doctor.
- Side effects
Headache, vomiting, stomach cramps or bloating, diarrhea, appetite and weight changes,
Changes in sex drive or ability, nervousness, brown or black skin patches, acne, swelling of hands, feet or lower legs (fluid retention), breast tenderness, enlargement, or discharge and difficulty wearing contact lenses.
- Taking other drugs including acetaminophen, anticoagulants ('blood thinners'), cyclosporine, medications for seizures, oral steroids, rifampin, salicylic acid, temazepam, theophylline and thyroid medication should be consulted for dose alterations or monitoring of side effects.
Selective Estrogen Receptor Modulators. (e.g., raloxifene). They are synthetic compounds that exhibit both estrogenic and antiestrogenic activities in different tissues. They had been used as an alternative to ERT/HRT in osteoporosis. They inhibit bone resorption and their usual dose is 60 mg/day.