PDF Ebook Menopause Disease Condition Overview
Menopause is the time in a woman's life after her menses has stopped. Many people use the term menopause to describe the years leading up to and following the last period. The time before the total cessation of menses when periods are irregular (usually 3 to 5 years before the final menstrual period) is more accurately termed the climacteric or perimenopause. Menopause may be natural, artificial, or premature. Menopause is usually identified retrospectively, when it has been over a year since the woman's last monthly period. Everything afterward is generally referred to as postmenopause, a time of estrogen-deficiency.
The average age of menopause in American women is 51 but it may begin as early as age 35 and as late as 59. Cigarette smokers tend to reach menopause earlier than non-smokers. Menopause is an experience that is unique to each woman. Some women notice little difference in their physiology while others find the change extremely troublesome and upsetting.
Etiology
Ovarian failure and the accompanying decline in estrogen production are responsible for the changes of menopause. A gradual or erratic decline in hormone levels is thought to occur in most women during the perimenopause rather than an abrupt cessation of ovarian function. At menopause, hormone levels don't always decline uniformly. They alternately rise, and fall again, not unlike the hormonal symptoms that occur during puberty. In women undergoing gynecologic surgery or chemotherapy, an abrupt cessation of ovarian function is more typical. Menopause that occurs as a result of medications such as Danocrine, GnRH analogues, or antiestrogens, is reversible.
Risk Factors
Aging is the most obvious risk factor for menopause. Genetic factors may predispose some women to an early menopause (under age 50). The only modifiable risk factor for early menopause is smoking, with heavy smokers starting earlier than light smokers. Menopausal and postmenopausal women have a greater risk of osteoporosis, heart disease, Alzheimer's disease, colon cancer, and diabetes. The incidence of these conditions is also largely affected by genetic and lifestyle factors.
Prognosis
The overt symptoms of menopause may take 1 to 2 years to diminish but in some women can persist much longer. In women undergoing gynecologic surgery or chemotherapy menopausal symptoms such as hot flashes are generally more severe. The greater concern, from a medical perspective, is that gradual, asymptomatic development of heart disease, osteoporosis, and other degenerative conditions may lead to significant morbidity and mortality. The onset of some of these conditions may be either prevented or delayed.
Prognosis
The overt symptoms of menopause may take 1 to 2 years to diminish but in some women can persist much longer. In women undergoing gynecologic surgery or chemotherapy menopausal symptoms such as hot flashes are generally more severe. The greater concern, from a medical perspective, is that gradual, asymptomatic development of heart disease, osteoporosis, and other degenerative conditions may lead to significant morbidity and mortality. The onset of some of these conditions may be either prevented or delayed.
With advancing age, the walls of the vagina become thinner, dryer, less elastic and more vulnerable to infection. These changes can make sexual intercourse uncomfortable or painful. A woman may experience pain or urgency with urination related to estrogen changes or have vaginal symptoms. Sexual desire may also be affected. Decreased libido is a common complaint.
Asymptomatic physiologic changes that can occur with menopause include decreases in high-density lipoprotein (HDL) cholesterol, glucose tolerance, and bone density. These changes may be accompanied by increases in homocysteine levels, blood glucose, blood pressure, low-density lipoprotein (LDL) and total cholesterol. While these changes can be totally silent they are not innocuous.
Differential Diagnosis
There are a variety of conditions that could mimic some of the symptoms of menopause. These include:
- • Adrenal dysfunction
• Hypothyroidism or hyperthyroidism
• Pituitary disorders
• Polycystic ovary disease
• Uterine cancer
Monitoring Parameters
Menopausal women should plan on having regular physical exams and screening tests that monitor for cancer, risk of heart disease, diabetes, hypertension, and osteoporosis. This includes periodic screening of blood lipids, blood pressure, blood glucose, mammography, bone densitometry, sigmoidoscopy/colonoscopy, and pap smear. Women should continue to do screening breast exams once a month. If any of the screening tests show an unfavorable trend, then intervention is warranted for the specific abnormalities identified.
Content
DISEASE/CONDITION OVERVIEW
- • Etiology
• Risk Factors
• Prognosis
• Signs and Symptoms
• Differential Diagnosis
• Monitoring Parameters
WESTERN MEDICAL THERAPIES
INTEGRATIVE MEDICINE STRATEGY
COMPLEMENTARY AND ALTERNATIVE THERAPIES
- • Herbal Therapies
• Dietary Supplements
• Complementary Therapies
• Wellness Recommendations
REFERENCES
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