Women's Services Encyclopedia

Menopause

Menopause occurs typically in females between the ages of 43 and 55. It is a time of many changes in a woman’s body, and the changes result in psychological and physical changes.

Menopause for many women takes place over several years, so that the changes may be slow in occurring. Changes in life circumstances may coincide with the changes of menopause, so it may be difficult to determine what causes what.

The physical changes of menopause are many. The ovaries slow their functioning and eventually stop producing estrogen. The lack of estrogen creates the “hot flashes” common to menopause, as well as drying of the vaginal tissue, which makes sexual intercourse uncomfortable. Women are usually protected from coronary artery disease while they are producing estrogen, but menopause robs them of this protection. Estrogen also protects bones from becoming brittle, so that osteoporosis affects 25 to 50 percent of women at menopause.

Replacement hormones can relieve hot flashes and vaginal dryness while preventing osteoporosis. There has been some concern that hormonal replacement can increase a woman’s risk for cancer, but these concerns are largely unfounded. Careful evaluation prior to treatment, including PAP smear and mammogram, and frequent checkups during treatment will ensure that the hormone treatment is without complication.

Estrogen Replacement Therapy:

• Evidence now shows that age-related bone loss can be avoided, perhaps indefinitely, with even low doses of estrogen replacement. The addition of calcium is also recommended. To be most effective, though, therapy needs to be started as soon as possible after the onset of menopause. Estrogen therapy for osteoporosis must be lifelong; once stopped, bone loss begins and progresses rapidly.
• Estrogen therapy will also reverse the atrophy affecting the genitourinary tract during menopause. It restores cervical and vaginal secretions and thickens the vaginal tissue to its premenopausal state. Because estrogens are absorbed through the skin, an estrogen cream will work as well for those symptoms as oral estrogens.
• Your physician can determine the amount of estrogen you are still producing and decide on the amount you need.
• The only women who should not take hormonal replacement are those with breast or endometrial cancer, chronic liver disease, or a history of thromboembolism.

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