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$Title{Menopause Difficulties}
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Copyright (c) 1991-92,1993   Tribune Media Services, Inc.


Menopause Difficulties


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QUESTION:  There are difficulties enough when a woman enters menopause, and
the confusion of taking medications just adds to the problems.  Although I
have tried to understand it all, I could use some of your easy to understand
advice.  Could you please discuss menopause for me and all the other gals who
need this information?

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ANSWER:  There is no reason for menopause to mark a change in your life style.
Menopause is defined as the cessation of menstrual periods for 1 year.  It can
occur naturally or surgically when the ovaries are removed.  Either way, the
result is decreased production of the hormones estrogen and progesterone.
     One consequence of reduced estrogen is osteoporosis, a loss of bone
density that may lead to spine and hip fracture, a major health problem today.
In fact, 1.3 million fractures, mostly spine hip and wrist, occur each year in
the United States.
     Another consequence of decreased estrogen in menopause are hot flashes
and night sweats that may significantly affect the quality of sleep.  These
are the vasomotor symptoms that affect approximately 85 percent of women and
are due to an abnormal signal from the heat regulation center of the body.
     The natural reduction in estrogen may also result in changes in vaginal
tissue--"senile" vaginitis.  Inadequate lubrication causes dry, painful
intercourse.  There is also an increased susceptibility to lower urinary tract
infections.
     How can estrogen replacement therapy offset these problems?  First, clear
evidence now shows that age-related bone loss can be forestalled, 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.
     Medium to high doses of estrogen will prevent hot flashes.  Those and
night sweats tend to diminish with time, so your physician may taper the
dosage in accordance with the extent of symptoms.
     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.  A progesterone supplement may
also be given to women with an intact uterus.  We now have enough experience
to feel confident that the benefits of hormone replacement therapy outweigh
the risks.  The only women who should not be treated are those with breast or
endometrial cancer, chronic liver disease, or a history of thromboembolism.
     The menopausal period of life can be a anxious time for a woman, but with
good counseling from your physician and a real understanding of this natural
life process, you can pass through it with a minimum of discomfort or fear,
and without breaking stride in the normal pattern of your life style.

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The material contained here is "FOR INFORMATION ONLY" and should not replace
the counsel and advice of your personal physician.  Promptly consulting your
doctor is the best path to a quick and successful resolution of any medical
problem.