defined as the cessation of menstruation. Inherent in the true
meaning of the word menopause is the concept of ovarian aging. As
a woman gets chronologically older, her ovaries get physically
older - literally used up.
How do I know
when I am going through menopause?
the menopause ("change of life") it is important to emphasize that
for most women, the menopause is not a sudden, isolated event;
rather it is a multi-faceted, start and stop process that may
evolve over several years. This transition period is sometimes
perimenopause, or in medical
terms, the climacteric.
Women who have
their ovaries removed surgically become post-menopausal
immediately after surgery, without going through a peri-menopause.
Conversely,if a woman were to continue taking birth control pills
all her life, she would pass through menopause and never know it.
process is gradual, it may not be easy to tell when you are
entering the climacteric: the diagnosis is made from a series of
clues or symptoms. The average age of menopause is 51, but that
means that for most women the climacteric begins earlier, in the
mid-forties. So your age gives you the first clue.
The second clue
involves your menstrual periods. A woman having erratic,
irregular, or unpredictable periods, sometimes skipping periods
and sometimes having periods too frequently, may be in the
climacteric. This pattern of unpredictable, sparse or frequent,
light or heavy, periods is called anovulatory or dysfunctional
bleeding. The gynecologist is concerned about cancer of the uterus
and will perform an endometrial biopsy, or in some cases, a
uterine D&C (dilatation and curettage). This is a necessary
precaution, although cancer of the endometrium (uterine lining) is
uncommon in the climacteric.
The third clue
involves how you feel. The most troublesome, but harmless, symptom
of the climacteric is the hot flush (or "flash"), experienced by
many, but not all, women. This symptom is subjectively described
as a wave of warmth or flushing that encompasses the entire body
(although the most intense sensation may involve the face, neck
and chest), accompanied by an increased heart rate and a variable
amount of perspiration. One woman described feeling "like a boiled
tomato with the skin ready to burst." When a hot flush occurs at
night, a woman may awake with her bedclothes soaked in sweat
A fourth clue may
be psychological instability. Severe mood swings, drastic changes
in mood for no apparent reason, (bursts of tears, depression,
irrational anger, tantrums) are a symptom of many psychological
disorders but are also a common, and debilitating, manifestation
of the climacteric. For purposes of discussion, I call these
symptoms "menopausal distress.
The only blood
test that may be helpful in making the diagnosis is a measurement
of FSH (follicle stimulating hormone).The measurement of estrogen
levels is rarely helpful and can even be confusing.
helps you make a smooth transition into menopause and beyond. She
Let you know what physical and
emotional changes to expect
Help you to explore all your
options to deal with minor or complex issues
Work with you to develop an
individual strategy, depending on your symptoms and your
Many women find
menopausal and post-menopausal life to be liberating. No monthly
bloating, cramping tampons or pads. No pregnancy concerns. Don't
be afraid of this stage of your life. Both short and long term
conditions can be managed with the help of your doctor.