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What is Menopause?

Menopause is 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?

When discussing 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 called the 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.

  • First Clue

Because the 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.

  • Second 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.

  •  Third Clue

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 ("night sweats").

  •  Fourth Clue

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.

  • Blood Tests

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.

Dr. Kiran Mehndiratta helps you make a smooth transition into menopause and beyond. She can:

  • 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 preferences.

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.

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