Archive for About Menopause

Understanding Bioidentical Hormones for HRT

bioidentical hormones

For years, doctors have prescribed synthetic hormones such as Permarin for Hormone Replacement Therapy, also known as HRT. Now many other forms of hormones are available for patients seeking alternative and natural remedies.

What are Bioidentical Hormones

Bioidentical hormones are very similar to the hormones that are made in the body, much more naturally functioning than synthetic hormones. Bioidentical HRT is desirable because it reacts on a molecular level in the body the same way human hormones function.

Where do Bioidentical Hormones Come From

The source of the natural version of hormones is from plants and sometimes animals. Some people picture natural hormones as coming straight out of the ground, like an herb but in reality, most are processed in a lab or manufacturing facility.

Who Prescribes Natural Hormone Therapy

It used to be that the majority of doctors who prescribed natural hormones were considered alternative, natural or sometimes complementary, health care practitioners who embrace both traditional and alternative medicine. However, today, many mainstream doctors are also working with patients and compounding pharmacies for prescribing natural HRT.

A prescription isn’t the only alternative for obtaining bioidentical hormones. Many compounding pharmacists can test people for hormone levels and recommend specific products. Online self care is also available. Some sites offer ways for patients to check their own hormone levels with a saliva test. This kind of testing is a preferred method and is considered more accurate than blood tests. The late Dr. John Lee, authority and author of What Your Doctor May Not Tell You About Menopause Hormone and Balance Made Simple considered saliva testing the only viable option for evaluating precise hormone levels.

How to Use Natural Hormones like Progesterone and Estrogen, DHEA and Testosterone

There are many different options in strength and types of HRT. The best way to know what the correct type and amount of hormone needed is to either be tested by a health care practitioner or pharmacist who uses bioidentical hormones or research symptoms thoroughly and self-test. Most professionals diagnosing hormone replacement therapy use a combination of test results combined with patient symptoms to decide on treatment.

Natural HRT can be administered through creams, oils and gels, called transdermal, or as supplements, lozenges and even suppositories.The transdermal method is one of the most popular forms because it is easy to use and allows for rapid absorption of bioidentical hormones. Most are applied once or twice a day.

Natural progesterone is available prepackaged, without a prescription and can be used to balance a lack of progesterone orcounter estrogen dominance, having too much estrogen. Progesterone HRT can be used for perimenopause, menopause, PMS, and for male and other hormone issues. Progesterone can even be used to help with migraine headaches. Natural HRT cream is usually rubbed on locations where skin is thinner: the wrists, inner arms, stomach, thighs, ankles and neck. It’s important to rotate the location where transdermal hormones are applied to avoid building up a resistance at the site.

Estrogen is not one, but a group of hormones and is available in multiple forms as well. Natural Estradiol and Estriol are used in natural estrogen supplementation and are applied transdermally. Black cohosh is an herb with estrogen properties that is taken as a supplement in pill form. DHEA and testosterone usually come in cream form. A compounding pharmacist is a good source of information on the best way to use specific types of hormones for individual situations.

What’s Best in Natural HRT

Everyone is different and there is no one single “best” HRT. Because of the complexity of symptoms and possibility of individual hormone fluctuation, the most effective way to use natural HRT is to keep track of how a person is feeling and accurately test hormone levels. Sometimes trial and error is needed for success.

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What Women Look For In Men

This article is a truncated, yet genteel exegesis to and for all men attempting to declassify the female psyche.

As the great philosophical Empiricist John Locke would argue, everything must be derived from experience and so to attempt to jauntily accentuate the female wonderings and musings it is necessary to go deep into the soul.

Make Her Feel Comfortable

Of paramount importance is the ability to make the woman feel comfortable. Seems obvious perhaps, however, this is not always the case! Time and time again men fall into the trap of putting the opposite gender in a position they feel too alien in. If the woman is quite reserved do not take her out to a booming night scene, likewise, if she is more extroverted ensure that all that inner-energy can be released constructively.

Never touch a woman unless she explicitly or indirectly gives the man permission to and certainly do not attempt to posses them.

There is nothing a woman hates more than a man who tries to control her – those types who insist on driving them anywhere and everywhere when they can walk with their mates, or those who constantly ring them up seeking to cow the other half. Men, relax! She is fine and she does not need a dummy!

Give Moderate Praise to Women

Of other significance is excessive praise. If a woman is relatively good-looking, do not praise her looks. She has heard it all before thus it comes across as churlish and lacking in ideas. Beauty is, like suffering, a subjective thing. The most beautiful looking girls can never be secure in their beauty as they constantly compare themselves with other females. A girl praising another girl’s looks is much more powerful than a man praising a girl’s looks!

Women Want a Sense of Adventure

Women also seem to want to be put on edge. They need a sense of adventure with a man, a feeling of “something different” to what she has grown up to and known. Attraction is illogical and so the man must do illogical things – within the realms of sanity!

For example, men everywhere, ensure that whilst in a lavish department store with her, put her on edge. Pose with schmancy clothes; get her to take photographs as a pair, and more pertinently of herself in front of the watching people! Although some women are shy to such things, they will do so only if they feel comfortable in and around the man’s presence.

Women Need a Good Listener

It goes without saying that women want a man who can listen to them, who is sensitive enough not to laugh and at the same time women want men who they feel can make sense of all their issues. So men everywhere need be good listeners and have a great memory! Women love men who can remember the finest details such as why her favourite colour is red, what school she went to, her first kiss and why she hates her uncle’s wife’s sister!

Lastly, men everywhere ought to remember Carl Jung’s theory of the “archetype”. This postulates that deep in the collective unconscious lies the notion of an “archetype”. The archetype reflects a psychological need and women everywhere need something or someone in their lives to fulfill the role of nurturing them and providing them with comfort in times of stress.

Things for Singles, People Looking for Serious Relationships to Remember

Quite simply, women desire men more than they care to admit and so seek to find one who mirrors and then absorbs all their fears, insecurities, ambitions, views, aspirations, catharsis and zaniness!

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Stupid Things Stars Say

stupid things stars sayElizabeth Hurley was recently quoted in an interview as saying that Marilyn Monroe was cool, but way too fat — that she’d kill herself if she was that fat.

Yes, it’s true.

Celebrities often discredit themselves from having any sort of worthwhile opinion by coming off as pretty shallow and insipid, but they can also make some sort of impact on society by what they say in interviews. Irresponsible comments can be taken very seriously and used harmfully by the adoring public. Elizabeth Hurley‘s uninspired editorial commentary makes me cringe, especially with the celebrity impact on the teenage girls’ body images.

With this in mind, I’m now paying tribute to a lot of stupid things recently said by celebrities — there’s a lot of lip service to the days of faint-inducing corsets and carcinogenic perfumes. Are they irresponsible, are they stupid, or are they just honest?

Pop diva Mariah Carey:
“Whenever I watch TV and see those poor starving kids all over the world, I can’t help but cry. I mean, I’d love to be skinny like that, but not with all those flies and death and stuff.”

Infamous waif model Kate Moss:
“It’s neurotic fat women who hate me–they’re stupid.”
“It was kind of boring for me to have to eat. I would know that I had to, and I would.”

Supermodel Kim Alexis:
“I would rather exercise than read a newspaper.”

Actress Natalie Portman:
(Maybe this is being a little critical, but it certainly sounds shallow)
“I’m pretty obsessed with tweezing it’s, it’s a little scary…they, they asked what you know, what my obsessions were, and I have like, a, a weird thing with tweezing I mean, you know, you got those like, those little growths that they’re coming back and you just have to get it out and it’s like, I get, I’m really…I’m, I’m a bi, tri-daily tweezer.”

Supermodel Beverly Johnson:
“Everyone should have enough money to get plastic surgery.”

Supermodel Tyra Banks:
“I love the confidence that makeup gives me.”

Supermodel Linda Evangelista:
“I won’t get out of bed for less than $10,000.”
“I can do anything you want me to do so long as I don’t have to speak.”

Early Menopause

When menopause occurs before the age of 40, it is called premature or early menopause. This may occur spontaneously when a woman’s ovaries stop functioning at an unusually early age, or it may be caused by surgery when a woman has her ovaries removed. It can also occur as a result of chemotherapy or radiation therapy for cancer.

Early menopause is a subject that receives little attention. Yet surprisingly, around one in a hundred women experience the symptoms of early menopause, including young women in their teenage years and early twenties.

What are the physical symptoms?

The physical symptoms are the same as for natural midlife menopause and include hot flushes, night sweats, palpitations, mood changes, loss of self esteem, depressed feelings, irritability, anxious thoughts, loss of energy, changes in urinary function, vaginal dryness and painful intercourse, as well as loss of libido and sexual function.

Following surgical menopause, symptoms may commence very quickly. Often they are intense unless treatment is initiated immediately after surgery. This is related to the abrupt changes in hormone levels and the fact that many of these women are younger and in general younger women have more severe symptoms.

How can early menopause affect a woman psychologically?

Although many women adjust well to early menopause with appropriate advice, education and support, it can also have a significant impact on a woman’s emotional health and well-being.

The issues a woman may face include:

  • Grief, depressed feelings, and sadness;
  • Loss of self esteem and control and a sense of helplessness;
  • Concern about how her partner will see her in terms of appearance, femininity, sexuality and sensuality;
  • Potential issues concerning fertility, adjustment to childlessness, reduced family size and loss of reproductive capacity; and
  • Feeling old before her time and out of harmony with her own age group.

What is involved in managing early menopause?

Early menopause is a time for personal adjustment. A woman may find support among her family and friends. However, be aware that every woman’s experience of menopause is different and individual, and the symptoms noted by friends and family may differ greatly from her own experiences.

Other sources of encouragement may include support groups, doctors or a psychologist.

Making the necessary lifestyle changes to diet, boosting calcium intake and maintaining an adequate level of physical exercise is important to help prevent osteoporosis.

Therapy to counteract the loss of oestrogen and progesterone is usually given as Hormone Replacement Therapy (HRT), but may also include supplementary testosterone.

Professional psychological support for women who are experiencing distressing psychological symptoms can be of enormous help, as can keeping informed about early menopause and what the treatment and therapy options are. Finding a support group may also help.

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Surgical Menopause

Surgical menopause is when a woman’s ovaries are removed prior to natural menopause. This causes a sudden and permanent drop in the ovarian hormones, oestrogen, progesterone and testosterone.

About 10 to 20% of women who have a hysterectomy, but retain their ovaries, also experience menopause slightly earlier (between one and four years) than average.

Hysterectomy

A hysterectomy is an operation to remove a woman’s uterus or womb.

Whilst it is a significant operation, there are many new surgical techniques available which reduce the operating of and recovery time. Hysterectomy is a necessary operation for some conditions. It is important to understand that removing the uterus alone will not affect the production of hormones, as long as the ovaries are still intact and functioning normally.

A total hysterectomy means that the whole of the uterus, including the body of the uterus and the cervix, is removed. However, a total hysterectomy does not mean removing the ovaries. Occasionally, and if possible, a subtotal hysterectomy is performed. In these cases, the cervix is retained because a woman’s cervix is sensitive to touch and may play a role in her sexual arousal.

Why is a hysterectomy performed?

Some of the reasons may include:

  • Cancer of the cervix, uterus, ovaries or tubes;
  • Uncontrollable continuous uterine bleeding (however this is rare);
  • Heavy or persistent bleeding;
  • Severe chronic pelvic pain;
  • Severe endometriosis;
  • Pelvic inflammatory disease (i.e. chronic infections of fallopian tubes & pelvis);
  • Some types of fibroids (this is usually the most common reason).

If a woman is unsure whether to have a hysterectomy or not, she should seek a second opinion. Sometimes, it is appropriate for a woman to take time in making her decision, unless of course there is an indication of urgent health problem such as cancer or uncontrollable life-threatening bleeding.

Deciding to have a hysterectomy

Some questions a woman may want to ask her health practitioner include:

  • Why is a hysterectomy necessary?
  • What is/are the reason/s to do it?
  • How will it be done?
  • What type of hysterectomy is recommended?
  • Is it necessary to take out the ovaries as well?
  • How long will the operation take and how long will I be in hospital?
  • What are the potential complications of this operation?
  • Do any tests need to be performed before the operation?
  • Will a blood transfusion be necessary?
  • How long will I need after the operation to recover and how long will I need to be off work?
  • What can I expect postoperatively?
  • Are there any other options instead of hysterectomy?
  • How long until I can drive a car after a hysterectomy?
  • Do I still need a Pap test after a hysterectomy and why?
  • What will happen to my hormone levels?

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Symptoms

In her forties or early fifties, it is possible for a woman to experience symptoms like hot flushes or night sweats, even if she still has regular periods. Some women may also experience mood changes for several months or years before periods actually cease. These symptoms may be due to gradual changes in the ovaries and fluctuating oestrogen levels.

This transition time, ranges from two to ten years before menopause, is called perimenopause.

During this time, many women may find the symptoms confusing, not knowing that what they are experiencing is in fact related to this transitional time before menopause.

Symptoms can start up to five years before menopause as hormone levels start to fluctuate. After menopause, symptoms generally last for a few years and gradually reduce in intensity. In 75% of women, symptoms have resolved by 5 years post menopause. In 25% of women, they can continue for many years.

While menopause is a normal biological event that affects every woman, there is enormous variation in how each woman experiences and views this transition, both in physical and psychological terms.

Her health and well-being, as well as the environment and culture in which she resides, may well influence a woman’s experience.

Decisions about therapies depend on each woman’s current symptoms and their severity, her current health status, her long-term health risks and her personal life expectations.

What are the common symptoms of menopause?

Symptoms are the best guide to identifying when menopause is occurring. Measuring hormone levels is generally of relatively little value, as these levels change rapidly from one day to another during perimenopause.

In some women, physical symptoms like night sweats are predominant, while other women may have few or no physical symptoms but experience significant psychological symptoms.

Between 10 and 20 percent of women have no symptoms, 60 percent experience mild to moderate symptoms and 10 to 20 percent have severe symptoms.

Hot Flushes and Night Sweats

Hot flushes and night sweats are the most common symptoms experienced by 85% of women during perimenopause and menopause.

Hot flushes (sometimes called ‘hot flashes’ or ‘power surges’) and night sweats are common symptoms caused by rising and falling oestrogen levels.

The rise and fall of hormone levels cause a sudden dilation (opening up) of the blood vessels near to the surface of the skin. The sudden rush of blood to these blood vessels often causes a feeling of intense heat, flushing and sweating, as well as possible crawling or itching sensations under the skin.

These symptoms are often uncomfortable, sometimes embarrassing, and usually unpredictable. Mild symptoms can often be alleviated by wearing comfortable cotton clothing and by implementing lifestyle changes, including exercise and general good health practices and by reducing the intake of caffeine and other hot drinks. If lifestyle changes don’t work, women with severe symptoms might consider HT and/or herbal or other complementary therapies.

Other symptoms that can occur may include:

Mood Changes (see Emotional Health and Wellbeing)

Joint and Muscle Pain

Although arthritis is not clearly linked to menopause, many women develop arthritis-like symptoms including joint and muscle aches.

Vaginal Dryness

This is directly related to insufficient oestrogen. Some women find adequate relief with non-oestrogenic creams, but most women with significant vaginal dryness may decide to use an oestrogen preparation inserted into the vagina.Women taking HT tablets may need a vaginal oestrogen preparation as well, to alleviate vaginal dryness and painful intercourse.

Concentration and Memory

Women who are perimenopausal often report having difficulty in concentrating and other minor memory problems (particularly remembering things that were recent). It is important to realise that this complaint can be exacerbated by stress and lifestyle issues and that attention to these important factors will help alleviate the problem. Further, the effects on concentration and short-term memory appear to be temporary and may or may not require treatment.

Disturbed Sleep

Some women experience disturbed sleep during menopause, particularly if they are experiencing hot flushes. Avoiding caffeine, alcohol and nicotine throughout the day and evening can help to increase sleep efficiency and sleep time. Daily exercise and relaxation techniques can also help ease sleep disturbance. If particularly troublesome, HT or some complementary therapies may help with sleeplessness that is related to menopause.

Headaches

Studies suggest that changes in hormone levels during perimenopause may play a role in headaches. Whilst most headaches are minor, some can be more severe and interfere with a woman’s daily life. Migraine headaches tend to peak at puberty, during pregnancy and in perimenopause due to changes in hormone levels at these times.

Skin Changes

The skin undergoes normal changes with ageing, creating slight sags and wrinkles. Drinking plenty of water will help keep skin moisturised and avoiding smoking and exposure to the sun will help to reduce the effects of ageing on skin.

Irritability (see Emotional Health and Wellbeing section)

Low Self Esteem (see Emotional Health and Wellbeing section)

Palpitations

A woman’s heart rate can increase by 8 to 16 beats during a hot flush and this is unlikely to be related to heart disease. It can make a woman aware of her heart beat (palpitations), but is of no consequence to her health. However if this is associated with shortness of breath or chest pain, or is particularly troublesome, frequent or of concern, it should be investigated further.

Decreased Libido (see Sexuality)

Weight Gain

After menopause, many women notice that they lose their waistline. This is due to a 10% redistribution of body fat from the hips and thighs to the abdominal region and is related to hormonal changes at menopause as well as ageing. Generally, a five-kilogram weight gain may be noticed around the time of perimenopause and menopause.

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Considering Your Options

Improved health, nutrition and medical treatments have resulted in increased life expectancy for both men and women. Most women in developed countries can expect to live at least 25 to 30 per cent of their life after menopause.

A great deal of research has been done and is still continuing into the effects on women’s long-term health during this time of life. Not all women suffer from signs of menopause, in fact 20 per cent have no symptoms. Some 60 per cent have mild symptoms, while only 20 per cent suffer severe symptoms.

Nutrition, physical activity and an emphasis on a healthy lifestyle for bone and heart health and weight management are vital at this stage of life.

There are many ways of coping, though it often depends on the severity of the symptoms. There are a range of therapies available including hormone therapy – HT (also known as Hormone Replacement Therapy – HRT) as well as other therapies.

Coping with symptoms

Many women cope with mild symptoms without any treatment.

  • Regular exercise often helps because this promotes wellbeing, enhances relaxation and sleep, and may reduce menopausal symptoms other than hot flushes.
  • Healthy eating habits with foods rich in phytoestrogens such as soy products or linseed may be beneficial.

Women with mild to moderate symptoms may prefer to take herbal or plant hormone therapies, which should be either monitored or prescribed by a qualified naturopath or herbalist with an interest in women’s health.

Women with more severe symptoms may find hormone therapy (HT) beneficial.

Choice of therapy

There has been increasing interest in natural therapies for menopause and for general health maintenance. Many women may not be aware that natural and prescription hormones may come from the same natural source, such as the Mexican Yam.

Research conducted so far on natural therapies has generally involved small trials which have suggested little benefit over placebo (dummy pills) for these therapies. Natural therapies are also often assumed to have few or no side effects or risks but this has yet to be determined in large scale controlled scientific trials.

Factual and balanced information on both the benefits and risks of different treatments is provided here (for more see Therapies) so women can discuss their options with their health practitioner.

Hormone therapy (HT / HRT) – What are the benefits and risks?

Treatment of menopause symptoms

The most common menopause symptoms are hot flushes and vaginal dryness. Hot flushes and night sweats are symptoms of the fall in a woman’s oestrogen level at the time of menopause. No other therapy has been shown to be as effective as oestrogen replacement therapy in reducing hot flushes.

Vaginal dryness is related to oestrogen loss and women with significant problems may benefit from the use of vaginal oestrogen preparations such as tablets or cream.

Many women using oestrogen therapy also obtain relief from a range of other menopause symptoms which seem to be related to low levels of oestrogen – such as lowered mood, anxiety, insomnia, headaches, muscle and joint pain and decreased sex drive.

Other effects of HT

Osteoporosis

HT reduces the risk of osteoporosis. It acts by preventing bone loss. This decreases fractures of the vertebrae (spine) by up to 40 per cent and also reduces hip fractures.

Heart disease

Original studies indicated that oestrogen replacement therapy may protect postmenopausal women against coronary heart disease. Recent trials have confirmed these findings in women aged under 60 years, but may increase heart disease risk in women starting therapy with oral hormones over 60 and especially over 70 years of age. Standard oral therapy should be avoided in women who already have established coronary heart disease.

Short-term memory and Alzheimer’s disease

Some studies suggest that oestrogen may prevent or delay the onset of Alzheimer’s disease. A recent study in women starting HT over 65 years (average age 72) showed a small increase in the risk of dementia.

Colorectal cancer

There is evidence from a major trial that HT reduces the risk of colorectal cancer.

HT – Risks

Breast cancer

Many environmental and lifestyle factors must be considered in the incidence of breast cancer.

Studies including a large randomised trial have indicated that HT is linked to a small increase in breast cancer after 5-7 years of treatment with combined HT. This risk is of the same order as drinking more than two glasses of wine daily, being overweight/obese or having your first pregnancy over 35 years of age.

The effect of HT on breast cancer risk for women who have a family history of breast cancer (mother or sister) appears to be the same as for women who have no family history of breast cancer.

Thrombosis

There is an increased risk of venous thrombosis (blood clots in the veins) in women using HT, however the incidence is very low and more likely in the first year of therapy. More research is needed to identify which women are more likely to be at risk.

Any decision about HT is an individual one and should be made after each woman is informed about her individual risks, benefits, needs and concerns in consultation with her prescribing practitioner.

HT – Other considerations

Weight gain

Women tend to gain weight, particularly around the abdomen (stomach), in their middle years whether they take HT or not. Most studies do not show a link between weight gain and HT use. In fact in several studies women who used HT had less weight gain than those who did not.

Bleeding

Some women may experience vaginal bleeding after starting HT. In most instances this can be managed simply by varying the dose or type of HT used. However all persistent unexplained vaginal bleeding must be investigated to exclude other causes such as polyps or fibroids.

Skin

There is some research to suggest that postmenopausal HT may prevent some aspects of skin ageing by increasing skin collagen. However further studies are needed to evaluate the effects of oestrogen on the skin.

Overall the main reason women choose to commence HT is for symptom relief aiming for short-term use (usually between 1-5 years).

Phytoestrogens – What is the evidence?

Phytoestrogens are substances found in many edible plants. Common food sources include soy beans, legumes, lentils, tofu, whole grain cereals, vegetables, garlic and linseed. There is widespread belief that a diet rich in phytoestrogens will relieve menopause symptoms and protect against various cancers. These proposed benefits of phytoestrogens in foods are not supported by the available evidence from clinical trials in humans.

Phytoestrogen supplements have not been shown to significantly relieve hot flushes. Most studies show that high dose phytoestrogen supplementation is no better in reducing hot flushes than placebos.

Many women who use soy products may also have a high fibre, low fat diet. Studies have not separated the claimed benefits of phytoestrogens from other diet features such as high fibre, low fat and high intake of antioxidant vitamins.

Osteoporosis

There is no evidence that a high phytoestrogen intake will prevent osteoporosis.

Heart disease

Soy and other foods rich in phytoestrogens appear to have favourable effects on cholesterol levels and blood vessel function but it appears that other substances in foods other than isoflavones (phytoestrogens) may be necessary to maximise these beneficial cardiovascular effects. Therefore, phytoestrogens should be taken in the form of food.

Breast cancer

Again, protection against breast cancer may be more related to other dietary factors, such as intake of vitamins in the diet, high fibre and low saturated fat intake, in women who have a high dietary intake of phytoestrogens.

There is no evidence that phytoestrogen supplements protect against breast cancer in postmenopausal women.

Phytoestrogens – Risks

The safety and effectiveness of high dose phytoestrogen supplements have not been established and cannot be responsibly recommended. However, dietary intake of foods rich in phytoestrogens appears to offer health benefits.

Progesterone creams – What is the evidence?

Progesterone creams, available now only on prescription, are ineffective according to research conducted so far.

There are no studies supporting progesterone (in creams) as a sole hormone therapy. There is no evidence that progesterone creams can be safely substituted for synthetic progestins as part of HT.

Osteoporosis

There is no evidence from the research conducted of any benefits of progesterone creams in preserving bone.

Endometrial protection

There is no evidence from the research conducted that progesterone creams provide adequate endometrial protection for postmenopausal women who are using oestrogen replacement therapy. The amount of progesterone actually absorbed through the skin is totally inadequate to protect the endometrium.

A woman could be putting herself at risk if she substitutes synthetic progestogen tablets or patches with a progesterone cream, while continuing oestrogen.

Wild yam creams – What is the evidence?

Wild yam creams are available from health food stores and from direct distributors.

Wild yam is not a progesterone, and cannot be converted to progesterone. It is applied as a cream. Wild yam cream contains diosgenin, an oestrogen like chemical which can be converted in a laboratory to progesterone and oestrogens for the contraceptive pill and HT but it is not converted to progesterone by the body.

Diosgenin has not been shown to be beneficial in terms of relieving menopausal hot flushes, vaginal dryness or other common symptoms.

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Signs and Symptoms

Menopause is the last menstrual (monthly) period in a woman’s life. It is a natural occurrence which marks the end of the reproductive years, just as the first menstrual period, during puberty, marked the start.

Australian women are now living one third of their lives after menopause. Most women reach menopause somewhere between the ages of 48 and 55, the average being around 51 to 52 years. Early menopause before the age of 40 is called ‘premature’ menopause.

menopause-symptomsNowadays, the word ‘menopause’ tends to have broadened to include what is medically termed ‘the climacteric’. This is the transition phase during which the body is undergoing changes. For most women these changes occur gradually over two to six years around the last menstrual period. It is in these years that symptoms of menopause can occur.

  • 20 per cent of women have no symptoms
  • 60 per cent have mild symptoms
  • 20 per cent of women seek help for severe symptoms

Early menopause

Early menopause, before the age of 40, is termed ‘premature’ menopause. It may occur spontaneously as a result of early failure of the ovaries; be caused surgically when a woman has her ovaries removed; or be caused chemically by chemotherapy for cancer.

Symptoms of early menopause are basically the same as for natural menopause.

Due to the long-term effects of oestrogen deficiency, the risk of developing osteoporosis or heart disease for women experiencing early menopause are considerably higher than for women reaching menopause at the expected age. For this reason, it is of extreme importance that advice is sought from your doctor. Treatment is usually long-term hormone replacement therapy, but the risks, particularly of breast cancer, do not increase until after 50.

For more see Early Menopause

What happens around menopause?

As we approach menopause, the production of hormones (i.e. oestrogen) by the ovaries starts to slow down. As this process accelerates, hormone levels fluctuate more and often a woman notices changes in her menstrual cycle.

  • Cycles may become longer, shorter or totally irregular
  • Bleeding may become lighter
  • Bleeding may become unpredictable and heavy (seek advice from your doctor)

Eventually the hormone levels will fall to a level where menstruation (periods) will cease altogether and menopause is reached. Contraception is needed until you have had one year without a natural period.

Other signs and symptoms

The most common symptom is the hot flush; however women may sometimes experience several of the symptoms listed below:

  • Hot flushes and night sweats
  • Aches and pains
  • Crawling or itching sensations under the skin
  • Headaches
  • Vaginal dryness
  • Reduced sex drive (libido)
  • Urinary frequency
  • Tiredness
  • Irritability
  • Depression
  • Sleeping difficulty
  • Lack of self esteem
  • Forgetfulness

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Perimenopause

What is perimenopause?

Perimenopause occurs because the ovaries run low on eggs or follicles. The menstrual cycle may become irregular, and cause complex changes within the ovaries, brain and uterus.

Many women feel the changes and feel different.  Every woman has her own individual pattern, some more severe than others.

During this transition, women may also experience menopausal-like symptoms.

Perimenopause begins with the onset of irregular periods and/or symptoms and finishes 12 months after the final menstrual period.

Symptoms

Mood changes

  • Sore breasts
  • Bloating
  • Headache / migraine
  • Hot flushes / sweats
  • Tiredness – increasing
  • Insomnia
  • Weight gain
  • Forgetfulness
  • Lack of concentration
  • Reduced capacity to cope with daily activities

Your periods may also change, becoming:

  • Infrequent and lighter
  • Irregular in pattern
  • Irregular in flow – e.g. heavier than normal / with clots
  • More painful

What can I do?

There is no test to determine when your period will finish. Hormone levels can swing enormously during perimenopause so cannot indicate if eggs will be released or not.

It is important to:

  • Use contraception until 12 months after your last period
  • Increase healthy eating habits
  • Increase physical activity
  • Seek help if concerned about how you feel
  • If necessary, discuss therapies with your health practitioner

When should I see my health practitioner?

  • If your symptoms are interfering in the quality of your life
  • If you are bleeding between periods or after intercourse
  • If you have distressful premenstrual symptoms
  • If your periods are:
    • Heavier than normal
    • Increase in pain

What therapies are available?

  • Combined oral contraceptive pill (if you are at low risk, e.g. non-smokers, normal blood pressure)
  • Hormone therapy
  • Mirena intra-uterine device – IUD (for heavy bleeding)
  • Natural therapies (see an accredited naturopath)

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About Menopause

Menopause, known also as the “change of life”, is literally the very last menstrual period in a woman’s life. It is said to occur when a woman has not menstruated naturally for 12 consecutive months.

Menopause is a natural occurrence. A woman’s ovaries no longer release an egg every month, she stops having periods and she is no longer able to have children naturally. As the ovaries are the main source of female hormones (oestrogen, progesterone and testosterone), the levels of oestrogen, and progesterone hormones drop considerably with testosterone slowly declining with age affecting other parts of her body.

Menopause usually occurs between the ages of 48 and 55.

Among Australian women, the average age is about 51 to 52 years.

However, a few women experience menopause much earlier and others may still be menstruating in their late fifties. The age at which a woman goes through menopause is not influenced by race, height, the age that she experienced her first period, the number of children she has had, or whether she used the contraceptive pill as a method of birth control. However, cigarette smoking can influence the age at which a woman may go through menopause, with smokers and even former smokers reaching menopause an average of two years earlier.

As the average life span for Australian women, other than indigenous women, is now about 83 years and increasing, women are now living around one third of their lives after menopause.

Menopause is the last menstrual (monthly) period and is a natural part of every woman’s life. It means the end of a woman’s reproductive years, just as the first menstrual period, means the start. Most women reach menopause between the ages of 48 and 55.

Menopause symptoms can begin gradually over two to six years before the last menstrual period. This time is called perimenopause – from the time periods become irregular until the first year after that final period.

For more information see Perimenopause, Signs and symptoms, Your options and Your questions

Why Does Menopause Happen?

As a woman approaches menopause, hormone levels increasingly swing up and down and often, a woman notices changes in her menstrual cycle. For example:

  • cycles may become longer, shorter or totally irregular;
  • bleeding may become lighter; or
  • bleeding may become unpredictable and heavy.

(Women with unpredictable or heavy bleeding should seek advice from their health practitioner as soon as possible).

Changes in hormone levels can also contribute to some of the symptoms that a women might experience at this time. This process can take up to four to six years on average in women.

Eventually, hormone levels will fall to a level where menstruation stops altogether and menopause is reached.

A woman needs to continue using contraception for a further 12 consecutive months after her last natural period.

Early menopause

Early menopause, before the age of 40, is called ‘premature’ menopause. It may occur:

  • Naturally when the ovaries have stopped working
  • Surgically when a woman has her ovaries removed
  • Chemically from chemotherapy / radiotherapy for cancer

Women who experience early menopause are at greater risk of osteoporosis and heart disease because of the long-term effects of low oestrogen levels. If you think you are experiencing early menopause it is important to talk to your doctor.

For more information see Early Menopause

Surgical menopause

Surgical menopause is when the ovaries are removed prior to natural menopause, (also known as oophorectomy). This causes a sudden and permanent drop of the ovarian hormones: oestrogen, progesterone and testosterone. The surgical procedure may include the removal of the uterus (womb), which is known as a hysterectomy.

Following a surgical menopause, symptoms may commence very quickly. Often the symptoms are intense unless treatment is initiated immediately after surgery.

About 10-20 per cent of women who have a hysterectomy, but retain their ovaries, may also experience menopause slightly earlier (between one and four years) than average.

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