That’s a common question asked by many women who are on a journey to their “climacteric.” No, not towards the climax but the “change of life” for women. The climacteric, menopause, change of life, or whatever you call it, happens to all women at some point in their lives. Menopause is defined as having no menstrual cycle for twelve months, and all other symptoms can vary for each woman, such as temperature changes, moodiness and irritability. Picture the women sitting in a room or meeting and without warning, she starts sweating profusely and complaining it is hot. She’s the person in church frantically fanning, experiencing her own “private summer” while everyone else is unaffected. She is kicking the covers off at night and opening windows when it is already below freezing.
At 20 weeks of life, while in our mother’s womb, we have our maximum number of eggs. During a normal menstrual cycle, intricate reactions between our hormones (estrogen, progesterone, and testosterone) prime the lining of the uterus (endometrium) to nourish a fertilized egg. For most women, an egg is released during ovulation around cycle day 14. The egg is viable for about 12-24 hours and awaits fertilization by a sperm. If fertilization does not occur, the thick uterine lining is not needed and with proper signaling, it is sloughed off and bleeding occurs. Hence your 5-7 day menstrual cycle.
The age at which menopause occurs is affected by multiple factors: genetics, surgery, medicines, toxins, and radiation. The average age is 51 years old. Women in the same family tend to complete menopause around the same time. However, the manner and number of years prior to completion can vary within the same family. Women undergoing removal of their ovaries will experience a surgical menopause. Medications such as Lupron (used for endometriosis) and Tamoxifen (adjunct for breast cancer) can cause a medical menopause. Large doses of toxins used to treat cancers such as chemotherapy and radiation may also cause menopause.
If the ovaries stop working before age 40 without any of the above situations present, it is referred to as premature ovarian failure (POF). This may be due to genetic or chromosomal factors such as Turner’s or Fragile X syndrome, autoimmune disorders such as Addison’s disease, Lupus, Type 1 diabetes, Sjrogen’s, hypothyroidism, Graves, or rheumatoid arthritis.
The production of female hormones comes from ovaries (65%) and the remainder divided between the skin and adrenals. Ovarian hormones are responsible for wrinkle free skin, vaginal lubrication, bone protection, clarity of thoughts, mood, memory, regular cycles, temperature regulation and libido. It’s easy to see that a loss of these hormones will lead to some degree of deficits.
The transition to menopause for most women is gradual and may occur over 2-8 years as symptoms wax and wane over this period of time. The more common symptoms are hot and cold flashes, night sweats, sleep disturbances ranging from frequent awakenings to insomnia, headaches, migraines, memory lapses, fogginess of thought, irritability, fatigue, pain with intercourse, vaginal itching, vaginal dryness, weight gain, lack of interest in sex, dry skin, urinary frequency, urinary incontinence, irregular cycles, wrinkles, acne, and hair loss. Our risk for heart disease and stroke increases with the loss of estrogen.
The diagnosis of menopause can be accomplished with blood or saliva tests measuring hormone levels of FSH, LH, estradiol, progesterone and testosterone. High levels of FSH and LH >20ng/ml along with no cycle for 12 months is diagnostic for menopause. Low levels of estradiol, progesterone and testosterone are also found in menopause.
The treatment for menopause is varied and may consist of herbs, essential oils, plant-based formulations, bio-identicals, pellets or other non-hormonal pharmaceuticals. Your healthcare provider can do some initial testing and make recommendations for specific therapies. For those who want to do nonconventional therapies, compounding pharmacies may be helpful.
Whether you decide to weather the storm alone or seek professional help with your symptoms, know that you have options. Know the triggers such as: hot weather, smoking, spicy foods, caffeine, stress, eating sugar, alcohol or tight clothing. Relief is around the corner! Ask for it!
By: Dr. Gloria Ivey-Crowe
Women Physicians of Northern Virginia