Adjusting Your Attitude About Menopause

Baby boomers are handling menopause differently from earlier generations. Today when women reach menopause they can look forward to living another 30 or more years. 

That means a third of a woman's life may be lived after menopause. More women are talking about menopause, and more is being written about it than ever before.

In the past, premenopausal women held divergent notions about menopause and aging. Some believed it was a natural transition that should be managed by natural means; others considered menopause a medical condition requiring treatment. It's important for women today, however, to know that menopause is a normal event. 

A health care evaluation

A woman has reached menopause when she has not had a menstrual period for one year. The time of transistion, or perimenopause, usually begins when a woman is in her 40s. Each woman's experience can be very different, however.

Although most changes occurring during perimenopause will not continue far beyond menopause and will stop without treatment, it is important to seek a medical evaluation. Hot flashes and other changes can be a sign of disease or can be caused by other conditions such as a thyroid disorder. Any changes should always be reported to your health care provider.

The most reliable test for menopause measures the blood level of the follicle-stimulating hormone (FSH), which is produced by the pituitary gland. This hormone stimulates the ovaries to secrete estrogen. As the ovaries age and production of estrogen declines, the pituitary gland tries to stimulate greater estrogen production by releasing more FSH into the blood. When a woman's FSH rises to a constant level in the blood of 30 to 40 mIU/mL or higher, it is generally accepted that she is nearing menopause.

Many women go through the menopause transition with minimal discomfort. Those who do experience discomforts may reduce them by making lifestyle changes. These include stopping smoking; exercising; modifying alcohol intake; eating a healthy diet, and practicing safe sex. For those who need additional help with symptoms, hormone therapy (HT) is an option. The decision on whether to use HT should be made by a woman and her health care provider.

Variety of symptoms

Studies have consistently shown that two symptoms--hot flashes/vasomotor symptoms and vaginal dryness--are definitely related to menopause. Sleep disturbances, irritability, fatigue, depression, and other symptoms may be a result of menopausal changes, however, they may also be due to other physical changes. Health care providers need to listen carefully to their patients' concerns so proper treatments can be explored. 

When bleeding becomes abnormal

In the perimenopausal years, menstrual periods typically become lighter and farther apart. Irregular periods are common and normal during perimenopause. You shouldn't assume that all changes are related to menopause, however. Other conditions may be the cause.

Talk to your health care provider if the following conditions appear:

• Periods are very heavy, gushing or accompanied by clots.

• Periods last more than seven days.

• Intervals are shorter than 21 days from the start of the last period.

• Spotting or bleeding happens between menstrual periods.

• Bleeding occurs after intercourse.