What Is Menopause?

Menopause is defined in the dictionary as the permanent cessation of the menstrual cycle. This occurs when a woman's egg supply and ovarian function is depleted. It can occur naturally, or surgically with removal of both ovaries. A woman is said to be in menopause when there has been no menstrual period for 12 months. The average age of menopause is around 50 years in the US. Perimenopause refers to the time before menopause when the hormone levels begin to decline, the menstrual periods may become irregular, and fertility is reduced. Perimenopause may come before actual menopause by as much as 2-8 years, the average being about 4 years. Smoking is known to accelerate the transition phase by 2 years, as it speeds the aging process in general.

The classic symptoms of menopause include night sweats, difficulty sleeping, vaginal dryness, depression, and mood swings. One US study showed nearly 60% of US women had hot flashes as early as 2 years before menstruation stopped. Other symptoms in the perimenopause/menopause time frame include poor handling of stress, a more obvious pre-menstrual syndrome (PMS), weight gain, water retention and bloating, problems with memory. These symptoms are related to the drastic changes that are occuring in the body with reducing levels of estrogen and progesterone.

What About Hormone Replacement Therapy (HRT)?

The question as to whether or not to use HRT has now become a very complex issue. Nearly 30% of menopausal women in the US are taking hormones, commonly given to relieve the side effects as listed above. In the Women's Health Initiative (WHI) 16,000 women were studied for over 5 years, but then the study was prematurely stopped when it was discovered that the combination of estrogen/progesterone replacement therapy resulted in an unfavorable risk to benefit analysis. There is no doubt that the therapy did benefit women's hot flashes and risk of developing osteoporosis. Unfortunately the study revealed definite increased risk of developing endometrial (uterus) cancer, breast cancer, venous blood clots, and probably a risk of stroke and heart attacks. There was also question as to whether the use of HRT could be linked to gallbladder disease, ovarian cancer, colon cancer and even possibly an increased incidence of memory loss and dementia. Some of these risks were directly linked to the time HRT therapy was taken. In other words, the longer you take HRT therapy the higher the risk.

What About Alternative Therapy?

Several naturally occuring plant extracts have been shown to help with the symptoms of menopause and present a natural alternative to hormone replacement therapy:

Black Cohosh--studies in Germany have shown a decrease both in the number and level of menopausal symptoms.

RedClover--rich in phytoestrogens, these little molecules can be extracted from plants such as soy and have a similar structure to estrogen itself but lack the side effects of estrogen itself.

Flaxseed--Also contains a substance with weak estrogen activity.

Soy Isoflavones--also contain molecules with similar structure to estrogen.

Of course, you should talk to your doctor about your choices of therapy during the menopause and perimenopause time and what the possible side effects and risks may be to the various treatment options.

Sylvia Seamands,MD--Dr. Seamands is a retired physician who spent years as a practicing Internist and medical director for several managed care orginzations. She authors information articles for and co-owns http://www.womenshealthshoppe.com, which is dedicated to women's health issues and alternative health solutions.