Given practical information, medical attention and a positive attitude, most women can expect to experience menopause as a time of change, challenge and new-found personal freedom.  More and more women are finding the years of menopause and beyond are the best of their lives. Information about managing menopause and treating the diseases that often occur after it, is constantly expanding.

The Symptoms:    1.Hot flashes, flushes, night sweats and/or cold flashes, clammy feeling     2.Bouts of rapid heart beat     3.Irritability     4.Mood swings, sudden tears     5.Trouble sleeping through the night (with or without night sweats)     6.Irregular periods; shorter, lighter periods; heavier periods, shorter cycles,  longer cycles     7.Loss of libido (see note)     8.Dry vagina (see note)     9.Crashing fatigue    10.Anxiety, feeling ill at ease    11.Feelings of dread, apprehension, doom (see note)    12.Difficulty concentrating, disorientation, mental confusion    13.Disturbing memory lapses    14.Incontinence, especially upon sneezing, laughing; urge incontinence (see note)    15.Itchy, crawly skin (see note)    16.Aching, sore joints, muscles and tendons (see note)    17.Increased tension in muscles    18.Breast tenderness    19.Headache change: increase or decrease    20.Gastrointestinal distress, indigestion, flatulence, gas pain, nausea    21.Sudden bouts of bloat    22.Depression (see note)    23.Exacerbation of existing conditions    24.Increase in allergies    25.Weight gain (see note)    26.Hair loss or thinning, head, pubic, or whole body; increase in facial hair    27.Dizziness, light-headedness, episodes of loss of balance    28.Changes in body odor    29.Electric shock sensation under the skin and in the head (see note)    30.Tingling in the extremities, (see note)    31.Gum problems, increased bleeding    32.Burning tongue, burning roof of mouth, bad taste in mouth, change in breath odor    33.Osteoporosis (after several years)    34.Changes in fingernails: softer, crack or break easier    35.Tinnitus: ringing in ears, bells, 'whooshing' buzzing etc.

NOTES:  Symptom 1 (flashes) Hot flashes are due to the hypothalamic response to declining ovarian estrogen production. The declining estrogen state induces hypophysiotropic neurons in the arcuate nucleas of the hypothalamus to release gonadotropin-releasing hormone (GnRH) in a pulsatile fashion, which in turn stimulates release of luteinizing hormone (LH). Extremely high pulses of LH occur during the period of declining estrogen production. The LH has vasodilatory effects, which leads to flushing. Symptom 7 (loss of libido) For some women the loss is so great that they actually find sex repulsive, in much the same way as they felt before puberty. What hormones give, loss of hormones can take away. Symptom 8 (dry vagina) results in painful intercourse Symptom 11 (doom thoughts) includes thoughts of death, picturing one's own death Symptom 14 (incontinence) reflects a general loss of smooth muscle tone Symptom 15 (itchy, crawly skin) feeling of ants crawling under the skin, not just dry itchy skin Symptom 16 (aching sore joints) may include such problems as carpal tunnel syndrome  Symptom 22 (depression) different from other depression, the inability to cope is overwhelming. There is a feeling of loss of self. Hormone therapy ameliorates the depression dramatically. Symptom 25 (weight gain) often around the waist and thighs, resulting in 'the disappearing waistline' Symptom 29 (shock sensation) "the feeling of a rubber band snapping in the layer of tissue between skin and muscle. It is a precursor to a hot flash" Symptom 30 (tingling in extremities) can also be a symptom of B-12 deficiency, diabetes, alterations in the flexibility of blood vessels, or a depletion of potassium or calcium Some of the 34 signs may also be symptoms of one of the following:   hypothyroidism    diabetes    depression with another etiology    Multiple Sclerosis    other medical conditions  If you have reason to believe you may have one of these conditions, please see your doctor for treatment. The Women Who Created This List of Symptoms

COPING WITH MENOPAUSE Women may notice the first signs of bodily changes in their menstrual patterns, skin, and shape as early as their late 30s. Menopause — the cessation of the menstrual cycle — is certainly the most notable sign of advancing age for women. The hormonal changes that spur the end of menstruation affect our entire bodies, from the texture of our skin to the condition of our heart and bones.  The medical definition of menopause is the end of menstruation, so menopause can only be diagnosed after the fact. But the bodily changes leading up to menopause may take place over a decade. Most women reach menopause between the ages of 45 and 55. At age 52, 80 percent will no longer be menstruating. There does not appear to be any consistent relationship between a woman's age at the onset of menopause and her age at her first menstruation, nor does marriage, childbearing, height, weight, or use of oral contraceptives appear to make a difference. However, women who smoke do tend to reach menopause a year or two earlier than nonsmokers.

MENOPAUSE: MYTHS AND REALITIES  Myth: Menopausal women are unhappy and depressed.  Reality: Most women cope very well with the physical challenges of menopause. Serious mental health problems do not increase. While some women may experience emotional distress, this is often related to sleep disturbance and deprivation due to hot flashes.  Myth: All women going through menopause are plagued by hot flashes.  Reality: About 80 percent of American women experience only mild symptoms, or none at all, during menopause. When hot flashes do occur, in most cases they are mild and disappear after a few months, rarely persisting for more than 2 or 3 years.  Myth: Menopause is the end of your sex life.  Reality: Libido, or sexual desire, does decline with aging, but many women continue to enjoy a satisfying sex life deep into old age. Some women find sex more enjoyable after menopause when concerns about pregnancy are past.

Mid-Life Medical Checkup  Most women will live many vital, useful, and enjoyable years after menopause. To stay healthy during this phase of life, preventive health measures and medical care are needed. When the signs of mid-life changes begin to appear, it's a good reminder to set up an appointment for a thorough medical checkup. A good relationship with a doctor who is aware of your health history and personality can give you an excellent resource to turn to when questions about menopausal signs and symptoms arise.

What is continuous hormone replacement therapy?  Continuous hormone replacement therapy involves taking hormones every day after menopause, when the ovaries stop making enough of the female hormones estrogen and progesterone, or after surgery to remove the ovaries.  Are there different types of hormone replacement therapy?  Yes. There are different types of hormone replacement therapy. One type involves taking estrogen alone, but hormone replacement therapy with estrogen alone can increase the risk of cancer of the uterus (womb) and endometrium (lining of the uterus). Adding progestin, a synthetic form of progesterone, to your treatment seems to keep the risk of these two cancers down.  In the past, women taking these two hormones would take estrogen for the first part of the cycle and progestin during the latter part of the cycle. But this form of hormone replacement therapy may cause bleeding every month, much like having a menstrual period. Many women quit taking the hormones because of this monthly bleeding.  Taking both of the hormones every day throughout the month seems to fix this problem for many women - most women taking continuous estrogen and progestin therapy quit having bleeding after three to six months.  How is continuous hormone replacement therapy taken?  Your doctor will probably start you on the estrogen and progestin at the same time. He or she will probably start you on a low dose of progestin to see if you have bleeding on the lowest dose.  Take both pills every day. You don't have to stop on certain days of the months.  If you have bleeding, tell your doctor. The dose of progestin may need to be increased.  What are the benefits of hormone replacement therapy? Hormone replacement therapy can be beneficial in many ways:  It can reduce your risk of osteoporosis, a condition that causes the bones to become porous and thin and more likely to break.  It can relieve symptoms of menopause, such as flushing, night sweats and vaginal dryness.  It can decrease your risk of heart attacks.  What are the risks of hormone replacement therapy?  As mentioned before, estrogen taken alone can increase the risk of cancer of the uterus and endometrium.  Progestin can cause tender breasts, fluid retention, swelling, moodiness and cramps. These side effects seem to be less for some women who take continuous hormone replacement therapy. Progestin may also reduce how well estrogen works to protect against heart disease. Studies are still being done on the use of progestin.  Generally, women who have had endometrial cancer, breast cancer, blood clots, stroke, unexplained vaginal bleeding or liver disease shouldn't take hormone replacement therapy.  Are there any signs of problems I should look for?  Yes. If you bleed after you haven't had any periods for several months, call your doctor. Also call your doctor if you notice any breast lumps or pain, or if you have any questions.  This information provides a general overview on continuous hormone replacement therapy and may not apply in each individual case. Consult your physician to determine whether this information can be applied to your personal situation and to obtain additional information.

Creams containing estrogen are used to treat symptoms such as vaginal dryness, soreness and itchiness. They do not help symptoms such as hot flashes and night sweats.  HRT patches adhere to the skin, and the estrogen they contain is absorbed by the body. The patches must be replaced periodically Tablets are the way in which estrogen and progestin or androgen are usually taken. They are prescribed in different ways or doses. Your doctor will determine which is best for you. HRT is not without side effects and risks. The decision to use HRT should be made only after discussing the pros and cons with your doctor. Estrogen therapy is generally not recommended for women who have had breast cancer, endometrial cancer or liver disease.

Does menopause affect bladder control? Yes. Some women have bladder control problems after they stop having periods (menopause or change of life). If you are going through menopause, talk to your health care team. After your periods end, your body stops making the female hormone estrogen (ES-truh-jun). Estrogen controls how your body matures, your monthly periods, and body changes during pregnancy and breast-feeding. Estrogen also helps keep the lining of the bladder and the urethra (yoo-REE-thrah) plump and healthy. Lack of estrogen causes the bladder control muscles to get weak. Your doctor may give you medicine to replace estrogen to prevent future bladder control problems. Be sure to tell your doctor if you or your family has a history of cancer. If you face a high risk of cancer of the uterus or breast, the doctor may not prescribe estrogen. Pressure from coughing, sneezing, or lifting can push urine through the weakened muscle. This kind of leakage is called stress incontinence. It is one of the most common kinds of bladder control problems in older women.

Herbal Remedies  Listed here are some of the options that have been used effectively by women all over the world for thousands of years. Examine all your options before making a decision about Estrogen Replacement Therapy. Then do what is BEST for you, and HAVE FAITH in whatever choice you make.

ALFALFA High mineral and vitamin content. Estrogen precursor for menopause. Mild diuretic. BLACK COHOSH Relieves menstrual cramping. Especially effective to ease menopausal distress and p.m.s. Promotes normal hormone activity. Reduces nerve spasms and night sweats associated with menopause. Also effective in treatment of osteo- and rheumoatoid arthritis pain, as an anti- inflammatory. Has been found helpful in cases of tinnitus. Do not use during pregnancy without professional advice, because it is a uterine stimulant and might cause contractions. CAYENNE   An excellent tonic is l/2 teaspoon apple cider vinegar, l/2 teaspoon raw honey, and a few grains of cayenne (some take up to l/2 tsp if you can!) in a warm glass of water or a cup of herb tea. (A possible treatment for hot flashes. Keeps the blood healthy, and permits on-going normal perspiration).  CHASTE BERRY/VITEX Stimulates pituitary gland. Helps regulate and normalize hormone production. Normalizes estrogen/progesterone balance. Especially beneficial with menopausal problems and other hormonal imbalances. Most effective over long period of time. No side effects reported. One of the most useful herbs for women for centuries Used for menstrual cramps, P.M.S., menopause, post birth control pill rebalancing.  LICORICE ROOT Used in women's formulas for centuries. Has estrogenic properties, used to normalize and regulate hormone production. Similar to adrenal cortical hormones, so stabilizes unbalances during menopause. Use with caution if you have high blood pressure and/or water retention or diabetes. Effective as treatment for thinning/drying vaginal walls. NETTLE Native American female tonic. One of the best sources of plant iron, calcium, vitamin A, chlorophyll, protein. Excellent hormone therapy during menopause. Reduces water retention. Corrects symptoms of PMS. Recommended for use over long periods of time. Can have allergic reaction when eaten raw. Purchase as dried for tea, or as already made tea. WILD YAM Antispasmodic. Anti-inflammatory. Used for painful menstruation and ovarian and uterine pain. Used to reduce menopause problems, arthritic and rheumatoid arthritic pain.

COUNTERACTING OSTEOPOROSIS & MORE      Calcium: seaweeds, kelp, yogurt, almonds, sesame seeds, darkgreen leafy veggies.      Iron: Check latest research. Tests indicate some menopausal-aged women may      have too much iron in their blood, because menstrual flowing is diminishing, and      this may be a primary cause in higher incidence of heart attacks, rather than      diminished estrogen! If iron is indicated, remember spinach, beets and beet greens,      apricots, oat cereal, raisins and the herbs: parsley, watercress, nettle and alfalfa.      Magnesium: More and more studies indicate the necessity of magnesium for      emotional balance, especially during menopause.       Vitamin E: (limit dose if diabetic, hypertensive, rheumatic heart), 400-600      I.U.daily.      Vitamin A      Bee Pollen: A concentration of nearly all known nutrients. Be wary if allergic.      Spirulina: A wonder food for menopausal women. Exceptionally high protein food.      Its B vitamins strengthen the nervous system and counteract mood swings and      depression. Its gamma-linolenic acid helps prevent osteoporosis and arthritis.       Exercise: especially weight-lifting (if osteo-porosis is a concern, because it can help      build bone mass), walking and calisthenics. Essential for maintaining bone density      as well as all-around fitness, physically and emotionally.      The Kegel Exercise: Tighten and release the muscle that stops urination to make      entire pelvic area healthier: fresh blood to vaginal tissue, more moisture.      Drink water!      Avoid caffeine and alcohol.

Laura Krieger/Elchai, M.A. in Creative Communications, writes, lectures, and      conducts workshops on alternative options for health, healing and      self-empowerment. As an herbalist and holistic counselor, she has a special interest      in the use of herbs and other natural energy sources that strengthen the immune      system and promote physical and emotional well-being.

To learn more about Menopause, contact these organizations:  The American Menopause Foundation, Inc.  350 Fifth Avenue Suite 2822  New York, NY 10118 212-714-2398  National Osteoporosis Foundation  P.O. Box 96616, Dept. PhA  Washington, DC 20077-7456 1-800-464-6700   National Institute on Aging  Information Center  P.O. Box 8057  Gaithersburg, MD 20898-8057  1-800-222-2225 National Women's Health  Resource Center  2425 L Street, NW,  3rd Floor  Washington, DC 200

*The information on this page is not intended to diagnose, treat, cure, or prevent any disease or condition. It is not intended to replace professional medical care.Consult your doctor regularly about matters concerning your health, particularly regarding symptoms that require diagnosis or immediate medical attention.

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