Menopause: Advice from a Pro to Reduce Symptoms
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Menopause - Jane K Allende
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Introduction
The menopause is a natural phenomenon which occurs in all women when their finite number of ovarian follicles is depleted. As a result, oestrogen and progesterone hormone levels fall, and luteinising hormone (LH) and follicle stimulating hormone (FSH) increase in response. Menstruation becomes erratic and eventually stops and there are a number of secondary effects described as 'menopausal symptoms' - see under 'Presentation', below.
The climacteric, menopausal transition stage, or perimenopause, is the period of change leading up to the last period. The menopause itself is a retrospective diagnosis of the time when menstruation permanently ceases. It can only be defined with certainty after twelve months' spontaneous amenorrhoea.
Premature menopause (occurring before the age of 40) can occur in primary ovarian failure, surgically-induced menopause (hysterectomy with or without bilateral oophorectomy), radiation-induced menopause and chemotherapy-induced menopause.
Epidemiology
Menopausal transition stage usually begins when women are in their mid-to-late 40s. The final menstrual period (FMP) usually occurs between the ages of 40 and 58. Average age of menopause in the UK is 51 years.
The menopause can be 'induced' by surgical removal of the ovaries or by iatrogenic ablation of ovarian function by chemotherapy, radiotherapy or by treatment with gonadotrophin-releasing (GnRH) analogues.
Population studies identify smoking and low socio-economic factors as being associated with premature menopause. Other factors that can affect the age at which women have their final period include age at menarche, parity, previous oral contraceptive history, BMI, ethnicity, family history, and a history of breast surgery.
Most women do not seek medical advice for menopausal symptoms. Variations in consultation patterns for menopause depend on many factors,