The New Nation - Internet Edition

The formal definition of menopause is the last menstrual period. However, during the years building up to menopause, many women's cycles will be irregular, with several months between periods. So it can be difficult to know whether the last period you had was in fact the final one. A rule of thumb is that if you haven't had a period for 12 months, they're probably finished, and your menopause is 'back-dated' to the last period you had.

Most women reach menopause between the ages of 45 and 55, with the average being about 50 or 51 years. But there is a lot of variation - some women reach menopause in their 30s and early 40s, while others keep menstruating until the late 50s. The reasons for early menopause are little known. It's often said that if you start menstruating early, you'll stop early, but research shows this not to be true. The only known indicator is that if you have a family history of early menopause, then you are more likely to also.

Do you have any way of knowing whether you are nearing menopause?

For some women, there will be no warning - their periods will simply stop. But most will go through a phase of erratic periods before they reach menopause. Periods will get further apart, or occasionally closer together. This phase is called the 'menopausal transition', or 'perimenopause', and it can last for several years.

A hot flush is a sudden feeling of being overheated, usually accompanied by sweating and redness in the face. It is the most common symptom women experience during the years surrounding menopause (and sometimes for many years afterwards).

Lots of women do experience mood swings and depression during menopause, some of them severely, but menopause is not directly responsible. Hormonal fluctuations do make women more vulnerable to stress, so that they might not cope as well with life's ups and downs as they usually do. Depression does occur during menopause, and it needs to be taken seriously (doctors can help with medication or psychological treatments). But it does not seem to be any more common than in other age groups; menopause does not cause depression on its own.

Many women (and men) do notice a drop-off in sexual response as they get older, and the fall in oestrogen levels after menopause can cause vaginal dryness which can make sex uncomfortable. However, vaginal dryness is easily treated with lubricants or hormones. Research suggests that the most important ingredient for a good sex life is a good relationship with your partner.

Hormone replacement therapy, commonly known as HRT, is the standard pharmaceutical treatment for menopausal symptoms. It is usually made up of two kinds of hormones - oestrogens and progestin (a synthetic form of progesterone). Levels of these hormones fall after menopause, and hormone replacement therapy helps relieve symptoms and has some long-term health benefits, such as osteoporosis prevention. There are, however, many controversies over the risks and benefits of HRT:

Oestrogens are the sex hormones that control the menstrual cycle, the growth and function of the uterus and uterine lining, and secondary sex characteristics (such as breast development, vaginal secretions and sexual interest) in women. They also affect bone, brain, heart, blood vessel and skin tissue. There are three main types of oestrogen produced by the body: oestrone, oestradiol and oestriol. These are often collectively referred to in the singular form, as 'oestrogen'. Women's oestrogen levels fall drastically during menopause, with widespread implications for long-term health.

Progesterone is the hormone, which, during a woman's fertile years, is produced by the ovaries and has effects, which are in some ways opposite to those of oestrogens. During the menstrual cycle, oestrogens build up the uterine lining (called the endometrium), but if the egg is not fertilised the lining is not required; it is progesterone which stimulates the lining to shed, causing a period. Progesterone is included in hormone replacement therapy in a synthetic form called progestin. It helps protect the endometrium from over-stimulation by oestrogens, which can contribute to endometrial cancer. Because of the progestin in HRT, most women taking HRT have 'withdrawal bleeding' - a kind of 'false period' which lasts for a few days. Women who have had a hysterectomy (surgical removal of the uterus) do not need progestin, so they are prescribed oestrogen alone and do not experience bleeding.

Menopause Survival Tips

The general consensus is that your menopause is likely to be similar to your mother's menopausal experience.

Take one aspirin tablet per day (325 mg., 1/2 a regular adult dose) as a natural anti-coagulant. Antiplatelet therapy reduces the risk of any serious vascular event by about one quarter; risk of non-fatal heart attack by one-third, non-fatal stroke by one quarter, and vascular death by one sixth. If heart attack (or stroke) symptoms occur, take one aspirin immediately as its anti-coagulant effects can mean the difference between life and death.

Become more aware of nutrition -- what you put into your body. The types of oils you use in cooking, the way you prepare your foods. Canola, Sunflower, Safflower and Olive oils are the best. Sunflower oil actually serves as a cleanser of your arteries to remove plaque and prevent more plaque from forming. Certain fats are good for your body, while others are bad. As you are aging your skin, hair and nails are likely to become drier and more brittle and lose their natural oils. Moisturize your skin and deep-condition your hair. And eat lots of fruit and fiber.

Avoid processed foods, nicotine, caffeine, artificial sweetners and "junk" food. These are no-no's for menopausal women. Try to cut down or, better yet, stop drinking carbonated drinks, especially diet sodas - and more especially, those made with aspertame (Nutrasweet). The carbonation can cause bloating.

Keep a journal. Journalling can be extremely useful. A suggestion -- when you have a hot flash, mood swing, palpitations, bout of binge eating, sudden elevated anxiety, panic attack, or any number of repetitive behavioral problems, take a pen and paper (or treat yourself to an actual journal) and write down:

What you were doing/What you were thinking /what you were feeling /with whom you were interacting/what they said to you /what you ate just prior to the onset of the problem

t and anything else you can think of that might be useful in identifying your triggers.

By keeping a running journal of the 'changes' you experience, you'll be able to identify those circumstances, foods, people, thoughts, activities that may have triggered the physical and emotional changes. Through examination, you can see if there's a pattern to the emotional UPS and downs, you can utilize the process of elimination in pinpointing the cause of the problem! When a hot flash hits, you can peel off the top layer (without getting arrested) and wear cotton as it is the most absorbent and cool of all fibers.

Additional suggestions:

Drink a glass of cold water or juice at the onset of a flash

At night, keep a carafe or thermos of ice water or an ice pack alongside your bed

Use cotton sheets, sleeping garments, lingerie, and clothing to let your skin "breathe"

Believe it or not, one of the quickest remedies for hot flashes and sweats is in your own refrigerator. Open the freezer and pull out a bag of frozen vegetables. Place it on your face, neck, inner arms and wrists. It's refreshing and often can thwart a hot flash instantly. When unanticipated hot flashes or sweats hit, especially while travelling, a handy item to have is a mini portable personal fan. Remember, this isn't a taboo subject any longer. There's no need to be embarrassed. It's a natural occurrence. So, use your frozen veggies, or whip out your hand fan and, uncomfortable as it may be, try to find the humor in it. Everyone else will, too.

Eat lots of garlic! Garlic is excellent for blood pressure and cholesterol. You can also take garlic in a gel tablet - odorless, too. Also, eat lots of broccoli. It's loaded with phytochemicals, vitamins and contains the highest amount of antioxidants than any other vegetable. Stacked with protective compounds , such as isothiocyanates and sulforaphane, as well as indole-3-carbinol (I3C), a substance that is said to have anticancer actions, broccoli tops the list of 'must serves'. The entire Brassica family of vegetables, (which includes Brussels sprouts, cauliflower, cabbage, Chinese cabbage, bok choy, kale and collard greens), contains a compound that activates certain enzymes in the human body to protect cells from genetic damage.

Try adding cinnamon and ground flaxseed to your morning oatmeal. It's been discovered that cinnamon is very effective in lowering hyptertension. Ground flaxseed blends nicely with oatmeal and is one of the most important things you should take. Flax is good for your heart, for maintaining healthy cholesterol and triglyceride levels, one of the "good fats" our bodies need, has anti-carcinogenic properties to protect us from various forms of cancer. Flaxseed is an excellent source of fiber and especially Omega 3 Fatty Acids. A 2 tablespoon serving provides 2400 mg of Omega 3.

You know how we suddenly develop cravings for chocolate? They've said that chocolate is the "feel good" food - probably raising seratonin levels. However, while it may make us feel good for a short while, chocolate and all sweets can bring on hot flashes, raise insulin levels, cause palpitations, anxiety and even depression in some, so while everyone's exalting chocolate to the sky, remember it's not good for every peri and postmenopausal woman.

Avoid toxic situations and people! Menopause can be likened to Murphy's Law -- whenever anything can go wrong, it does! Our patience is tested to the max while we're coping with all these changes. It seems all our demons, every unresolved issue of our life, hits us right between the eyes during perimenopause. We each know at least one someone who pushes all our wrong buttons. If you know certain situations or people are invariably going to cause you grief, do everything within your power to avoid them. Avoid inconsequential arguments.