|05-28-2004, 10:03 PM||#1|
Out fart the hottie!
Location: I have super gonorrhoea
I'm having hotflashes. Am I having Menopause?
WHAT HAPPENS AT THE MENOPAUSE?
OK, now let's just be clear about what actually happens at the menopause. What goes on is this. The woman's output of female hormones drops off quite suddenly - often dramatically! (In the case of a person who has an artificial menopause - caused by having her ovaries removed surgically - the change happens overnight.)
A major effect of this drop in hormones is that the woman's periods stop. To find out how they should stop, please see the next section. Other striking effects which may occur (and which may cause a lot of distress) are:
Hot flushes (known to Americans as 'hot flashes')
Vaginal dryness - which inevitably causes sexual discomfort.
These three symptoms can now be successfully treated - as we'll see in a moment.
WHAT SHOULD HAPPEN TO THE PERIODS?
But first, let's just explain what should happen to your periods - because there's a lot of misunderstanding about this. Many women have grown up with the idea that when you reach the menopause, you should expect horrendously heavy menstruation or 'flooding'. This isn't so. Heavy bleeding is abnormal, and usually indicates some other problem.
In fact the periods should finish in THREE ways:
1. They stop suddenly, and never return.
2. They get less and less in amount, and gradually stop.
3. They get further and further apart - and gradually stop.
Anything else needs checking out by your GP or gynaecologist. In particular, bleeding which occurs AFTER your periods have stopped needs urgent investigation.
PSYCHOLOGICAL/EMOTIONAL PROBLEMS AT THE MENOPAUSE
Understandably, quite a few people do run into psychological problems at the time of the menopause - particularly depression, anxiety and stress-related illnesses.
These problems are often related to feelings that your reproductive life is at an end (which is nearly always true), that your sex life is at an end (which is complete nonsense!), and that you are less attractive (which is unlikely to be the case). Naturally, women who are going through a difficult menopause tend to worry that their partners will leave them. They often fret that their children are now growing up and leaving the home, and that they will lose touch with them (the 'Empty Nest Syndrome').
If you're having emotional problems, please don't hesitate to see your GP and get some help. You may need medication - such as anti-depressants - for a short while. DON'T bottle things up: do talk to your partner and your friends about your feelings - and see a counsellor if necessary.
HORMONE REPLACEMENT THERAPY (HRT)
HRT 'makes good' the deficiency in female hormones. It is now used by hundreds of thousands of women to combat the symptoms of the menopause, and particularly the three major symptoms mentioned above: hot flushes, sweating attacks, and vaginal dryness.
But can I make one thing clear? It is idiotic to make sweeping generalisations about HRT - because there are many different types of it. In Britain at the moment, there are more than FIFTY HRT preparations on the market!
So anything I say here about HRT is on a general guide - for more specific information, please talk to your GP, gynaecologist, or Menopause Clinic. In particular, please remember that there are some women who shouldn't take the hormones - particularly those who have had cancer of the breast or certain other cancers.
There are several different methods of giving HRT:
VAGINALLY. Hormones given directly into the vagina - as creams or pessaries or rings - will replace the missing female hormone called 'oestrogen' and defeat vaginal dryness, thus making sex a lot more comfortable.
SKIN PATCHES Hormone-containing skin patches can be used either on their own - or combined with tablets. The point of using a skin patch is that the hormone goes directly into the blood stream - without having to go through the stomach and pass through the liver. This reduces the chance that the HRT will cause nausea.
IMPLANTS Not all that much used in the UK, these are little 'pellets' of hormone, which are inserted under the skin through a small cut.
TABLETS In the UK, this is still the commonest way of taking HRT. There are THREE main categories of HRT tablet:
1. OESTROGEN-ONLY HRT. Nowadays, this should only be used by women who have had a hysterectomy - because of the risk of causing womb cancer.
2. COMBINED SEQUENTIAL HRT. This type of treatment *******s a second hormone - to protect the womb. You will usually get a period every month.
3. COMBINED CONTINUOUS HRT. This treatment also contains two hormones. After the first few months, you'll probably have no periods.
ADVANTAGES TO HRT
Quite apart from relieving menopausal symptoms, HRT has certain health benefits. It helps ward off osteoporosis (thin bones - a common condition which causes so many fractures). It may help protect you against heart attacks and strokes. It seems to give a lot of women a feeling of well-being - and many claim they look better too.
DISADVANTAGES OF HRT
Like any other medication, HRT can cause side-effects, such as nausea, tummy upsets and sometimes weight gain. Full details from your doctor or clinic - or the leaflet in the pack.
More importantly, there is almost certainly a slightly increased chance of breast cancer with most forms of HRT. And the type of HRT described above as 'Oestrogen-Only' can sometimes cause cancer of the womb.
IMPORTANT NOTE: OUR KNOWLEDGE OF HRT IS CHANGING CONSTANTLY, AND TODAY'S INFORMATION WILL SOON BE OUT OF DATE! FOR UP TO DATE INFORMATION, YOU MUST RELY ON YOUR OWN DOCTOR OR CLINIC.
Q. I am 51, and my doctor has suggested a test to see if I am menopausal. My symptoms are tiredness - plus periods happening about every three weeks. How accurate is the test - and what is involved?
A. It's just a simple blood test. The lab will check the level of several female hormones in your blood sample - and then advise your doc as to whether you seem to be going into the menopause or not. As you're still having periods (though rather frequent ones), my guess is that you're not yet very far advanced into the 'change'.
Q. I've been really 'down' ever since I reached the menopause 10 years ago. Will HRT cure my depression?
A. Probably not, ma'am. But it may make you feel rather better in yourself. However, depression usually requires treatment with anti-depressants plus perhaps counselling.
Q. Does one take HRT for LIFE? I'm 62, and I feel really great on it! Can I continue it into my 70s and beyond?
A. That isn't often done in the UK - though it is in America! I reckon that you just need to see how things go. By the time you reach 70, we'll know an awful lot more about the risks and benefits of HRT. Meantime, good luck!
Q. I had my womb removed some years ago. So can I take HRT with complete safety?
A. No: nothing in life is COMPLETELY safe. Obviously, the fact that you've had a hysterectomy means that HRT can't give you womb cancer. But there is a slightly increased risk of breast cancer - as mentioned above - plus other possible side effects.
NON - MENOPAUSE QUESTIONS & ANSWERS
Q. My husband had a triple bypass 7 years ago, and since then has refused to consider lovemaking. I guess he is nervous, but in fact while he was in hospital the doctor told him he could resume. I think it has now become a 'mind' matter rather than a physical one. Is this common? I feel very isolated and rejected.
A. I'm sure you do, ma'am. I'm so sorry to hear about all this. It is actually very possible that your husband has become impotent and - like so many older males - doesn't dare tell his wife about it. I think you should ask him about this.
If he IS suffering from impotence ('erectile dysfunction'), then it would probably be quite easy to treat the problem - for instance, with Viagra (which at the present moment is considered OK for guys who've had by-passes).
Other than that, I can only suggest that you implore your husband to come for counselling with you - to Relate or a sex problems clinic. I do hope he'll agree, because it's quite unfair to leave you so frustrated and rejected. Why should you be forced to go without sexual fulfillment?
Q. I'm a man of 68, and I want to take up jogging. But my wife is worried that this could be bad for the heart. What do you think, doc?
A. Jogging is generally BENEFICIAL for the heart. But I have to admit that there is always a TINY risk of exercise provoking a heart attack.
Best thing is to see your GP, who can rapidly establish whether you would be at any great risk if you go running.
And when you start jogging (as I expect you will), please make sure you take it EASY to start with. Have a great time.