Your mother’s Menopause

Your mother’s Menopause

You may have heard about menopause, but never really thought about how it can impact your life. After all, you are nowhere near “that age.” However, it is possible that your mother may be approaching menopause (or may even be post-menopausal). This brochure is designed to help you understand what menopause means to her now, and what it might mean to you in the future. Read this brochure and share the information with your family and friends. Encourage your mother to see her physician and learn about ways to enjoy good health in her postmenopausal years.

What happens At menopause?

As women get older, their ovaries produce less and less estrogen. As a result, they may begin to experience changes in their menstrual cycle, such as irregular menses or increased or decreased menstrual flow. This stage of life represents the change from the reproductive to the post-reproductive years. Eventually, a woman will have her last menstrual period; this is called menopause. For most women, menopause occurs around the age of 50. Because life expectancy for women is about 80 years, this means women spend nearly one third of their lives beyond menopause.

Menopause means a woman no longer has to worry about her period or getting pregnant. However, the estrogen deficiency associated with menopause can lead to many changes in the body. Some women may not feel comfortable discussing these changes, and some of them might not even know that the symptoms they are experiencing are a result of menopause. You can help your mother by discussing the effects of the estrogen deficiency that occurs at menopause (review below), letting her know she is not alone or “crazy” because she experiences these symptoms. Encourage her to see her physician so she can take steps to avoid some of the effects of estrogen deficiency.

Short- Term Symptoms
Of Estrogen Deficiency

Hot Flushes & Night Sweats

The hot flush – a sudden sensation of heat that spreads over the body, particularly on the head, face, and chest – is the hallmark symptom of menopause. It is often accompanied by flushing (red face) and sweating, and may be followed by a chill. Hot flushes can interfere with normal daily functioning, and if they occur at night (called night sweats), they can disrupts sleep.

Vaginal Dryness

The fall of estrogen levels at menopause can cause vaginal atrophy (thinning and loss of elasticity). This often leads to vaginal dryness, which can make sexual intercourse painful or uncomfortable. In addition, vaginal burning, itching, discharge, and occasional bleeding may occur.

Urinary Problems

As with the vaginal lining, the urethra (the canal through which urine is discharged from the bladder) and bladder rely on estrogen to function properly. The estrogen deficiency associated with menopause may cause the urethra and bladder to atrophy. As a result, urinary problems, such as an increased need to urinate, pain or burning on urination, leaking of urine during coughing or laughing (stress incontinence), or bladder infections, may occur.

Psychological Effects

For many women, estrogen deficiency is also associated with psychological effects, such as anxiety or mood swings. Other symptoms may include irritability, loss of concentration, headaches, crying spells, tiredness, loss of libido, and depression.

If you’ve noticed any of these changes in your mother, it may indicate that she is estrogen deficient. Encourage her to speak with her physician to find out.

Long-Term Health risks
Associated with Estrogen Deficiency

Increased Risk for Cardiovascular Disease

Before menopause, estrogen in the body helps protect against cardiovascular disease. Thus, premenopausal women have a lower risk of cardiovascular disease than men. However, after menopause, when estrogen levels fall, this protection is lost. In fact, cardiovascular disease is the leading cause of death among post-menopausal women. The estrogen deficiency associated with menopause may increase the risk of cardiovascular disease.

Changes in Cholesterol Levels

The loss of estrogen at menopause is associated with changes in cholesterol levels. Estrogen deficiency causes levels of high-density lipoprotein (HDL) cholesterol – the “good” cholesterol – to decrease and levels of low-density lipoprotein (LDL) cholesterol – the “bad” cholesterol – to increase. In addition, total cholesterol levels frequently increase. These changes can lead to atheroselerosis (blocking of the arteries), heart attack, and stroke.

Increased Risk for Osteoporosis

Osteoporosis is characterized by decreased bone mass and by an increased likelihood of experiencing a fracture. The estrogen deficiency associated with menopause contributes greatly to the development of this disease. Without the protective effects of estrogen, bone masse decreases rapidly after menopause.

As a result, bones may become thin and brittle and fracture easily. The most common places for fractures to occur are in the hip, spine, and wrist. If osteoporosis occurs in the haw, it may result in tooth loss.

Alzheimer’s Disease

Alzheimer’s disease is a progressive disease that attacks the brain and results in impaired memory, thinking, and behavior. It is the most common form of dementia – a loss of intellectual function, such as thinking, remembering, and reasoning, so severe that it interferes with daily living and eventually results in death. Evidence suggest that the estrogen loss associated with menopause may contribute to the development of Alzheimer’s disease.

What can you do?

If you think your mother is menopausal, talk to her about any short-term symptoms she may be experiencing and help her understand her long-term health risks. Most important, encourage her to see her physician. Treatment options are available that can help eliminate the short-terms symptoms of menopause and reduce the long-term health risks associated with estrogen deficiency.

Estrogen replacement can prevent or reduce
The symptoms associated with estrogen deficiency

The best way for your mother to alleviate the symptoms associated with estrogen deficiency is to replace the missing estrogen in her body. Estrogen replacement cans relieve many of the short-term symptoms and reduce the long-term health risks associated with estrogen deficiency.

Estrogen replacement and short-term
Symptoms of menopause

Estrogen replacement can do all the following:

• Eliminate or lessen hot flushes and night sweats
• Improve the quality of sleep
• Increase vaginal lubrication, thus helping prevent painful intercourse
• Relieve vaginal symptoms such as irritation and painful sexual intercourse, and prevent urinary tract infections.
  
  
  

Estrogen replacement and long-term health
Risks of menopause

• Estrogen replacement can reduce the incidence of cardiovascular disease
  Studies have shown that women who use estrogen replacement have at least one half the risk of cardiovascular disease as women who do not use estrogen replacement. Thus, by replacing the estrogen that is lost at menopause, a woman can help protect herself against cardiovascular disease.

• Estrogen replacement can improve cholesterol levels
  Estrogen replacement has been shown to decrease levels of LDL cholesterol (the “bad” cholesterol) and to increase levels of HDL cholesterol (the “good” cholesterol). This is one of the mechanisms for the protective effects of estrogen on the heart.

• Estrogen replacement can protect against osteoporosis
  Estrogen replacement is the best way to prevent postmenopausal bone loss. It has been shown to reduce bone loss at the hip, spine, and wrist, where most osteoporotic fractures occur and to reduce the risk of hip fractures by about 50%. In order to maintain the benefit of estrogen replacement therapy on bone, therapy must be continued. Once therapy is stopped, bone loss accelerates. Estrogen replacement can also protect against tooth loss. Therefore, many women choose to take estrogen replacement from menopause onward to obtain the most protection against osteoporosis.

• Estrogen replacement may protect against Alzheimer’s disease
  There is growing evidence that estrogen may protect against Alzheimer’s disease. One study showed that women who used estrogen had about half the risk of developing Alzheimer’s disease as nonusers. Another study showed that women who had used estrogen replacement had a 35% lower risk of Alzheimer’s disease than women who had never used estrogen. In addition, the age of onset of Alzheimer’s disease has been shown to be later in women who have used estrogen replacement than in women who have not. Although findings are not yet conclusive, the use of estrogen by postmenopausal women may decrease the risk of delay the onset of Alzheimer’s disease.

• Estrogen replacement may have other beneficial effects
  As science advances, so does our ability to determine the effects of estrogen on the body. Two other areas of focus in estrogen research are colon cancer and age-related macular degeneration.

• Colon cancer:
  Approximately 15% of all cancers occur in the colon and the rectum. Preliminary studies have shown that estrogen replacement may reduce the risk of colon cancer. In one study, women who were recent users of estrogen replacement had half the risk of developing colon cancer as women who did not use estrogen replacement. The study also showed that women who had ever used estrogen replacement had about a 30% decreased risk of fatal colon cancer compared to nonusers, and women who were currently using estrogen replacement had a nearly 50% decrease in risk compared to nonusers. Another study showed a decrease in risk of colon cancer with increased years of estrogen use.

• Age-related macular degeneration:
  Macular degeneration is an eye disorder that can lead to blindness. Studies have shown that women have a greater risk for age-related macular degeneration and that this risk may be related to decreased estrogen levels. Preliminary evidence indicates that the use of estrogen replacement in postmenopausal women is associated with a decreased risk of age-related macular degeneration.

Although early results are promising, additional studies are needed in these and other areas to evaluate the protective effects of estrogen replacement.

Estrogen replacement and risk for _Breast cancer and endometrial cancer

• For women with a uterus, a progestin in added to estrogen replacement to reduce the risk of endometrial cancer.
• Data regarding estrogen replacement and risk for breast cancer are inconclusive.
• It is important to weigh the benefits of estrogens replacement therapy against the risks.
• Encourage your mother to discuss the risks and benefits of estrogen replacement therapy with her physician.
  
  
  

Types of estrogen replacement available

• Oral tablets
• Vaginal creams
• Vaginal inserts
• Transdermal patches
• Topical creams and gels
• Injectables

Let your mother know that her physician can tailor a program to suit her needs. Her medical history, health status, lifestyle, response to therapy, and preferences will play a role in determining the appropriate form of therapy for her. Encourage her to ask her physician about the options available. The more she knows, the more she can take control of her health.

Is estrogen replacement after menopause for everyone?

Although most women can replace the estrogen lost after menopause with estrogen replacement therapy, this treatment should not be used in women with any of the following:

• (1) known or suspected breast cancer,
• (2) known or suspected estrogen-dependent neoplasia,
• (3) know or suspected pregnancy,
• (4) undiagnosed abnormal genital bleeding,
• (5) active thrombophlebitis or thromboembolic disorders, or
• (6) hypersensitivity to any of the ingredients used in estrogen replacement therapy. Encourage your mother to discuss the risks and benefits of estrogen replacement therapy with her physician.
  
  
  

Making therapy work

You have just read about some of the effects of estrogen deficiency and how estrogen replacement can be used to reduce or eliminate many of the short-term symptoms and long-term health risks of menopause. Many women use estrogen replacement therapy solely to relieve short-term symptoms, such as hot flushes. However, long-term therapy is essential if they wish to reduce the chances of developing heart disease and osteroporosis.