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It is important to realize that until menopause is complete, a woman still can become pregnant even when periods are light or missed.
Perimenopause, also known as the climacteric, includes the time before menopause when hormonal and biological changes and physical symptoms begin to occur. Hot flashes — A hot flash is a feeling described as suddenly being hot, flushed and uncomfortable, especially in the face and neck. Irregular periods — A woman can have irregular periods for several months to years before her periods finally stop. Depression — The chemical changes that happen during menopause do not increase the risk of depression. Osteoporosis — This condition is a thinning of the bones that increases the risk of fracturing a bone, especially in the hips or spine. Cardiovascular disease — Before menopause, women have lower rates of heart attack and stroke than men. For most women, the diagnosis of menopause is made based on a woman's description of her symptoms and the ending of her menstrual periods. Because women can still become pregnant while they are perimenopausal, doctors may do a pregnancy test when a woman's periods become irregular, infrequent or light. Perimenopause usually lasts three to five years but it can take as few as two years or as many as eight years for some women.
Diet, exercise and lifestyle changes can reduce the symptoms and complications of menopause.
Exercise to prevent weak or thin bones must be weight-bearing exercise such as walking, low-impact aerobics, dancing, lifting weights, or playing a racquet sport such as tennis or paddle ball. Dark green vegetables (except spinach, which contains another ingredient that reduces the amount of calcium that can be absorbed from the food) — One cup of turnip greens supplies 197 milligrams of calcium, and 1 cup of broccoli provides 94 milligrams.
Dairy products — One cup of milk provides approximately 300 milligrams of calcium, and 1 cup of yogurt supplies 372 milligrams. Sardines and salmon — Four ounces of sardines provide 429 milligrams of calcium, and 4 ounces of salmon have 239 milligrams of calcium. Estrogen taken as a pill or applied to the skin as a patch can reduce hot flashes, sleep disturbances, mood changes and vaginal dryness.
However, evidence has shown that there are some risks associated with the use of these medicines. Antidepressants — Medications such as venlafaxine (Effexor) and paroxetine (Paxil) are often the first choice for women with hot flashes who are not on hormone replacement therapy. Clonidine — This is a blood pressure medication that can relieve hot flashes in some women.
Calcium and vitamin D supplements — All postmenopausal women who have osteoporosis or are at risk of osteoporosis should take calcium and vitamin D supplements. Bisphosphonates — Etidronate (Didronel), alendronate (Fosamax) and other similar drugs are the most effective medicines that can be used to both prevent and treat osteoporosis.
Raloxifene (Evista) — This drug has some of the beneficial effects of estrogen without the increased risk of breast cancer. Parathyroid hormone — This is a synthetic form of a naturally occurring hormone produced by the parathyroid glands.

Calcitonin — This hormone is produced by the thyroid gland and helps the body keep and use calcium. Although menopause can cause some uncomfortable symptoms, both lifestyle practices and medication can help to ease these symptoms and complications. Disclaimer: This content should not be considered complete and should not be used in place of a call or visit to a health professional. The easiest way to lookup drug information, identify pills, check interactions and set up your own personal medication records. This usually occurs during middle age, when women are also experiencing other hormonal and physical changes.
While most women in the United States go through menopause around the age of 51, a small number will experience menopause as early as age 40 or as late as their late 50s.
Many women experience light, skipped or late periods for several months to a year before their periods stop altogether. If a woman has had her ovaries removed by surgery or has had damage to her ovaries for other reasons, such as radiation therapy, she may become menopausal from that process. Any vaginal bleeding that develops after a year of no periods is abnormal and should be evaluated by a doctor.
The lining of the vagina gradually becomes thinner and less elastic (less able to stretch).
However, many women experience major life changes during their middle age including menopause and sleep disturbances, which can increase the risk of developing depression. As estrogen levels drop and remain low during menopause, the risk of developing osteoporosis increases. After menopause, however, the rate of heart disease in women continues to rise and equals that of men after age 65.
In some cases, a blood test for levels of follicle-stimulating hormone (FSH) may be recommended.
An endometrial biopsy is an office procedure in which a tiny piece of endometrial tissue from inside the uterus is taken and examined under a microscope for signs of cancer. Medications, diet and exercise can prevent or eliminate some symptoms of menopause and enhance a woman's quality of life as she grows older.
The following recommendations are appropriate for all women who are approaching menopause or who are in menopause.
High caffeine intake, more than three cups per day, can aggravate hot flashes and may contribute to osteoporosis. Since you can have hot flashes any time, wearing layers can help you to cool off quickly during a hot flash and warm up if you get chilled after a flush.
The type of medication needed is a complicated decision and each woman should discuss the issue with her doctor. Estrogen therapy can increase the risk of heart disease, stroke, breast cancer and blood clots in a small number of women.
The usual recommended supplemental dose is 1,000 milligrams of calcium carbonate (taken with meals) or calcium citrate daily.
While it may improve symptoms for some women, the phytoestrogens (plant estrogens) that may help relieve hot flashes may also increase the risk of breast cancer.

No evidence has been found to support the use of acupuncture or homeopathy, but few studies of these therapies have been done. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. As a woman approaches menopause, her ovaries gradually makes less and less of these hormones.
Studies of women around the world suggest that differences in lifestyle, diet and activity may play a role in the severity and type of symptoms women have during menopause. They are caused by changes in the way blood vessels relax and contract and are thought to be related to the changes in a woman's estrogen levels. FSH levels are normally high in menopause, so high FSH levels can help to confirm that a woman is in menopause. This test may be done when a woman is having irregular, frequent or heavy bleeding, but it is not routinely recommended as a test for menopause. Vaginal moisturizers such as Replens or K-Y Vaginal Moisturizer can help to treat irritation due to dryness.
The treatment will depend on what symptoms are most bothersome and how bothersome they are. Although black cohosh has been previously promoted as a treatment for hot flashes, well-done medical studies conclude the root is no more effective than a placebo.
When menopause is diagnosed before age 40, it is considered to be abnormal or premature menopause. Heavier-than-normal bleeding should be evaluated by a doctor to exclude problems in the genital tract.
Symptoms can be noticed for several months to years before the last menstrual period and can continue for several years after. You can help prevent osteoporosis by getting enough vitamin D through sunlight or a daily multivitamin, eating a diet rich in calcium and performing regular exercise.
If natural sunlight is not an option, you should take 400 to 800 international units of vitamin D every day. Progesterone is necessary to balance estrogen's effect on the uterus and prevent changes that can lead to uterine cancer. Therefore, the decision to use hormone replacement therapy to treat symptoms of menopause is an individual decision.
These changes can make a woman more likely to develop vaginal infections from yeast or bacterial overgrowth and urinary tract infections. A woman should talk to her doctor about the risks and benefits of hormone replacement therapy for her.
This is because women begin to lose bone mass as early as age 30 but fractures resulting from osteoporosis don't occur until 10 to 15 years after menopause.

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