Science Fact - Menses Away!

I want to appeal to my women readers between the ages of 40 and 60 (and believe me, the number is skyrocketing), so I put together a little info session about menopause. It's not that these mature readers need a lesson about what's happening to their bodies. Far from it. If your body was about to experience what these brave women go through, you'd probably have collected information from the time you turned 29. Rather, by educating others about menopause I hope that I can spread a bit more understanding and compassion for our mothers, grandmothers, aunts, and friends.

Let's start with the basics. Menopuase means the stopping of menses (menstruation). At some point in a woman's life, usually somewhere around 51 years old, their periods will have become irregular and eventually disappear for an entire year. This is the definition that we use today for menopause. But the several years that lead up to this point can also be considered early menopause or perimenopause, so you may feel many of the symptoms of menopause even if you had a period (although a bit irregular) this month at age 44.

Why does menopause occur? It's all about estrogen. And your ovaries, the primary organs that produce estrogen. As you reach a certain age, the function of your ovaries gets worse and worse. This means you will produce less and less estrogen in your body. When the level of estrogen becomes sufficiently low, there is not enough drive to keep menstruation going. So it stops.

The symptoms of menopause come from a lack of estrogen, not from a lack of menses. What many women experience are:

• Weight gain


• Hot flashes


• Insomnia


• Night sweats


• Mood swings


• Short-term memory loss


• Fatigue


• Osteoporosis (thin bones)

And all of my fellow Queen's med student will remember the GU video dealing with this last symptom:

• Vaginal dryness

Overall, this natural part of aging is a pain in the ass. If these were side effects for a new drug, it would get pulled from the market unless the benefits were phenomenal. And I hardly think that middle age is fantastic enough to outweigh the adverse effects.

So what can be done to manage the horrible symptoms of menopause? One popular treatment is hormone replacement therapy, or HRT. The attempt of HRT is to replace the estrogen in your body so you don't feel so crappy. One of the biggest names in HRT is Premarin from Wyeth Pharmaceuticals. It was originally developed in Quebec near Montreal and has been the leading HRT supplier in North America for over 50 years. Sound good, right? Especially considering that premarin stands for pregnant mare urine. All you need is some horses, get 'em preggers, and let the money whiz in (after a purification step, of course). How can you lose? 14 types of horse estrogen for one low price!

Does it work? Well, sort of. It has been shown to reduce hot flashes, night sweats, and vaginal dryness. That's a good thing. But the therapy has its own side effects like headaches, irritability, and bloating. Oh, and the reported benefit of fighting against osteoporosis is wrong because after you stop HRT your bones become as thin as they would have normally become at that age.

Then there are some more serious concerns about HRT, too. A gigantic study was done recently called the Women's Health Initiative where HRT use was assessed. It was supposed to last 8 years, but they stopped it after 5 years because they felt the health risks of HRT outweighed the benefits. So what were those health risks? To start with, you immediately have an increased risk of blood clots. On top of that, the use of HRT would increase your risk for heart disease and breast cancer.

Personally, I'd stick with hot flashes. Or better yet, I would find a better alternative to help with the symptoms. Things like improving diet, exercise, herbal remedies, and (for you pharmaceutical-crazy readers) SERMs.

An interesting menopause fact is that about 400 years ago, there was almost no menopause. Wait a minute! Does this mean that we're causing menopause because of our bad diet or pollution or UV rays? Nope. It's actually caused by us living long enough to outlast our ovaries. So there's one more problem we've created by increasing our life expectancy.

Finally, if you're like me (male) you may feel a bit left out of the many wonders of menopuase. But don't worry, we have our own version!! It's called andropause because we slowly reduce our production of androgens like testosterone.