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Your Menopause Handbook
A Self-Help Guide for Healthy Living
By Lilah Borden
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Disclaimer
The advice contained in this material might not be suitable for
everyone.
The author only provides the material as a broad overview by a
layperson about an important subject. The author obtained the
information from sources believed to be reliable and from his own
personal experience, but he neither implies nor intends any
guarantee of accuracy.
All claims made for any product, treatment or other procedure that
is reported in this book is only the author's personal opinion. You
must do you own careful checking with your own medical advisor
and other reputable sources on any matter that concerns your
health or that of others.
Research is constantly changing theories and practices in this area.
The content is not intended to be a substitute for professional
medical advice, diagnosis or treatment. Always seek the advice of
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your physician or other qualified health care provider with any
questions you may have regarding a medical condition. Never
disregard professional medical advice or delay in seeking it for any
reason.
The author, publisher and distributors never give legal, accounting,
medical or any other type of professional advice. The reader must
always seek those services from competent professionals that can
review their own particular circumstances.
The author, publisher and distributors particularly disclaim any
liability, loss, or risk taken by individuals who directly or indirectly
act on the information contained herein. All readers must accept full
responsibility for their use of this material.
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Table of Contents
Please Read this First ......................................................................... 2
Table of Contents ................................................................................ 4
About the Author................................................................................. 8
1. Menopause – An Overview ............................................................. 9
2. What is Menopause?..................................................................... 13
Useful Menopause Terms ................................................................. 15
Causes of Menopause....................................................................... 16
4. Who Is Affected by Menopause? ................................................. 18
5. Signs and Symptoms of Menopause ........................................... 20
6. What Happens During Menopause? ............................................ 24
What Actually Happens During Menopause?..................................................... 24
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7. What are the Risk Factors for Menopause?................................ 26
8. Myths and Misconceptions about Menopause ........................... 28
Myth: Menopause causes weight gain ............................................................ 28
Myth: Menopause marks the end of sexual life.............................................. 28
Myth: Menopause denotes you have become old. ........................................ 28
Myth: Menopause causes memory problems. ............................................... 29
Myth: Menopause is natural, so it does not have major consequences. .... 29
Myth: Hormone replacement therapy is bad. ................................................. 30
Myth: Menopause causes depression............................................................. 30
Myth: Menopause could mean the end of an active life. ............................... 30
9. When to Seek Medical Advice ...................................................... 31
10. How Is the Menopause Diagnosed? .......................................... 33
12. Self-Testing for Menopause ....................................................... 38
13. Medical History for Menopause Diagnosis ............................... 40
14. Is It Possible to Delay the Menopause? .................................... 41
15. Life after Menopause................................................................... 42
16. Complications of Menopause and Other Conditions ............... 44
17. Menopause and Your Emotions ................................................. 46
18. Menopause and Depression....................................................... 48
19. Menopause and Bladder Function ............................................. 50
20. Menopause and Cancer .............................................................. 52
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21. Menopause and Osteoporosis ................................................... 53
22. Menopause and Smoking ........................................................... 55
23. Treatment Options for Menopause Symptoms ......................... 56
Treatment Options for Menopause Symptoms .................................................. 56
Treatment Options for Menopause Symptoms .................................................. 57
Bioidentical hormone replacement therapy (BHRT):..................................... 58
24. Medications.................................................................................. 60
Common Medications for Menopausal Symptoms............................................ 60
25. Hormone Replacement Therapy (HRT)...................................... 64
26. Bioidentical Hormone Replacement Therapy (BHRT) .............. 68
Formation of Bioidentical Hormones Bioidentical hormones are
chemically synthesized hormones produced from plants and
Popularity of Bioidentical Hormone Replacement Therapy.............................. 69
Advantages of Bioidentical Hormone Replacement Therapy....................... 69
Success Rate of Bioidentical Hormone Replacement Therapy.................... 70
27. How to Reduce or Eliminate Menopause Symptoms ............... 71
28. Ten Ways to Relieve Menopausal Hot Flashes ......................... 73
29. Diet Tips to Stay Healthy During Menopause ........................... 75
30. Exercise and Menopause............................................................ 78
31. How to Treat Menopause Symptoms Naturally......................... 80
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32. Herbal Remedies for Treating Menopause................................ 86
33. Menopause and Your Family...................................................... 88
34. Where to Find Help for the Menopause ..................................... 90
35. Supporting Someone Going through Menopause.................... 92
36. Menopause – Frequently Asked Questions .............................. 94
Is pregnancy possible during perimenopause?............................................. 94
What are the symptoms of menopause? ........................................................ 95
Do all women experience the same menopausal symptoms? ..................... 95
What happens during menopause? ................................................................ 95
Is hormone replacement therapy the best option?........................................ 96
Can hormone replacement therapy prevent osteoporosis? ......................... 96
Should women with a history of cancer opt for hormone replacement
What are the other treatments for menopause? ............................................ 96
37. Menopause - Glossary of Terms ................................................ 98
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About the Author
Lilah Borden
Lilah Borden has found that many women have more trouble than
they should when they approach and experience menopause
because of their lack of knowledge and preparation.
She believes that even more problems and distress are the result of
the lack of support that many women get from colleagues and,
especially, their partners and other close members of their families.
Because the effects and experiences of different women can vary
greatly as they go through menopause, many incomplete or
inaccurate “facts” are circulated.
Lilah hopes that this ebook will help to give every woman that reads
it more confidence to make their experience better.
She also believes that putting as much information as she could
gather in the book will help all readers to make better choices and
help give them the confidence to get support and understanding
from their families and friends.
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Part-I: Introduction
1. Menopause – An Overview
Menopause is a normal biologic process. It is the time in a
woman’s life when she stops having regular monthly periods.
It signifies the end of her reproductive period.
Normally, women enter menopause around the same age as their
mother did. This, typically, occurs between the ages of 45 and 55,
although this can vary, sometimes by as much as ten years.
Hormones like estrogen and progesterone regulate menstruation
and pregnancy in women. When your ovaries stop producing these
hormones, menopause is triggered.
Menopause can set in earlier in women who have never been
pregnant, live in high altitudes or smoke regularly. So, ladies, if
you want kids but have not had any and are in your thirties … get
busy.
Usually, the first indication of approaching menopause is irregular
periods. This time is called perimenopause. For some, this period
could last for as much as ten years.
The irregularities may be in the length of period, level of bleeding
and time between periods. If a woman stops having regular periods
for more than twelve consecutive months and she is not suffering
from any other ailment, she is in perimenopause.
Hormonal changes are the main cause for menopause. These
changes can also increase the risk of:
• Osteoporosis
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• increased incidence of fractures due to decreasing bone
density
• higher cholesterol levels, and
• heart disease.
Common symptoms of menopause include nausea, hot flashes,
mood swings, night sweats, fatigue, vaginal itching and dryness,
depression, heavy bleeding, weight gain, urinary incontinence,
lowered sex drive, insomnia, changes in breast shape, thinning of
skin and headaches.
Gosh, did I miss any?
Natural and Artificial Menopause
Menopause usually fits into one of two categories; natural or
artificial.
There is another type of menopause; premature menopause, but
it is not very common. If a woman ceases to have regular menstrual
periods before the age of forty, it is called “premature menopause”.
This is most likely due to genetic causes, autoimmune diseases,
smoking or exposure to harmful chemicals.
The majority of women have a natural menopause.
Artificial menopause occurs because of the surgical removal of
ovaries.
Tests
There are a few tests that determine menopause in women.
Blood tests check levels of follicle stimulating hormone or FSH.
This hormone prompts growth of eggs during your reproductive
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period. Their decreasing levels reduce estrogen levels and
menopause sets in.
Bone testing checks bone density levels. Lower than usual levels
indicate decreasing bone density, a common symptom of
approaching menopause.
There are medications for helping with menopausal symptoms and
menopause, there are also a few simple home remedies and certain
lifestyle changes you can try to get more relief.
Soy protein is claimed by some people to be very helpful for
menopausal symptoms. Drink soymilk, include soy flour or tofu in
your regular diet, or eat raw or roasted soybeans.
Refrain from spicy foods, alcohol, and caffeine, as these aggravate
menopause symptoms.
Consume a low-fat and low-cholesterol diet.
Regular aerobic exercise may provide some relief from hot flashes.
Strength training exercises can increase the strength of bones.
You might also try alterative therapies like deep breathing
exercises, acupuncture, biofeedback, hypnosis, meditation and
paced respiration with slow breathing.
Menopause is not an ailment or illness. But, if you want to alleviate
some of the symptoms, you can get hormone replacement therapy.
This may bring extensive relief from osteoporosis and hot flashes.
But, hormone replacement therapy may have serious side effects.
It may make you more vulnerable to strokes, breast cancer and
Alzheimer's disease.
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Some people claim that testosterone shots can provide great relief
from the unpleasant side-effects of menopause. They say that
women with high testosterone levels suffer little, or sometimes not
at all, from menopause. This is not a widely held view and there
does not seem to be any definitive supporting research.
Because menopause is not an ailment, you cannot prevent its
occurrence. But, you can increase the likelihood that you will have a
smooth transition period by reducing possible risk factors.
Increase calcium consumption in your diet. This is possible through
daily consumption of reasonable quantities of milk, yogurt, cheese,
calcium-fortified orange juice, salmon or calcium dietary
supplements.
WARNING: Excessive intake of calcium may increase the chance of
kidney stones. Therefore, always consult your health provider about
what is a suitable level of calcium supplementation for you.
It is a good idea to have a thorough annual check-up once you are
forty or beyond. This check-up should include pelvic examination,
breast examination and mammogram.
Checking for colon and heart disease is also very worthwhile.
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Part-II: Understanding Menopause
2. What is Menopause?
Normally, menopause occurs between the ages of 45 and 55. It is
not an ailment or disease. It is a normal biologic process, as normal
as breathing.
It does not begin within a narrow range of ages, like puberty or loss
of one’s first tooth. It typically occurs over a span of eight to ten
years.
Menopause marks the end of a woman’s fertility period. Her ovaries
no longer produce eggs, and production of hormones like estrogen
and progesterone also decrease.
There are many significant physical changes. The body attempts to
continue to send hormones to stimulate ovulation for as long as
possible, but it is a failing process.
Ovaries may respond erratically, causing erratic menstrual periods.
Eventually, the ovaries are unable to ovulate. This restricts, and
finally stops, monthly periods.
The ovaries still continue to ovulate for some time and produce low
levels of estrogen and, sometimes, androgens. Androgens are
substances, such as testosterone or androsterone, which promote
male characteristics. These are often converted into estrogen in a
woman’s fatty tissues.
The uterus lining also thins down due to low estrogen levels.
Sadly, menopause does not cause sudden stoppage of menstrual
periods. There could be irregular occurrences spread over several
years.
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These may include
lengthy or very short periods
excessive or very little bleeding
bleeding with clots and
variation of the time between menstrual periods.
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Useful Menopause Terms
Premenopause refers to most reproductive years in your biological
cycle
Perimenopause includes the years prior to the onset of
menopause, when one experiences different symptoms, especially
irregular menstruation and hot flashes
Menopause is the point of permanent cessation of menstruation
Post-menopause are the years following menopause.
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Causes of Menopause
There is no single cause or specific happening, which you can
attribute to the onset of menopause.
Menopause may be categorized as surgical, induced or premature.
Surgical menopause is due to surgical removal of ovaries.
Induced menopause is when ovaries are damaged due to x-rays,
drugs, or other factors.
Premature menopause is considered to be any onset before the
age of 40. It can be either natural or induced.
Menopause is a natural biologic process that occurs over a span of
time and involves various related processes.
Normally, women in their 40’s experience menopausal symptoms,
and attain menopause by their mid-fifties.
Although menopause is normally a natural process, it can
sometimes be related to an external cause, such as medical
situations like hysterectomy, damage to ovaries, cancer, etc.
Every woman is born with around two million eggs in follicles (sacs)
within her ovaries. A woman may still have around 300,000 by the
time of puberty. Only 400 to 500 eggs mature fully for release
during her full menstrual cycle. The rest of these eggs degenerate.
A woman could be left with less than ten thousand eggs when she
approaches menopause.
In the reproductive years, her brain releases specific chemicals that
induce the release of an egg each month. The follicle produces
higher levels of sex hormones, estrogen and progesterone, to
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thicken the uterus lining. This lining will provide necessary support
to the egg, if fertilized.
If there is no fertilization, the uterus lining breaks, the estrogen and
progesterone levels drop and menstruation occurs.
However, a woman’s ovaries do not stop producing estrogen
completely.
Progesterone levels also register varying levels.
These changing hormone levels may affect other glands of her
endocrine system.
So, she may experience changes in her breast tissue, bone density,
gastrointestinal tract, vagina, skin and urinary tract.
Some of these changes may disrupt her normal body functioning.
She may:
• suffer pain in her breasts
• experience vaginal dryness and itching
• develop urinary incontinence and
• have more pronounced signs of aging skin.
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4. Who Is Affected by Menopause?
Menopause affects women across all cultures, races, religions and
creeds.
Menopause normally affects women in their forties and fifties, with
95% experiencing it within the age range of 44 to 56.
Genetic factors have great sway over when she enters her
perimenopause. Smokers, and women living in high altitudes, may
have a comparatively early menopause.
Women do not all experience the same symptoms of menopause. It
depends on their lifestyles, diets and other social and cultural
factors.
Mayan women often suffer no symptoms, while Thai women are
believed to suffer some of the most excessive headaches due to
menopause.
Greek women experience high rate of hot flashes, while Japanese
women experience some of the lowest rates of hot flashes.
North American women report most symptoms, while Scottish
women report few symptoms.
A friend really appreciates her menopause. She suffers no ill
effects, but her menstrual flow is far lighter, and her period has
been reduced to just three days.
She has always been very healthy, and has regularly taken some
vitamins and supplements.
She also has always had a high testosterone level.
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Are these factors significant? If you view them in the light of the
fact that North American women seem to suffer the most, and she is
one, that might be seen to makes her exceptional.
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5. Signs and Symptoms of Menopause
Menopause does not occur one fine day, while walking in the park,
like a mugger’s attack. No one calls 911.
It is a process that usually is spread over a few years.
Menopause is the cessation of periods and is due to hormonal
changes.
These hormonal changes cause various symptoms. Different women
experience different symptoms and no single woman experiences all
symptoms (one prays not, anyway).
Signs and Symptoms of Menopause
Hot Flashes and Night Sweats
Hot flashes are the most common menopause symptom. You
suddenly feel very hot around your face, neck and other parts of
your upper body.
You may develop red blemishes on her arms, back, and chest.
These flashes may be experienced almost anytime and anywhere.
Hot flashes could wake you from your sleep.
This is often followed by excessive sweating and, sometimes, then
by a feeling of intense cold and shivering.
Insomnia
Night sweats may keep you awake. There could be many incidents
of night sweats in any single night. This disturbs your sleep and
reduces the chance that you will get any more sleep that night.
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Fatigue
Excessive night sweats disturb the sleep, with resultant fatigue.
Irritability
Irritability occurs when you become tense due to frequent hot
flashes in your day, and sweating at night. Lack of sufficient rest
can make you irritable.
Mood Changes
Changes in estrogen levels can have an effect on your moods. You
may experience severe mood swings and often feel depressed.
Mood swings can be aggravated by fatigue.
Vaginal dryness
Your vaginal lining becomes thinner and loses its flexibility. This can
cause vaginal dryness and intercourse may become painful.
Incontinence
With age and menopausal symptoms, the organs surrounding the
vagina begin shrinking and thinning. Different parts of the urinary
tract and urethra lose their elasticity and incontinence can result.
This may increase the chance of urinary tract infections, which lead
to frequent and/or sudden urination.
Osteoporosis
Menopause decreases bone density, so you may face a greater risk
of fractures. Osteoporosis would make your bones brittle and more
prone to bone ailments.
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Poor estrogen levels weaken the bones.
Hair changes
With the onset of menopause, your testosterone (male hormone)
levels start increasing while estrogen levels decrease. This
imbalance causes an increase in facial hair and thinning of normal
hair, as is common among men.
Drying of your skin
Poor hormone levels may result in shrinking of your skin. You may
develop age spots. Your skin may become dryer and look
malnourished.
Cigarette smoking may increase these effects.
Aches
Body aches, pain in the joints and headaches are common
menopause symptoms. Sometimes, you may suffer serious
headaches, leading to migraines.
Weight Increase
Increase in weight, especially in the pelvic region, is a common
menopausal symptom.
Irregular Periods
The ovaries do keep producing estrogen, although progesterone
levels are in decline. Menstrual periods do not follow what had been
your normal routine and could extend for many days or for a shorter
time. Bleeding could be heavy with excessive clotting, or just some
spotting.
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Anxiety
Menopause can cause palpitations (irregular and rapid, or pulsating)
heartbeats. You may become more restless and anxious with every
small incident.
Sore breasts
You may experience tenderness in your breasts, making them sore
and painful. Hormonal changes are a major cause for such
soreness.
Fluid retention
Hormonal changes can affect your gastro-intestinal tract. Excessive
fluid retention in your body could cause bloating.
Memory Loss
Progesterone affects the functioning of nerve cells and may cause
some loss of memory.
Decreased Sexual Appetite
Hormonal changes may cause changes in libido. Sexual arousal
may be low due to vaginal dryness and other discomfort.
Menopause, of course, will not protect one from STD’s unless it
completely turns one off from sex.
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6. What Happens During Menopause?
Menopause is a transitional period that usually culminates in
complete cessation of menstrual periods. Monthly periods occur due
to regular ovulation of ovaries. However, with age, your ovaries do
not function in the same way. Ovulation is less frequent and there
are fewer eggs in ovaries. Lower ovulation leads to less hormones.
Normally, different hormonal changes occur every month and these
changes transform into your menstrual periods. During your
menopause period, your body registers fewer rises in estrogen and
progesterone levels.
You have long periods with lower hormone levels.
Sometimes, there is a sudden jump in hormone levels and you may
have menstrual periods, though not in accord with your regular
cycle. This is because your ovaries do not suddenly stop producing
estrogen. Sometimes, estrogen and progesterone levels increase
and result in menstrual periods. Such irregular periods are common
during menopause.
However, over a few years, your ovaries come to have very much
lower levels of estrogen and progesterone.
These low levels can no longer induce menstrual periods and your
periods come to an end. This is the culmination of menopause. If
you do not have menstrual periods for a minimum period of twelve
months, doctors confirm you have entered menopause.
What Actually Happens During Menopause?
Estrogen and progesterone are the two most important hormones
responsible for your menstrual periods.
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Estrogen stimulates growth of the uterus lining to house your egg, if
fertilized.
Progesterone is responsible for thickening the uterus lining and
produces glycogen, which provides food for the embryo.
Every month, your ovaries release an egg for fertilization.
If fertilized, it is implanted within the thickened uterus lining and
proceeds through pregnancy.
If the egg is not fertilized, progesterone production stops and that
results in the uterus lining being shed in the form of menstrual
periods. That is your menstrual cycle.
This cycle does not stop abruptly. Reduced hormonal production by
the ovaries may cause some unpredictable changes in menstrual
cycles.