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Your Menopause Handbook

A Self-Help Guide for Healthy Living

By Lilah Borden

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“Your Menopause Handbook” by Lilah Borden

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Please Read this First

Terms of Use

This Electronic book is Copyright © 2008. All rights reserved. No

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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 Menopause Handbook” by Lilah Borden

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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.

Copyright © 2008 All Rights Reserved

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“Your Menopause Handbook” by Lilah Borden

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Table of Contents

Please Read this First ......................................................................... 2

Terms of Use............................................................................................................ 2

Table of Contents ................................................................................ 4

About the Author................................................................................. 8

1. Menopause – An Overview ............................................................. 9

Natural and Artificial Menopause ........................................................................ 10

Tests ................................................................................................................... 10

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

Signs and Symptoms of Menopause................................................................... 20

Hot Flashes and Night Sweats ......................................................................... 20

Insomnia............................................................................................................. 20

Fatigue................................................................................................................ 21

Irritability ............................................................................................................ 21

Mood Changes................................................................................................... 21

Vaginal dryness ................................................................................................. 21

Incontinence ...................................................................................................... 21

Osteoporosis ..................................................................................................... 21

Hair changes ...................................................................................................... 22

Drying of your skin............................................................................................ 22

Aches .................................................................................................................. 22

Weight Increase ................................................................................................. 22

Irregular Periods................................................................................................ 22

Anxiety................................................................................................................ 23

Sore breasts....................................................................................................... 23

Fluid retention.................................................................................................... 23

Memory Loss ..................................................................................................... 23

Decreased Sexual Appetite .............................................................................. 23

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

Genetic................................................................................................................ 26

Medical Treatments ........................................................................................... 26

Surgery ............................................................................................................... 26

Smoking.............................................................................................................. 26

Medications........................................................................................................ 27

Autoimmune diseases ...................................................................................... 27

Premature Ovarian Failure................................................................................ 27

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 a disease......................................................................... 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

Other Tests to Diagnose Menopause .................................................................. 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

Life after Menopause............................................................................................. 42

16. Complications of Menopause and Other Conditions ............... 44

Osteoporosis ..................................................................................................... 44

Cardiovascular disease .................................................................................... 44

Increase in body weight.................................................................................... 45

Urinary incontinence......................................................................................... 45

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

Irregular and Heavy Periods............................................................................. 56

Hot flashes ......................................................................................................... 56

Multiple symptoms ............................................................................................ 57

Vaginal dryness and irritation.......................................................................... 57

Treatment Options for Menopause Symptoms .................................................. 57

Hormone therapy............................................................................................... 57

Bioidentical hormone replacement therapy (BHRT):..................................... 58

Herbal remedies................................................................................................. 58

Lifestyle Changes.................................................................................................. 59

24. Medications.................................................................................. 60

Hormone replacement therapy ........................................................................ 60

Common Medications for Menopausal Symptoms............................................ 60

Non-hormonal .................................................................................................... 60

Hormonal............................................................................................................ 61

25. Hormone Replacement Therapy (HRT)...................................... 64

Benefits................................................................................................................... 64

Risks ....................................................................................................................... 65

HRT and Menopause ............................................................................................. 66

Precautions ............................................................................................................ 66

26. Bioidentical Hormone Replacement Therapy (BHRT) .............. 68

Formation of Bioidentical Hormones Bioidentical hormones are

chemically synthesized hormones produced from plants and

animals................................................................................................................. 68

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

The Downside of Lack of Exercise ...................................................................... 79

31. How to Treat Menopause Symptoms Naturally......................... 80

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Natural Treatment Options ................................................................................... 81

Herbal Remedies ............................................................................................... 81

Homeopathy........................................................................................................... 81

Proper Nutrition ..................................................................................................... 82

Aromatherapy ........................................................................................................ 82

Acupuncture and acupressure ............................................................................ 83

Exercises................................................................................................................ 84

Relaxation Therapies ............................................................................................ 84

32. Herbal Remedies for Treating Menopause................................ 86

33. Menopause and Your Family...................................................... 88

34. Where to Find Help for the Menopause ..................................... 90

Help For Menopause ............................................................................................. 90

35. Supporting Someone Going through Menopause.................... 92

Offering Support.................................................................................................... 92

36. Menopause – Frequently Asked Questions .............................. 94

What is menopause?......................................................................................... 94

When does menopause occur? ....................................................................... 94

What is perimenopause? .................................................................................. 94

Is pregnancy possible during perimenopause?............................................. 94

What is surgical menopause?.......................................................................... 94

What are the symptoms of menopause? ........................................................ 95

Do all women experience the same menopausal symptoms? ..................... 95

Is it possible to prevent menopause? ............................................................. 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

therapy?.............................................................................................................. 96

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.