MENOPAUSE

Menopause, or the permanent end of menstruation and fertility, is a natural biological process, not a medical illness. Even so, the physical and emotional symptoms of menopause can disrupt your sleep, sap your energy and - at least indirectly - trigger feelings of sadness and loss.

Hormonal changes cause the physical symptoms of menopause, but mistaken beliefs about the menopausal transition are partly to blame for the emotional ones.

First, menopause doesn't mean the end is near - you've still got as much as half your life to go. Second, menopause will not snuff out your femininity and sexuality. In fact, you may be one of the many women who find it liberating to stop worrying about pregnancy and periods.Most important, even though menopause is not an illness, you shouldn't hesitate to get treatment if you're having severe symptoms.

Many treatments are available, from lifestyle adjustments to hormone therapy.The signs and symptoms of menopause, however, often appear long before the one-year anniversary of your final period. They include:

Irregular periods

Decreased fertility

Vaginal dryness

Hot flashes

Sleep disturbances

Mood swings

Increased abdominal fat

Thinning hair

Loss of breast fullness

Menopause begins naturally when your ovaries start making less estrogen and progesterone, the hormones that regulate menstruation. The process gets under way in your late 30s. By that time, fewer potential eggs are ripening in your ovaries each month, and ovulation is less predictable. Also, the post-ovulation surge in progesterone - the hormone that prepares your body for pregnancy - becomes less dramatic. Your fertility declines, perhaps partially due to these hormonal effects.

Unfortunately, there's no way to know exactly which period will be your last. You have to wait until well after the fact - 12 months after, by official definition. In your final months before reaching menopause, it's still possible to get pregnant, but it's quite unlikely. Because this process takes place over years, menopause is commonly divided into the following two stages:

Perimenopause. You begin experiencing menopausal signs and symptoms, even though you still menstruate. Perimenopause may last four to five years or longer.

Postmenopause. Once 12 months have passed since your last period, you've reached menopause. Your ovaries produce much less estrogen and no progesterone, and they don't release eggs.

Hysterectomy

Chemotherapy and radiation therapy

Premature ovarian failure

It's important to see your doctor during both perimenopause and postmenopause for preventive health care as well as care of medical conditions that may occur with aging. Always seek medical advice if you have bleeding from your vagina after menopause.

Menopause itself requires no medical treatment. Instead, treatments focus on relieving your signs and symptoms and on preventing or lessening chronic conditions that may occur with aging. Treatments include:

Hormone therapy

Low-dose antidepressants

Gabapentin

Clonidine

Bisphosphonates

Selective estrogen receptor modulators

Vaginal estrogen

DIETARY THERAPY

Most people who have seriously studied the effect of diet on health are prepared to say that more than 75% of health problems are related to diet. Just consider that the three leading causes of death in this country -- heart attack, cancer, and stroke -- are all closely correlated with poor diet. The deficiencies and imbalances that a patient has are taken into account, and recommendations are made regarding what foods to eat and what foods to avoid.

Unfortunately, women in Western countries are exposed to higher levels of environmental estrogen than women in undeveloped countries. It is estimated that our environment adds 40% more "strong" (and harmful) estrogens to the body than are produced naturally. This could explain why the incidence of breast cancer is higher in developed countries, and is probably a complicating factor in many hormone-related conditions. Scientific studies suggest that higher levels of "strong" estrogen correlate with higher incidence of breast cancer in women. That is why women with a history of breast cancer, or a high risk of developing it are not recommended to be on hormone replacement therapy.

Phytoestrogens are chemicals produced by certain plants which resemble the estrogens that are produced by the human body, and which bind readily to estrogen receptors in the human body, but which are "weaker" forms of estrogen than human estrogen. The benefit of eating foods which are high in phytoestrogens, like soy beans, is that the "weak" estrogen of the plant binds to the body's estrogen receptors, displacing the "strong" estrogens, which are then discharged harmlessly from the body.

Studies indicate that a diet rich in phytoestrogens can reduce the adverse symptoms associated with menopause. The phytoestrogens that are bound to the body's estrogen receptors release slowly and naturally into the blood stream, providing a continuing source of estrogen as the body's naturally-produced estrogen supply diminishes. As long as phytoestrogens are replenished by eating phytoestrogen-rich foods, there will be a safe, natural supply of estrogen to cushion a woman through the process of menopause and into her post-menopausal years.

One study suggests that a diet high in soy could increase the number of cells in the vaginal epithelium, which would prevent the thinning of the vaginal wall. Although soy has never been a popular food in the United States, it is the richest source of phytoestrogens known, and it forms a major part of the typical Asian diet. Soy beans and soy food products like soymilk and tofu are eaten at every meal. The average Asian woman eats 50-60 grams of soy per day, compared with less than five grams eaten by an American woman. It is never too late to change over to a healthier way of eating, but it is true that soy foods have to be eaten in large quantities over a long period of time in order to receive the full benefit. A woman who wants a trouble-free menopause should begin to eat soy in her twenties or thirties. Included below is a recipe for a typical Chinese meal which utilizes tofu and other healthy vegetables.

For those women who are already experiencing the distress of hot flashes, night sweats, headaches, and insomnia, acupuncture and Chinese herbal formulas can provide a safe and effective way to achieve a trouble-free menopause.

ACUPUNCTURE and MENOPAUSE