Menopause

Clinically, menopause can be detected through patient history and the appearance of the typical clinical features. A pap smear can further support the diagnosis of menopause. The Pap smear may show a decline in the estrogen level of the vaginal mucosa, a clear sign of menopause. Additionally, a method called radio immunoassay which tests for antigens like hormone levels in the blood will also reveal specific clinical signs that are typical to menopause. Endocrine changes can be seen during menopause. The most prominent change occurs in the secretion of a hormone called the pituitary gonadotropins. An increase in the production of the follicle-stimulating hormone to as much as 15 times the normal is frequently seen during menopause.

During menopause, a woman may also experience osteoporosis. Osteoporosis is usually revealed during X-ray of the spine, femurs, and metacarpals. A condition called osteopenia may also occur during menopause. Osteopenia refers to bone mineral density that is lower than normal, but not as low as what is seen in osteoporosis. Menstrual bleeding is also a typical sign of menopause. The doctor may perform an endometrial biopsy, and dilation and curettage, to rule out any disease that causes menstrual bleeding.

Menopause normally doesn’t require treatment, as this is a normal physiologic change every woman undergoes in her life. However, some conditions may necessitate medical intervention to aid the patient get through menopause more easily. In cases where there is atypical or adenomatous hyperplasia in the endometrium or uterus lining, the patient will need drug support. The drugs will cause endometrial shedding and suppress endometrial growth. Women with menopause who suffer from osteoporosis may also require treatment. Estrogen therapy is often the treatment of choice for this problem. However, controversy still exists regarding the effectiveness of estrogen replacement therapy or ERT. Estrogen replacement therapy is strongly contraindicated to patients with a family history of cancer. If a woman in menopause undergoes ERT, she should be regularly monitored for possible cancer development. Any signs of cancer should be detected at its very earliest onset and even during its asymptomatic stages.

A woman in menopause who doesn’t want to get pregnant should not stop taking contraceptives until the complete cessation of menstruation is confirmed. Menopausal women should know that all the physiological changes they experience during menopause are but normal and predictable occurrences that come along with this stage. Any vaginal bleeding or spotting should be reported to a doctor if these occur after the complete cessation of menstruation. Some women may consider menopause as a threat to their femininity. Some will feel less wanted, and may think that sex life ceases with menopause. Others may think that their prime purpose of bearing a child has already stopped and their self worth has declined with menopause. These women should learn that menopause doesn’t end their sex life and they are still capable of enjoying an active and exciting sex life, even without producing any offspring. Women should understand that menopause can be the beginning of a new and different kind of independence. A kind of independence they have never experienced before that will provide them an exciting life ahead.