Testing of your Menopause Status - Overview

Women who suspect they are experiencing perimenopause should have a complete medical examination by a qualified professional. The diagnosis of perimenopause can usually be made by reviewing a woman’s medical history. The most common symptoms women notice are changes in menstrual periods and the onset of hot flashes. Menopause is confirmed when a woman has had no menstrual bleeding for 12 consecutive months.

In most cases, hormone tests aren’t reliable because in menstruating women, hormone levels are changing all the time. However, in younger women when menstrual irregularity is infrequently a sign of menopause, hormone testing may be more valuable to confirm that menopause has indeed occurred. Sometimes testing is done to check specific hormone levels, especially when fertility is an issue. This can help women make decisions about beginning or adjusting medications. For some women,  it may make sense to test for other causes  of symptoms that can mimic perimenopause, such as thyroid disease.

Sometimes, elevated follicle-stimulating hormone (FSH) levels are used to confirm menopause. FSH is a hormone produced by the pituitary gland that triggers the ovaries to secrete estrogen. As the ovaries’ production of estrogen declines, the pituitary gland tries to stimulate estrogen production by releasing more FSH into the blood. When a woman’s FSH blood level is consistently elevated to 30 mIU/mL or higher, and she is no longer having menstrual periods, it is generally accepted that she has reached menopause.

However, a single FSH level can be misleading in perimenopause since estrogen production doesn’t fall at a steady rate from day to day. Instead, both estrogen and FSH levels fluctuate from fairly high to fairly low during perimenopause. Therefore, one test with an elevated FSH level is not usually enough to confirm menopause. More important, a low FSH in a woman who is having hot flashes and changing periods does not eliminate the likelihood of perimenopause. Also, if a woman is using certain hormone therapies (such as birth control pills), an FSH test isn’t valid.  

Some healthcare practitioners recommend testing a woman’s saliva for estrogen levels. There is no conclusive evidence that this test provides accurate information around menopause.

Why Testing is Important?

Whether you visit with your doctor or self-test at home, it is always important to get an accurate picture of what is going on with your body. It can be frustrating to have to deal with symptoms like hot flashes and insomnia and not know why they are happening. Getting a test done to measure your hormone levels could provide you with an explanation for all those uncomfortable symptoms.

Getting tested will also help prepare you for changes that your body may be beginning to experience. Aging is associated with various health issues, including osteoporosis, heart disease, and infertility. By getting your hormones tested you may be able to get on top of these issues sooner, decreasing your chances of having to face a serious illness. Testing for menopause is also a way that you can take control of your body and your health.

Sources and Additional Information:

http://www.menopause.org/Portals/0/Content/PDF/menopausebasics.pdf

http://www.epigee.org/menopause/self_testing.html

http://womenshealth.about.com/od/menopause/a/menotesting.htm

http://www.webmd.com/menopause/guide/menopause-diagnosis-tests

Irregular Periods during Menopause: Symptoms, Causes, and Treatment

Overview

In general, irregular periods are very common during the perimenopause. The most common early menstrual irregularity noticed in the perimenopause is a shortening of cycle length. Women with prior 28 day cycles will commonly describe 24 to 26 day cycles during the early perimenopause. Eventually, the cycle length widens and skipping menses typically occurs. These changes in cycle may lead to heavier flow in the early perimenopause, followed by a lighter flow and occasional spotting in the later perimenopause. A common reason for the late periods and prolonged bleeding is due to 'anovulation' (not releasing an egg). When this occurs, there is no signal to the body to cause a period (if there is no pregnancy). When this continues for long enough, the body starts to shed the uterine lining in a 'piece-meal' fashion, which leads to the prolonged bleeding. This can occur for long periods of time, or can correct itself by the next cycle. The unpredictable aspect of the perimenopause can be the most frustrating.

Regular Periods

Before we can define an irregular period, we must first determine what a regular period is. People often say that a regular period occurs every 28 days, but actually, every woman's menstrual cycle is different. Depending on your body and your hormones, you may get your period every 20 days or your may get your period every 35 days. A good way to determine if your periods are regular is to keep a chart and count the number of days between each period. If they occur with roughly the same number of days between each cycle, then your periods are regular. A regular period typically lasts 5 days, but it is completely normal to menstruate for anywhere between 3 and 7 days.

Irregular Periods

Irregular periods aren't unusual they affect about 30% of women in their reproductive years. An irregular period is any type of bleeding that is abnormal when compared to your usual menstrual cycle. This can include a late period, an early period or bleeding between periods. It can also appear as particularly heavy bleeding (menorrhagia) or scanty bleeding. Many women also experience irregular periods in the form of a missed period, continuous periods, or periods that occur twice in one cycle.

Causes of Irregular Periods

Irregular menstrual periods are usually the result of hormonal signals that have been thrown out of sync. In order to produce a period, your body makes hormones, like estrogen and progesterone. These hormones are kept in the hypothalamus, pituitary gland, and ovaries inside your body. In order to trigger ovulation and menstruation, these parts of the body need to send signals to one another. Sometimes, these signals get crossed or skipped, causing irregular periods.

But what causes these hormone signals to get out of whack? Well, there are actually a number of things that can easily cause your hormone levels to change, other than the menopausal symptom. Among them:

• Pregnancy: If you are pregnant, your body will begin producing different levels of hormones. This will cause numerous pregnancy symptoms, including an end to your period.
• Stress: Stress is a common cause of irregular periods. If you are fatigued, worried, or anxious this can cause your hormones to become unbalanced.
• Diet: A poor diet or extreme weight loss or gain can also affect your hormones. Women with anorexia or bulimia often have no period or irregular periods.
• Exercise: Intense exercise can wreak havoc on your body, often causing irregular periods.
• Menarche: the cycles after a girl's first period may be irregular for some time. It can take up to 3 years to get regular periods.
• Hormonal Birth Control: Birth control pills and irregular periods sometimes go hand in hand. It can take a while for your body to adjust to the new levels of hormones delivered by hormonal birth control.
• Travel.
• Hormone problems. This may cause a change in the levels of the hormones that the body needs to support menstruation.
• Illegal drug use.
• Problems with the pelvic organs, such as imperforate hymen, polycystic ovary syndrome, or Asherman's syndrome.
• Breast-feeding. Many women do not resume regular periods until they have completed breast-feeding.

Complications

During the perimenopausal period, the most likely explanation for your irregular cycles is menopause. Perimenopause refers to the time before menopause when hormone levels, particularly estrogen, begin fluctuating. Perimenopause occurs, on average, about four years before actual menopause. Menopause is timed as the date of the final period, confirmed after periods have been missed for 12 months.

In the meantime, however, your hormones are all over the place. Some months, levels of estrogen and/or progesterone are up, and some months they're down. All of which affects your periods. You may go months with a normal period, or months with one that's so heavy you can't leave the house. Your period may last four days or two weeks. You may skip a month or have spotting between periods. You may find your period comes every 28 days or every 45 days. There just doesn't seem to be any rhyme or reason to it.

Perhaps the most bothersome part of all this is the heavy bleeding. It's not just a slight inconvenience. Heavy bleeding makes it difficult for women to leave their homes, sit in meetings, shop or exercise, because they fear having an "accident." Additionally, the fatigue that often accompanies heavy bleeding can interfere with your daily activities.

Plus, heavy bleeding can lead to iron-deficient anemia, the most common health-related threat of heavy bleeding. While most cases of anemia are easily treated with oral iron supplements, sometimes the bleeding is so severe a woman's entire volume of blood drops, leading to shortness of breath, severe fatigue and heart palpitations that require hospitalization.

Treatment

As irregular periods during menopause are related to low estrogen levels, the best way to overcome irregular periods is dealing with hormonal imbalance. The major types of treatment options include lifestyle changes, alternative therapy, and medical procedures.

As a first step to get relief, women should make an effort to change easily controllable factors in their daily lives, such as diet and exercise. However, although lifestyle changes help to treat symptoms of hormonal imbalance, such as irregular periods, they don't correct the underlying problem. To attain maximum relief from irregular periods, menopausal women should seek an alternative treatment to help reverse estrogen decline and treat irregular periods at its source. As a last resort, a few women with severe conditions may find it necessary to consult their doctor about undergoing certain medical procedures. Keep reading below to learn about what each option for treating irregular periods entails.

Lifestyle Changes

Irregular periods caused by fatigue, stress, and poor physical health should be corrected by adopting a healthy lifestyle. This is the easiest, cheapest and safest way to alleviate menopause symptoms. Here are some tips:

• Enjoy a healthy diet: Abnormally long period cycles or absent menstruation are sometimes caused  by  poor  nutrition  and  lack  of adequate fat in the diet. Avoid crash dieting and extreme restriction, and eat a healthy, balanced diet.
• Be prepared: In the years leading up to menopause, menstruation may occur sporadically and at unexpected times. Always having a supply of sanitary napkins or tampons on hand can help.
• Reduce stress: Practicing stress reduction techniques like yoga, meditation, or aromatherapy can help to alleviate some of the uncomfortable symptoms associated with PMS, like headaches and irritability.

Alternative Medicine for Irregular Periods

Because lifestyle changes only treat the symptoms of hormonal imbalance, such as irregular periods, herbal supplements are a great solution for fixing the actual problem. Herbal remedies are typically cost-effective and free from serious health risks or side-effects.

The main types of herbs that are effective at treating menopausal symptoms include phytoestrogenic herbs, which have low levels of plant hormones that have an estrogenic affect in the human body, and non-estrogenic herbs, which encourage the body to increase its own hormone secretion.

Both of these herbs have been used to successfully treat hormonal imbalance. Phytoestrogenic herbs, however, have been criticized for their tendency to make the body less responsive to producing its own estrogen, thus worsening the problem. Non-estrogenic herbs, on the other hand, encourage the body to correct hormonal imbalance by itself.

In medical terminology, these plants are called "selective estrogen-receptor modulators" (SERMS). They don't just raise total levels of estrogen, but have the unique capacity to selectively increase estrogen in some organs, and block or reduce it in others. In a premenopausal woman suffering from elevated estrogen levels, for example, these herbs can decrease estrogen, while in a postmenopausal woman, they help to augment hormone levels. This herb thus balances hormone levels naturally.

An excellent example of a safe and effective non-estrogenic herbal supplement for hormonal imbalance is MacaActive. This herbal supplement is noteworthy for its ability to balance hormone levels in women by nourishing the hormonal glands, thus alleviating most disorders related to hormonal imbalance, including irregular periods.

Medical Procedures

After lifestyle changes and alternative therapy, medical procedures (especially hormone replacement therapy or surgical procedures like hysterectomy) are the most extreme treatment solution. Pharmaceutical companies driven by profit motives lobby hard to make women think that this is the only option for treating menopause symptoms, but in reality serious medical procedures are only appropriate for a very small percentage of women. Due to the elevated cost and associated side effects, including a higher risk for certain types of cancer, this step should only be considered as a last resort for women with severe conditions. Women who think this treatment may be appropriate for them should seek advice from their doctor.

Sources and Additional Information:

http://www.menopauserx.com/health_center/sym_ir_bleeding.htm

http://www.epigee.org/menstruation/irregularperiods.html

http://women.webmd.com/tc/missed-or-irregular-periods-topic-overview

http://www.healthywomen.org/content/ask-expert/1786/irregular-periods-and-perimenopause

http://www.natural-progesterone-estrogen-supplements.com/irregular-periods-treatments.htm

Main Lifecycle Stages of Natural Menopause

Menopause is actually defined as the period beginning twelve months after a woman's last menstrual cycle. This is the point when a woman is not "going through" menopause but is "in" menopause.

Therefore, the Menopause as the term used to describe the time women stops having her menstrual periods is actually, is more commonly (and inaccurately) used to describe only one menopause stage, perimenopause. There are stages of menopause which women experience. These stages of menopause consist of:

• Premenopause
• Perimenopause
• Menopause
• Postmenopause

The timeline below illustrates the stages of menopause in relation to age. This is a representation of the number of years for each menopause stage that may help in understanding the stages of menopause. Each stage is described below in more details.

Definitely, the stages of menopause depend upon the reason for which the onset of menopause occurred. When menopause is induced by a surgical procedure or by radiation or drug therapy that causes damage to the ovaries, then the stages of menopause are different than those associated with natural menopause which occurs in all women, usually in the fifth decade of life.

The first stage, premenopause, as well as the last stage, postmenopause, last the longest. By dividing menopause into separate stages, it is easier to identify and address the health issues and symptoms unique to each.

Premenopause

This first stage lasts from the onset of menstruation to the last normal period. It is during her reproductive years that menopause may be the furthest thing from a woman's mind. For most women, this stage begins at 10 to 16 years of age, when the first period occurs, to the last normal period, which usually occurs in a woman's 40s or 50s.

You may notice in the literature that this term is often misused to describe the years immediately before menopause (perimenopause) and also to describe premature menopause.

It is during this initial stage of menopause that young women can lay the foundation for good health in later years through good nutrition and exercise.

Perimenopause

This stage is often the most stressful time for women. The menstrual cycle may become irregular before it ceases completely. Menstrual flow may become lighter or heavier. Each missed period raises questions about whether a woman is pregnant or entering menopause.

This stage, which lasts from 2 to 10 years, is often characterized by irregular menstruation with occasional missed periods. Until menses stop completely, it is still possible to become pregnant.

When discussing menopause, most women refer to perimenopause because it’s during this stage that the hormone levels change and levels of estrogen decline. As ovarian production decreases, the follicle stimulating hormone (or FSH) increases, triggering symptoms like hot flashes, headaches, memory problems, acne, mood swings, night sweats, and insomnia. Low estrogen levels may cause vaginal dryness and irritation.

Your period could go in any direction during this transitional time. Your flow may be heavier than normal; it may be lighter than normal; your period could come at closer intervals, and it may come at longer intervals. Some women have spotting between periods. You may have shorter periods of bleeding than normal, or you may have longer periods of bleeding than normal.

Perimenopause typically takes place between 45- and 60-years-of-age. Early signs of perimenopause usually occur in a women in mid 40-s. It was noticed, that women who experience early menopause typically follow their mothers pattern.

While changes in the menstrual pattern are common during this time, women should maintain a dialogue with their doctor because frequent or heavy bleeding needs to be evaluated further.

Menopause

Menopause occurs when a woman does not have her period for 12 months, starting from the day when a woman has her last period. This is actually the shortest stage and the only one with a defined length. If a woman skips several menses and then they return, the clock starts again. It is retrospective. Women do not know they are in menopause until 1 year without a period passes (some specialists claim that menopause can be defined by more than 6 consecutive period-free months, however there are cases, when menstruations return after 6-months period, announcing that menopause has not started yet). Only after the confirmed “waiting period” they look back and realize they are in menopause. This can be a time of mixed emotions for many women as the childbearing years are over, children are grown and retirement beckons.

Menopause is the permanent termination of menstruation and fertility. This stage begins when a woman has her last period. this stage, ovaries no longer produce eggs as hormone production stops, and common changes become noticeable - including vaginal dryness and loss of sex drive.

Postmenopause

Postmenopause begins 12 months after the last period and lasts until death. With women's increased life expectancy, the postmenopausal stage is a relatively new stage of life. A woman's life expectancy has increased from 48 years in 1900, to 80 years in 2005, according to the U.S. Centers for Disease Control and Prevention's publication: Health, United States, 2008. The majority of women did not live to the postmenopausal years in the early 1900s. Today they often enjoy an active lifestyle into their 70s and 80s.

Generally by this stage, most menopausal symptoms have ceased. Vaginal atrophy, which is due to low, rather than fluctuating, estrogen levels, may persist. Postmenopausal women with low estrogen may be at increased risk for osteoporosis and should consume adequate calcium and vitamin D and have a screening test for low bone density.

Sources and Additional Information:

http://www.menopause-black-cohosh.org/articles-menopause/stages.html

http://www.livestrong.com/article/88924-menopause-stages/

http://www.menopauseinsight.com/menopause/stages-of-menopause.aspx

http://www.menopause-faq.com/menopause-stages.htm