Are hormone levels or other blood tests helpful in detecting menopause?
Because hormone levels may fluctuate greatly in an
individual woman, even from one day to the next, hormone levels are not a
reliable method for diagnosing menopause. Even if levels are low one day, they
may be high the next day in the same woman. There is no single blood test that
reliably predicts when a woman is going through the menopausal
transition. Therefore, there is currently no proven role for blood testing
regarding menopause except for tests to exclude medical causes of erratic
menstrual periods other than menopause. The only way to diagnose menopause is to
observe the lack of menstrual periods for 12 months in a woman in the expected age
range.
What are the treatment options for menopause?
Menopause itself is a normal part of life and not a disease that requires
treatment. However, treatment of associated symptoms is possible if these become
substantial or severe.
Hormone therapy
Estrogen and progesterone therapy
Hormone
therapy (HT) , also referred to as hormone
replacement therapy (HRT) or postmenopausal hormone therapy (PHT), consists of
estrogens or a combination of estrogens and progesterone (progestin). Hormone
therapy has been used to control the symptoms of menopause related to declining
estrogen levels such as hot flashes and vaginal dryness, and HT is still the
most effective way to treat these symptoms. But long-term studies (the
NIH-sponsored Women's Health Initiative, or WHI) of women receiving combined
hormone therapy with both estrogen and progesterone were halted when it was
discovered that these women had an increased risk for heart attack, stroke, and
breast cancer when compared with women who did not receive HT. Later studies of
women taking estrogen therapy alone showed that estrogen was associated with an
increased risk for stroke, but not for heart attack or breast cancer. Estrogen therapy alone,
however, is associated with an increased risk of developing endometrial cancer
(cancer of the lining of the uterus) in postmenopausal women who have not had
their uterus surgically removed.
Hormone therapy is available in oral (pill), transdermal form (patch and
spray). Transdermal hormone products are already in their active form without the need for
"first pass" metabolism in the liver to be converted to an active form. Since transdermal hormone products do not have effects on the liver, this route of administration has become the preferred form for most women. A number of preparations are available for oral and transdermal forms of HT, varying in the both type and amount of hormones in the products.
There has been increasing interest in recent years in the use of so-called "bioidentical" hormone therapy for perimenopausal women. Bioidentical hormone preparations are medications that contain hormones that have the same chemical formula as those made naturally in the body. The hormones are created in a laboratory by altering compounds derived from naturally-occurring plant products. Some of these so-called bioidentical hormone preparations are U.S. FDA-approved and manufactured by drug companies, while others are made at special pharmacies called compounding pharmacies that make the preparations on a case-by-case basis for each patient. These individual preparations are not regulated by the FDA, because compounded products are not standardized.
Like transdermal HT products, bioidentical hormone therapy products are administered transdermally. They are typically applied as cream or gels. Their advocates believe that their use may avoid potentially dangerous side effects of synthetic hormones used in conventional hormone therapy. However, studies to establish the long-term safety and effectiveness of these products have not been carried out.
The decision about hormone therapy, is a very individual decision
in which the patient and doctor must take into account the inherent risks and
benefits of the treatment along with each woman's own medical history. It is
currently recommended that if hormone therapy is used, it should be used at the
smallest effective dose for the
shortest possible time. The WHI study findings do not support the use of HT for
the prevention of chronic disease.
Oral contraceptive pills
Oral contraceptive pills
are another form of hormone therapy often prescribed for women in perimenopause to treat irregular vaginal bleeding.
Prior to treatment, a doctor must exclude other causes of erratic vaginal
bleeding. Women in the menopausal transition tend to have considerable
breakthrough bleeding when given estrogen therapy. Therefore, oral
contraceptives are often given to women in the menopause transition to regulate
menstrual periods, relieve hot flashes, as well as to provide contraception.
The list of contraindications for oral contraceptives in women going through the
menopause transition is the same as that for premenopausal women.
Local (vaginal) hormone and non-hormone treatments
There are also local (meaning applied directly to the vagina) hormonal
treatments for the symptoms of vaginal estrogen deficiency. Local treatments
include the vaginal estrogen ring, vaginal estrogen cream, or vaginal estrogen tablets. Local and oral
estrogen treatments are sometimes combined for this purpose.
Vaginal moisturizing agents such as creams or lotions (for example, K-Y Silk-E Vaginal Moisturizer or KY Liquibeads Vaginal Moisturizer) as well as the use of lubricants during intercourse are non-hormonal options for managing the discomfort of vaginal dryness.
Applying Betadine topically on the outer vaginal area, and soaking in a sitz bath or soaking in a bathtub of warm water may be helpful for relieving symptoms of burning and vaginal pain after intercourse.
Gout is a condition that results from crystals of uric acid depositing in tissues of the body. Gout is a condition that can lead to abnormally elevated levels of uric acid in the
blood, recurring attacks of joint inflammation (arthritis), deposits of
hard lumps of uric acid in and around the joints, and decreased kidney
function and kidney stones.
Night sweats are severe hot flashes that occur at night and result in a drenching sweat. In order to distinguish night sweats that arise from medical causes from those that occur because one's surroundings are too warm, doctors generally refer to true night sweats as severe hot flashes occurring at night that can drench sleepwear and sheets, which are not related to an overheated environment.
Though uterine cancer's cause is unknown, there are many factors that will put a woman at risk, including: over age 50, endometrial hyperplasia, using hormone replacement therapy, obesity, using tamoxifen, being Caucasian, having colorectal cancer. Symptoms of cancer of the uterus (endometrial cancer) include abnormal vaginal bleeding, painful urination, painful intercourse, and pelvic pain. Treatment depends on staging and may include radiation therapy or hormone therapy.
Cervical cancer is cancer of the entrance to the womb (uterus). Regular pelvic exams and Pap testing can detect precancerous changes in the cervix. Precancerous changes in the cervix may be treated with cryosurgery, cauterization, or laser surgery. The most common symptom of cancer of the cervix is abnormal bleeding.
Rosacea is a skin disease that causes redness of the forehead, chin, and lower half of the nose. In addition to inflammation of the facial skin, symptoms include dilation of the blood vessels and pimples (acne rosacea) in the middle third of the face. Oral and topical antibiotics are treatments for rosacea. If left untreated, rhinophyma (a disfiguring nose condition) may result.
Learn about osteoporosis, a condition characterized by the loss of bone density, which leads to an increased risk of bone fracture. Unless one experiences a fracture, a person may have osteoporosis for decades without knowing it. Treatment for osteoporosis may involve medications that stop bone loss and increase bone strength and bone formation, as well as quitting smoking, regular exercise, cutting back on alcohol intake, and eating a calcium- and vitamin D-rich balanced diet.
There are many causes of scalp hair loss. This featured article covers the common ones such as patchy hair loss (alopecia areata, trichotillomania, and tinea capitis), telogen effluvium, and androgenetic alopecia (male-pattern baldness, female-pattern baldness).
Hot flashes (or flushing) is the most common symptom experienced by a woman prior to and during the early stages of menopause. Hot flashes can be caused by other conditions. Diagnosis is made by taking a patient history and at times, blood tests. Treatment options include hormone therapy, bioidentical hormone therapy, and medications. There are non-FDA approved natural remedies.
Dry eyes are caused by an imbalance in the tear-flow system of the eye, but also can be caused by the drying out of the tear film. This can be due to dry air created by air conditioning, heat, or other environmental conditions.
Vulvodynia or vaginal pain, genital pain is a condition in which women have chronic vulvar pain with no known cause. There are two types of vulvodynia, generalized vulvodynia and vulvar vestibulitis. Researchers are trying to find the causes of vulvodynia, which may include nerve irritation, genetic factors, hypersensitivity to yeast infections, muscle spasms, hormonal changes, and more. The most common symptoms of vaginal pain (vulvodynia) is burning, rawness, itching, stinging, aching, soreness, and throbbing. There are a variety of treatments that can ease the symptoms of vulvodynia (vaginal pain).
Hot flashes are experienced by many women, however, not all women undergoing menopause experience hot flashes. A hot flash is a feeling of warmth that spreads over the body. Treatment for hot flashes include hormone replacement therapy and alternative prescription medications such as SSRIs (Effexor, Paxil, Prozac), clonidine (Catapres), megestrol (Megace), and gabapentin (Neurontin). Few alternative treatments for hot flashes (for example phytoestrogens - isoflavones, black cohosh, and vitamin E have been scientifically studied.
Insomnia is the perception or complaint of inadequate or poor-quality sleep because of difficulty falling asleep; waking up frequently during the night with difficulty returning to sleep; waking up too early in the morning; or unrefreshing sleep. Secondary insomnia is the most common type of insomnia. Treatment for insomnia include lifestyle changes, cognitive behavioral therapy, and medication.
Gum disease is caused by plaque and may result in tooth loss without proper treatment. Symptoms and signs of gum disease (gingivitis or periodontal disease) include receding gums, bad breath and pocket formation between the teeth and gums. Treatment depends upon the stage of the gum disease, how you responded to earlier treatments, and your overall health.
Vaginal dryness and vaginal atrophy occurs in women during perimenopause, menopause, and postmenopause. With vaginal atrophy, the lining of the vaginal wall becomes thinner, drier, less elastic, and light pink to bluish in color. Symptoms of vaginal atrophy include vaginal dryness, itching, irritation, and/or pain during intercourse. Treatment options for vaginal dryness and vaginal atrophy include hormone treatment and over-the-counter vaginal lubricating and moisturizing products.
Lichen sclerosus is a skin disease that causes white spots to form on the skin, which later grow into large, thin, and crinkled patches of skin that tear easily. Symptoms include itching, pain, blisters, and bleeding. Patches on the upper body usually go away over time, but patches in the genital region may scar if left untreated, causing problems with urination or sex. Treatment may involve surgery or the use of a very strong cortisone cream.
Premature menopause is when a woman goes through menopause before the age of 40 because of genetics, illness, or a medical procedure. Symptoms of premature menopause include irregular or missed periods, mood swings, hot flashes, periods that are heavier or lighter than usual, vaginal dryness, bladder irritability, incontinence, dry skin, eyes or mouth, sleeplessness, and decreased sex drive. Though premature menopause cannot be reversed, the symptoms can be managed with methods similar to those used for natural menopause.
Male menopause refers to the decline in testosterone production in men. As men age, they often experience many of the same symptoms that women experience in menopause. Testosterone replacement therapy may relieve some of these symptoms.
Menstruation (menstrual cycle) is also referred to as a "period." When a woman menstruates, the lining of the uterus is shed. This shedding of the uterine linking is the menstrual blood flow. The average menstrual cycle is 28 days. There can be problems with a woman's period, including heavy bleeding, pain, or skipped periods. Causes of these problems may be amenorrhea (lack fo a period), menstrual cramps (dysmenorrhea), or abnormal vaginal or uterine bleeding. There are a variety of situations in which a girl or woman should see a doctor about her menstrual cycle.
Burning mouth syndrome (BMS) is a condition that causes pain in the mouth. BMS may be caused by menopause, dry mouth or allergies. Signs and symptoms include tingling or numbness of the tip of the tongue, bitter or metallic taste, and dry or sore mouth. Treatment depends upon the cause of your burning mouth syndrome.
Just about everybody masturbates. Masturbation itself is the self-stimulation of the male or female genitals to achieve sexual pleasure or arousal to the point of orgasm. Masturbation involves stimulating the penis or clitoris. Masturbation is very common among people who have, or do not have sexual relations with a partner. Masturbation can relieve sexual tension that can build up over a period of time. Masturbation generally is considered normal unless it becomes a problem by inhibiting sexual activity with a partner, done in public, or causes distress to the person masturbating. Some experts suggest that masturbation can improve a person's sexual health and personal relationships.
Enjoying a satisfying sex life as we age is important to both physical and mental health. As we age, diseases and conditions may pose challenges in our sexual health, and sexual experiences. Learn how to manage your conditions and still have a gratifying sex life as you age.
Sexual health information including birth control, impotence, herpes, sexually transmitted diseases, staying healthy, women's sexual health concerns, and men's sexual health concerns. Learn about the most common sexual conditions affecting men and women.
Adult-onset asthma is asthma that is diagnosed in people over 20 years of age. Symptoms include wheezing, coughing, shortness of breath and difficulty breathing. Treatment may involve anti-inflammatory medications or bronchodilators.
Sexual dysfunction refers to a problem that arises during any phase of the sexual response cycle, preventing an individual or couple from experiencing sexual satisfaction. Physical, medical, and psychological conditions may affect sexual functioning, resulting in inhibited sexual desire, inability to become aroused, lack of orgasm, and painful intercourse. Treating the underlying physical and psychological problems usually resolves most female sexual problems.
People who have bladder spasms, the sensation occurs suddenly and often severely. A spasm itself is the sudden, involuntary squeezing of a muscle. A bladder spasm, or "detrusor contraction," occurs when the bladder muscle squeezes suddenly without warning, causing an urgent need to release urine. The spasm can force urine from the bladder, causing leakage. When this happens, the condition is called urge incontinence or overactive bladder.
Women's health is an important topic area to guide a woman through the stages of her life, as well as knowing the conditions and diseases that may occur. Educating yourself so that the transitions into different phases of life is key to a healthy, happy, and productive life.
A cystocele is also known as a fallen or prolapsed bladder. Heavy lifting and straining may cause a cystocele, which causes urine leakage and incomplete emptying of the bladder. Mild cystoceles may require no treatment, while large cystoceles may require surgery.
Millions of women suffer from urinary incontinence (UI). UI occurs twice as often in women as in men. There are many types of urinary incontinence: stress incontinence, urge incontinence, overactive bladder, functional incontinence, overflow incontinence, transient incontinence, and mixed incontinence.
Gum problems may be caused by improper brushing and flossing, gum disease, canker sores, treatments and hormonal changes. Symptoms of gum problems include red, swollen, sore and bleeding gums. These symptoms can be prevented by brushing twice a day, flossing daily, eating a well-balanced diet, drinking enough water, not smoking, and relaxing.