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Postmenopause

Alternate Names

  • change of life

What is going on in the body?

When a woman reaches menopause, her estrogen level has declined enough so that she has no menstrual bleeding, and bearing children is no longer possible. It is important to remember that once a woman has been through menopause, she is postmenopausal for the rest of her life. It is not a condition that she "outgrows".

Risks

What are the causes and risks of the condition?

Menopause is caused by natural aging. During menopause, a woman's estrogen level decreases. This eventually causes a woman to stop menstruating.

Prevention

What can be done to prevent the condition?

If they live long enough all women will go through menopause and move into postmenopause.

Diagnosed

How is the condition diagnosed?

A healthcare professional can diagnose postmenopause by looking at a woman's medical history and her symptoms. A blood test can be used to determine the follicle stimulating hormone (FSH) level which is elevated in menopause.

Long Term Effects

What are the long-term effects of the condition?

A woman who is postmenopausal is at higher risk for osteoporosis, and heart disease as a result of decreased estrogen production by the ovaries.

Other Risks

What are the risks to others?

Menopause is not contagious and poses no risk to others.

Treatments

What are the treatments for the condition?

While menopause itself is not treated, the symptoms that go along with menopause are sometimes treated. All of the risks due to estrogen loss may be prevented or treated. Some ways to do this include making lifestyle changes and taking hormone therapy (HT).
Calcium supplements may be taken by those women who do not get enough calcium through their diet. Urinary tract infections may come back again and again. To prevent these infections, a woman should urinate frequently, especially before and after sexual intercourse. She should also drink plenty of fluids and keep the genital area very clean.

Side Effects

What are the side effects of the treatments?

Side effects of HT can include headaches, bloating, and irritability. Long-term use of hormone therapy may increase the number of women who get breast cancer. If a woman has a family history of breast cancer, menstruated before age 12, or did not have her first pregnancy until she was older, hormone therapy may not be advised.
Women who are at higher risk of developing blood clots may also be unable to use hormone therapy. The American Heart Association recently issued recommendations about hormone therapy (HT) in women. For women who have already had a heart attack or have heart disease, it appears that HT does not protect against having another heart attack or dying from heart disease.
The studies that support this information were done with women over 65 years of age. The latest analysis of the Women's Health Initiative data indicates that if women start HT before age 60 and do not have underlying cardiac disease they do not increase their risk of heart problems.
For women who have not already had a heart attack or who do not have heart disease, HT should not be started for the sole purpose of preventing heart disease. The research is not strong enough to support doing that at this time.
It is not necessary for a woman to stop HT if she is doing well on it. Overall, the decision to use HT should be based upon the proven benefits and risks of HT. A woman should discuss the benefits and risks with her healthcare professional. Together, they can choose the most appropriate course of action. A woman who is using hormone therapy during perimenopause may want to reassess using HT after menopause.

After Treatment

What happens after treatment for the condition?

Most symptoms of menopause go away within four years of cessation of menses, however about 30% of women will have persistent symptoms for longer periods of time.

Monitor

How is the condition monitored?

Postmenopause is monitored by yearly health maintenance exams. If a woman has menstrual bleeding 6 months or more after her last period, she should contact her healthcare professional. The lining of the uterus (the endometrium) should be sampled with an endometrial biopsy or a dilatation and curettage (D&C). Any new or worsening symptoms should also be reported to the healthcare professional.

Sources

Menopause, National Institute of Aging, NIA Information Center, PO Box 8057, Gaithersburg, MD 20898

Age Page: Hormone Replacement Therapy, National Institute of Aging,

Taber's Cyclopedic Medical Dictionary, F.A. Davis Company, Philadelphia, PA

What Is Menopause? National Institute of Health, December 1992, [hyperLink url="http://www.nih.gov/" linkTitle="www.nih.gov"]www.nih.gov[/hyperLink]

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