Menopause

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Menopause is the time in a woman's life when the ovaries stop producing estrogen. Menopause is usually recognized by the cessation of menstrual periods. Other symptoms of menopause include flashes, mood changes, difficulty sleeping, and vaginal dryness. If a woman is not menstruating because she has had a hysterectomy or endometrial ablation, other symptoms of menopause often alert her that menopause is starting.

Approaching menopause, the bleeding pattern for many women will perhaps change, with cycles either becoming shorter initially, and then with time the menstrual interval will begin to lengthen, be variable and perhaps some cycles skipped altogether, and then finally the periods stop entirely. A woman is said to be menopausal if more than 6 months have elapsed and she has not had a period.

Among postmenopausal women with prior hysterectomy, cessation of conjugated equine estrogen (CEE) therapy reduces the risk of stroke, and the risk of breast cancer remains reduced, according to a study to be published on April 6 in the Journal of the American Medical Association.

Concern that risks outweighed the possible benefits of estrogen use caused the cessation of the Women's Health Initiative Estrogen-Alone Trial. However, researchers decided to continue monitoring patients for outcomes despite the study protocol discontinuation to gain insight into the long-term effects of the conjugated equine estrogens (CEE) therapy. What they found was surprising-and somewhat positive.

About two-thirds of the U.S. population takes in sufficient amounts of vitamin D, but 8 percent may be at risk for vitamin D deficiency, according to a March data brief published by the U.S. Centers for Disease Control and Prevention's National Center for Health Statistics.

According to some estimates, hot flashes affect approximately 32 million women in the United States and may be the most common menopause-related discomfort. Although estrogen can effectively treat this symptom, concerns over estrogen’s safety have caused clinicians and patients alike to seek effective alternatives.

Sexual desire in patients with breast cancer is not affected by adjuvant endocrine therapy, but is significantly reduced in those women with chemotherapy- or gonadotropin releasing hormone (GnRH) agonist-induced menopause, according to a study published online March 2 in The Journal of Sexual Medicine.

After reaching menopause, women experience body composition changes such as loss of lean body mass, increase in body fat mass, and a shift to central or android fat distribution-all of which are associated with negative health issues. Researchers have hypothesized that hormone therapy might help counter these changes, but thus far studies have been limited by size, type (ie, observational), or length of intervention.

High body mass index (BMI) and low levels of physical activity are associated with increased risk of triple-negative and estrogen receptor-positive (ER+) breast cancers in postmenopausal women, according to a study published online March 1 in Cancer Epidemiology, Biomarkers & Prevention.

Breast cancer incidence rates among non-Hispanic (NH) white women in the United States stabilized between 2003 and 2007 after a sharp decline between 2002 and 2003 that followed a drop in the use of postmenopausal hormone therapy, according to a study published online Feb. 28 in Cancer Epidemiology, Biomarkers & Prevention.

Nitroglycerin ointment appears to increase bone mineral density (BMD) and decrease bone resorption in postmenopausal women when administered daily, according to research published in the Feb. 23 issue of the Journal of the American Medical Association.

Menopausal women treated with the selective serotonin reuptake inhibitor escitalopram have fewer, and less severe, hot flashes than women taking a placebo, according to a study published in the Jan. 19 issue of the Journal of the American Medical Association.