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Getting Straight with Menopause
By Lois Thomson

Marianne WizdaWhat is menopause?  And what isn't it?  There are many misconceptions and questions about menopause that have yet to be answered, but Dr. Marianne Wizda said the straight definition is when a woman has "no periods for a full year."

Dr. Wizda is a gynecologist – a Certified Practitioner with NAMS, the North American Menopause Society – with the Washington Health System, and she talked about what is established:  "We do know that women are born with all the eggs they are going to have in a lifetime, and they decrease from then on.  At menopause, women are no longer releasing eggs and the ovaries are no longer making estrogen."

She went on to say that the average age for this to occur is 52, but symptoms such as erratic periods, problems with sleeping, night sweats, hot flashes and what people describe as hormonal mood swings, can occur for years around that time.  "So when women are still having periods but are having some or all of those symptoms,  that is  called  'perimenopause.'  That transition time can be 10 years for some women."

There is still a lot that is unknown, including what actually causes hot flashes and night sweats.  The two biggest challenges Dr. Wizda sees are menopausal weight gain and changes in libido.  "I wish I had a better answer for the weight gain other than diet modifications and exercise, but I don't.  Libido changes are complex and there is no simple answer.  That can be difficult for couples, especially since men are 'wired' differently."

Dr. Marianne Wizda, gynecologist at Washington Health System, said no one has all the answers as to why menopausal symptoms are different in women. "We know there are differences in menopause symptoms in different cultures, race, ethnicity and body type. But for an individual, I don't think anybody can say why one woman may experience many symptoms, and others almost none. There are a small percentage of women whose hot flashes improve but may never go away."

Of course these symptoms can have an impact.  "Once your body loses all its estrogen at menopause, there's generally a fairly big decline in bone density.  This will continue over the years if the person is not doing anything to stabilize that."  For that reason, most women usually need to take Vitamin D and calcium supplements after menopause.  Strength training is extremely important for the menopausal women as well, not only for bone density, but also for the loss of muscle mass during the aging process.

Dr. Wizda added that it can be difficult to determine whether some things are just general causes of aging or whether it's the menopause itself.  Heart disease is big concern for women as they age, and women should address the known risk factors, including hypertension, diabetes and elevated cholesterol with their primary care physician.

Dr. Wizda concluded, "I think the bottom line about menopause is that it is a very different experience in all women.  There are different treatment options for women depending on what symptoms they are experiencing – whether it is bleeding problems, sleep disturbances, mood changes, hot flashes:  there is no one treatment for all, and each should be individualized."

For more information, call is 724-225-3640 or visit www.whs.org.

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