Depression is a biologically based disease typically caused by an imbalance or fluctuation of hormones in the brain. As women begin to experience signs and symptoms of menopause, about 10-15% of the time depression also sets in.

Depression is characterized by a prolonged melancholic or hopeless mood and consistent disinterest or feelings of apathy toward previously pleasurable activities. Other symptoms include:

• Anxiety
• Lack of motivation
• Inability to concentrate
• Frequent bouts of crying
• Insomnia or sleeping too much
• Significant weight gain or loss
• Feelings of despair
• Suicidal thoughts
• Preoccupation with death

Is Depression The an Effect of Menopause Symptoms or a Symptom Itself?

The exact relationship between menopause and depression is unclear. It is possible the physical and emotional stress women begin to experience during perimenopause brings about depression. The process of aging and the inability to bear children in the future can be a source of sadness or distress for many women. Hot flashes, headaches, fatigue and other symptoms of menopause can also cause anxiety and stress. Depression may be a reaction to both the implications of the onset of menopause and its symptoms combined.

Alternatively, it is thought that women may experience depression as a result of the fluctuating hormone levels menopause is characterized by. In addition to regulating reproductive processes, it is believed that estrogen, progesterone and other hormones may also affect mood. In particular, a drop in estrogen may contribute to feelings of sadness or melancholia. Clearly, many of the symptoms of menopause – anxiety, insomnia, and fatigue, for example – parallel as symptoms of depression, suggesting the possibility of a cause and effect relationship between the two.

Diagnosis and Treatment

Regardless of the exact cause, women experiencing depression must seek medical help for treatment. Only a doctor can make an accurate diagnosis of depression and provide the treatments that can help alleviate symptoms. Although some symptoms of menopause are tolerable enough that women may not seek treatment for their relief, depression is a serious matter than requires immediate attention. Waiting to seek help only prolongs or intensifies suffering. Unlike a “blue” mood, depression does not lift on its own.

There are many avenues of treatment available for treating depression. Lifestyle modifications are often recommended and can be a very important part of treatment. Eating well-balanced meals, getting adequate exercise, and avoiding the use of alcohol or drugs can all contribute to a faster, more comprehensive recovery. Antidepressants may help tackle some of the biological causes of depression, while psychotherapy can address some of the mental and emotional ones. For women experiencing symptoms of both menopause and depression, hormone replacement therapy might be the best treatment option.

Unlike menopause, depression is not something all women must go through, nor is it a transitional phase or “just another symptom.” Whatever the cause and regardless of the prescribed treatment, women should always take recovery from depression seriously and make a lifelong commitment to mental health.

Women face many challenges physically and emotionally as they begin to experience the transition known as menopause. On top of the natural symptoms associated with aging, the hormonal imbalance caused by menopause can wreak havoc on their lives. Headaches, hot flashes, and anxiety are just a few of the discomforting symptoms that can occur. As if this wasn’t enough to exhaust anyone, there is the added stress of insomnia.

Menopause symptoms often seem to feed into each other, and this can definitely be the case with menopause insomnia. While it is true that insomnia may occur independently of other symptoms, chances are it is either the result or a contributing factor to other physical or mental discomforts.

The good news is, the actions you take to alleviate any given menopause symptom are likely to lessen the occurrence and severity of others.

Try the following to help alleviate menopause insomnia naturally, and see how they help treat other symptoms, too:

1. Practice deep breathing exercises at bedtime. Deep breathing helps you relax and can alleviate anxiety and release the tension associated with headaches.
2. Drink warm milk before bed time. Milk contains tryptophan – an amino acid with tranquilizing affects. This can also help relieve stress as it causes you to relax.
3. Turn down the heat. We tend to fall asleep faster and sleep more soundly in cooler temperatures. This can also help reduce night sweats, or at least help with the discomfort associated with them.
4. Avoid caffeine, nicotine and alcohol for at least 4 hours before bedtime. All four can interfere with your ability to fall asleep and stay asleep. They are all considered hot flash “triggers,” as well. Caffeine and nicotine exacerbate tension and stress, while alcohol can contribute to depression.
5. Take a warm shower or bath prior to bedtime. Bathing raises and then lowers the body’s temperature back to normal which can induce sleepiness.
6. Enjoy quite activities for several hours prior to bed time. Reading, listening to music or relaxing with a favorite non-strenuous hobby is a great way to unwind and quiet your body and mind for a more restful sleep. Relaxation also helps alleviate hot flashes, headaches, moodiness and anxiety.
7. Exercise regularly. 30 minutes of aerobic exercise daily is proven to reduce insomnia, and it also helps alleviate many of the symptoms associated with menopause. Avoid exercising within 4 hours of bed time, however.

For some women in their late 30s or early 40s, the changes they begin to experience as their bodies transition toward middle adulthood are hardly noticeable. Even when traditional pre-menopausal symptoms are practically non-existent, women may still face disturbing thoughts or physical discomfort typical of menopause anxiety. Taking the time to address symptoms of anxiety prior to and during the onset of menopause can go a long way toward alleviating them.

Feeling Overwhelmed?

If you’ve never experienced anxiety before, it’s important to recognize the signs and talk to your doctor as soon as symptoms appear. A constant sense of foreboding, nearly constant worrying, and newly acquired fears or phobias all signal anxiety. Difficulty breathing, heart palpitations, muscle tension and trembling are some of the physical ways anxiety may manifest itself. Symptoms may creep up slowly over time, or they may seem to appear suddenly. Either way, it is not uncommon to feel overwhelmed by anxiety.

Once you begin to identify the symptoms of menopause anxiety, take proactive steps to combat them. If your doctor determines your anxiety is a response to hormonal changes, there are a variety of herbal supplements that may help. Additionally, birth control pills for pre-menopausal women or hormone replacement therapy for those in peri- or actual menopause may be prescribed.

Combat Anxiety With Action

Do certain places, people or things cause you stress? If you can identify specific stressors, eliminate them if possible. If stressors cannot be removed, try focusing on how you handle them. Deep breathing exercises and relaxation techniques can be practiced and incorporated in a variety of circumstances. Do you repeatedly find yourself stressed out and anxious when you return home from work? Try taking a soothing shower right away, or engaging in a few moments of deep breathing exercises before entering the house. Alternatively, could you change your routine? Would stopping by a park on the way home for a brisk walk relieve tension? To successfully combat anxiety, take a persistent, creative approach.

Don’t Worry, Be Healthy

A healthy lifestyle goes a long way to relieving menopause anxiety, as well. Examine your diet, sleep and exercise habits and look for areas that need improvement. Exercise is a proven stress reliever and at least 30 minutes of exercise daily can alleviate and prevent menopause anxiety symptoms. A nutritious diet coupled with a quality multivitamin will also help. Although many women are tempted to turn to alcohol, sedatives or smoking to relieve menopause anxiety, all will do more harm than good in the long run. Getting a natural night’s sleep is essential, and adequate exercise should help stave off insomnia.

A Bounty of Benefits

A practical approach to menopause anxiety can benefit women in other ways, too. Relaxation techniques, exercise, healthy eating and plenty of rest can help alleviate and prevent or lessen other symptoms of menopause, too. These simple, yet powerful guidelines can help women feel better than ever about themselves and their bodies at any time in their lives.

During perimenopause and after the onset of full menopause, it is highly beneficial for women to reevaluate their diets and vitamin supplementation regimen. Adequate dosages of several vitamins and minerals can help with the discomfort of many of the most common symptoms of menopause, including vaginal dryness, moodiness, and hot flashes. In addition, taking a quality multiple vitamin for menopause can help counteract some of the increased risk for development of osteoporosis and heart disease characteristic of menopause.

Average multiple vitamin supplements are generally adequate prior to perimenopause, but probably will not suffice as an appropriate vitamin for menopause. Popular multiple vitamin supplements tend to contain minimum doses of vitamins, minerals, and antioxidants. For example, the 150 or 200 mg of calcium many brands contain is a far cry from the 1250 mg. required by women during perimenopause. For postmenopausal women, the recommended dosage jumps to 1500 mg. Vitamin E and Folic Acid can be extremely beneficial prior to and during menopause, but in accordance with the RDA (recommended dietary allowance) most supplements contain only a fraction of doctor recommended doses.

It is wise to consult with your doctor about choosing a multiple vitamin for menopause or premenopause as soon as you begin experiencing signs or symptoms. The following are general guidelines outlining some of the benefits vitamin supplements may offer menopausal women, and at what dosages they may be most effective.

Vitamin A: 4,000 to 10,000 IUs daily helps prevent vaginal dryness; deters infections; boosts collagen levels for skin and bone health

B Vitamins: 50 mg. B-complex daily helps boost energy levels; prevents vaginal dryness; prevents water retention; deters infections; helps relieve emotional symptoms (mood swings, anxiety, etc.)

Vitamin C: 500 to 1000 mg. daily helps alleviate vaginal dryness; reduce hot flashes; prevent infections; boosts collagen levels for skin and bone health; promotes heart health; helps relieve emotional symptoms; alleviates insomnia

Vitamin D: 400 IUs daily promotes bone health

Vitamin E: 100 to 800 IUs total daily (taken in two or more doses) reduces mood swings and anxiety; helps prevent cancer and heart disease; slows effects of aging; prevents thinning/irritation of the vagina (atrophy)

Calcium: 1000 to 1500 mg daily helps prevent osteoporosis; may promote heart health; may prevent cancer

There are several other minerals that if included in a multiple vitamin for menopause, may be beneficial. These include Iodine, Magnesium, and Potassium. A healthy diet that features fish, vegetables, and citrus fruits or bananas regularly combined with a supplement containing the RDA of all three minerals is likely to provide adequate, beneficial quantities.

It is crucial that a doctor be consulted before an increase in the dosage of any vitamin for menopause symptom relief. In combination with other health conditions and or hormone replacement therapy (HRT), higher doses of vitamins and minerals can result in illness, the worsening of pre-existing conditions, or toxicity. Discuss dietary changes, too, such as the inclusion of new foods such as soy products or the reduction of consumption of others, such as red meat.

All women experience menopause. It is a natural part of the aging process just as menstruation naturally occurs as puberty. Few doctors or women would argue for medical intervention for menstruation, and menopause should be no different. Women learn to use common sense to ease their bodies through menstruation. Why not use the same approach and opt for a menopause natural remedy?

Diet and Exercise as a Menopause Natural Remedy Choice

Fortunately for women today, there are a number of options that can be considered and explored when selecting a menopause natural remedy. Women are no longer limited to merely choosing hormones for replacement therapy. The variety of natural remedies ensures there is a solution for virtually everyone, and one size does not have to fit all.
Lifestyle changes make sense for many as a menopause natural remedy.

For women looking to improve their health along with alleviating symptoms, improvements to diet and exercise are a practical solution. Studies clearly indicate an appropriate diet and adequate exercise can help curtail and even prevent the majority of menopause symptoms. In addition, a healthier diet and increased level of physical fitness can help prevent osteoporosis and heart disease. As estrogen levels decline during menopause, the risks for both increase.

The Menopause Diet

If you’re overweight and you know your diet is nutritionally imbalanced, try gradually switching over to a healthier eating plan. Include more vegetables and a variety of fruits in your meals. Consider trying soy products which contain natural plant estrogens known to ease symptoms. Replace less healthy choices with more nutritious ones in time. Choose healthier fats and oils for consumption and cooking to help with heart health. Be sure to drink plenty of water, too – at least 8 glasses a day.

Exercise for Physical Fitness

If you don’t exercise and lead a mostly sedentary lifestyle, check with your doctor before you begin any exercise program. Then start to gradually increase your activity level rather than rushing out for a gym membership. Try a short walk after dinner, and gradually increase how far you go. If you enjoyed any games or sports in the past, consider taking them up again. Swimming, playing tennis or even a game of Frisbee can help you get fit.

Exercise should be something you enjoy doing for yourself, not a grueling chore. Remember that physical fitness helps combat osteoporosis and heart disease, and reduces menopause symptoms. These are the goals you should keep in mind as you progress towards better fitness.

For many women, the signs of menopause are not only a cause of discomfort, but a source of apprehension. The onset of night sweats, moodiness, and insomnia are enough to unsettle anyone. Menopause symptoms can and do affect many women’s abilities to manage their careers, family and social lives.

Women should seek out menopause help when they first begin to feel uncomfortable. Having a plan in place ahead of time is extremely beneficial. Preparations make it simpler to take actions. If you are already in pre- or peri-menopause, how effectively are you coping? Already in the midst of menopause? It’s a perfect time to formulate a plan to get the menopause help you may need.

Step 1: Communicate With Those Closest to You

Make the time to talk to your spouse, partner, children and friends about what you are experiencing. Many women habitually avoid discussing the changes they experience for years during their monthly menstrual cycle. Menopause must be disassociated from such notions of keeping things “personal.” It is a prolonged transition that can have strong effects on your mental and emotional as well as physical well-being. Do yourself and your loved ones a favor and tell them what is happening. They may surprise you by being an unexpected source of menopause help once they know what you are going through.

Step 2: Consult With Your Physicians

Your family doctor and gynecologist can be a great resource for menopause help. They can answer questions, recommend treatments, and suggest ways you can reduce discomfort with appropriate lifestyle modifications. Learn as much as you can from your doctors and be sure to share complete information about any herbal supplements or over the counter menopause remedies you may be using. Research the options available to treat persistent. Discuss HRT with your doctor and make an informed decision you are comfortable with.

Step 3: Make Healthier Lifestyle Choices

As they seek out menopause help from family, friends and their physicians, many women are surprised to learn that a healthy diet, regular exercise, and adequate sleep can help alleviate and reduce menopause symptoms. A healthy lifestyle is always beneficial, but realizing how much it can contribute to an overall feeling of physical and emotional well-being during menopause encourages many women to make a long term commitment to better living.

Step 4: Set Goals For The Future

While in the midst of a headache, hot flash, or moodswing, setting goals may seem like the last thing on your mind. The key is to do what you can, when you can to stay focused on enjoying your life. Planning to take a course, join a club, or take a trip are fun goals that remind us the challenges we experience short term are transitory. Menopause itself is a transition, and exploring new opportunities concurrently can be a great way to relieve apprehension about the changes it involves.

By the time women are in their thirties they are usually experiencing some of the more unwelcome signs of aging. Skin, hair tone and texture become duller and coarser, fine lines start to appear, and extra pounds start adding up. Periodontal disease can become a concern and the senses don’t function quite the way they used to. The heart, bones, and reproductive organs undergo changes too that may not be so obvious.

Perhaps the very last thing any woman wants to deal with on top of all the other physical changes she experiences throughout her mid-to-late 30s and into her 40s is early menopause. The end of the reproductive years represents a transition to “middle age” many women find mentally disturbing as well as physically uncomfortable. Delaying thoughts of menopause as long as possible has its appeal.

As with most things in life however, nature takes its own course. For many women, it pays to be prepared – even if that means facing the challenges of menopause before we’d like to. Women who are likely to experience early menopause (before the age of 40) will benefit from some mental and physical preparation beforehand. In the case of early menopause, ignorance is definitely not bliss!

Will I Go Through Early Menopause?

It is estimated that 1 in 100 women go through early menopause. If your mother, maternal aunts, or older sisters experienced early menopause, chances are you will, too. Early menopause can occur spontaneously, but it can also result from surgical procedures or illnesses. Among other things, it can be brought on by ovarian failure or surgical removal of the ovaries. Chemotherapy may also induce early menopause chemically.

How Can I Prepare?

Research shows that women who make changes in their lifestyle in their 20s and early 30s can affect both the severity and the duration of the symptoms associated with menopause – whether early or not! If you think you are likely to experience early menopause, you may wish to make lifestyle changes earlier on that can help you during the transition.
Help your body be prepared for early menopause by:

• Exercising regularly
• Eating a nutritional diet
• Managing stress
• Not smoking

To prepare yourself for early menopause mentally and emotionally:

• Discuss your feelings and concerns about menopause with your partner or closest friend
• Talk to relatives who have already experienced menopause
• Talk to your doctor or gynecologist about questions and concerns you have about health risks associated with early menopause (such as osteoporosis)
• Research menopause in books, magazines, and online
• Learn about HRT, natural supplements, and other treatments that can help alleviate the symptoms associated with menopause.

Menopause signals change much as the onset of menstruation does during the early teen years. With preparation and planning, women can experience the transition more smoothly and enjoy their lives to the fullest throughout it at any age.

Have you noticed a slight itch in your vaginal area lately? Is this itch uncomfortable and annoying? Are you experiencing menopause at this time?

Vaginal itching and menopause often occur simultaneously as the thickness of skin decreases and takes on a much drier texture. Many women experience an uncomfortable tightness within the vaginal walls. Dry skin cells flake off and begin to accumulate on the surface of skin in the vaginal area, causing additional itching and discomfort. This layer of dead skin cells may also result in bacterial or fungal infections that cause further irritation. The good news is it’s easy to relieve itching during menopause with the right moisturizer and a healthy, well balanced diet.

The Right Moisturizer

For quick relief of vaginal itching during menopause, apply a moisturizer that contains vitamin E or castor oil. Herbal remedies for relieving the itching and menopause dryness include Aloe Vera, Myrrh Oil, and Tea Tree Oil. Use Aloe Vera for its natural compound of vitamins A, C and E with enzymes and minerals important for adequate moisture of the skin. Aloe Vera gel can be rubbed on the top of the vaginal area to ease skin irritation.

Another essential oil that acts as an antiseptic and stimulant for aggravated skin is Myrrh Oil (Commiphora species). For cleansing the vaginal area, try anti-bacterial Tea Tree Oil (Melaleuca alternifolia).

Many women consult with their doctor about itching and menopause. Medical creams may be prescribed in cases of severe irritation or if over the counter moisturizers fail to offer relief. Itching during menopause may be a sign of a yeast infection. Be sure to tell your doctor if you have recently taken prescription antibiotics, as these often contribute to the onset of yeast infections.

Controlling Irritation

In addition to using appropriate moisturizers, the following tips can also help alleviate itching during menopause:

• Do not scratch the area; apply diluted vinegar instead
• Wash your genital area with unscented soap
• Avoid the use of douches
• Wear loose clothing to avoid irritation
• Avoid synthetic material for undergarments
• Avoid cleansing products (soaps, laundry detergent, etc.) that contain strong chemicals

Moisturize From Within

Staying well hydrated and eating nutritiously can also help alleviate itching during menopause. Drinking at least 8 glasses of water per day and including lots of fruits and vegetables in your diet can also promote hydration. Alcohol and smoking have a dehydrating affect on the body and should be avoided. A combined approach of a healthy lifestyle plus extra attention to cleansing and moisturing goes a long way to breaking the itching and menopause connection.

Premarin is among the most commonly prescribed medications for women experiencing discomforting symptoms associated with menopause. Premarin is one brand of conjugated estrogen products used for estrogen replacement therapy (ERT). When women experience menopause or undergo a hysterectomy, diminishing levels of estrogen in their bodies may cause a host of uncomfortable symptoms and unhealthy side effects.

As the name implies, estrogen replacement therapy aims at alleviating symptoms by relieving hormone deficiencies within the body. Not only can a menopause drug such as Premarin help alleviate symptoms like hot flashes and vaginal dryness, it is also used to reduce the increased risk of osteoporosis and heart disease associated with menopause.

What Exactly is Premarin?

As a conjugated estrogen product, Premarin consists of a mixture of estrogen salts. Sodium estrone sulphate and sodium equilin sulfate are the key compounds in Premarin. The ingredients in Premarin are naturally derived substances collected primarily from the urine of pregnant mares. It is administered via the lowest possible of five dosage varieties in tablets or topical creams.

Is Premarin Safe?

Your doctor will need to determine the level of safety involved in prescribing Premarin on an individual basis. A careful consideration of medical history and the severity of symptoms will contribute to a responsible evaluation of ERT eligibility.

Women who are pregnant or may become pregnant are advised against taking Premarin as it is known to cause birth defects. Women who are breast feeding should discuss the effects of Premarin on the composition of breast milk, as well.

Special consideration must be given to the following conditions in determining the safety of Premarin administration:

• Circulation or blood clotting disorders
• Abnormal vaginal bleeding
• Breast, uterine or certain other cancers

The following conditions may also limit safe administration of Premarin and should be discussed with your doctor prior to the start of ERT:

• Liver disease
• Kidney disease
• High blood pressure or heart disease
• Asthma
• Epilepsy
• High cholesterol
• Diabetes
• Gallbladder disease
• Uterine fibroids
• Diabetes
• Epilepsy

Certain other conditions may also affect your eligibility for safe administration of Premarin. A variety of medications may interact with Premarin. Women should discuss all medical conditions past and present and make their doctor aware of any medications they are currently or have recently taken prior to the administration of Premarin.

What Risks are Associated with Premarin?

Studies have determined there are several risks associated with Premarin, particularly under certain circumstances. Premarin is associated with an increased risk of the development of endometrial hyperplasia, which can lead to uterine cancer. Taking progestin in conjunction with Premarin can decrease this risk.

Heart attack, stroke, blood clots and breast cancer are other risks associated with Premarin use. Taking Premarin at the lowest possible dose for the shortest period of time necessary for symptom alleviation is one way of counteracting these risks.

Regular medical examinations are another way women can help ensure risks are minimized during the use of any menopause drug.

Hot Flashes

Vasomotor flushes or hot flashes are characterized by sweating and an intense feeling of heat around the head and neck. Hot flashes can be problematic for several months, several years, or even 10 years or more. When they create sleep deprivation, depression can result.

In Nancy Pickard’s novel Twilight, the character Jenny Crain has a conversation with a friend about hot flashes. She says, “Jenny, I want you to know that hot flashes can be wonderful.” Jenny can’t believe her ears and she gulps. Her friend continues. “Really. This is the only time in my life I’ve ever been warm. I get up to go to the bathroom in the middle of the night, and my feet aren’t freezing. Sometimes I lie in bed and think, oh, this is so nice.”

Hot flashes or hot flushes are not magical changes. They can result when estrogen is low and an imbalance occurs. They are a way your body cools you off. The disruption in temperature control in your hypothalamus is associated with a sharp rise in blood levels of epinephrine, a potent stimulator of heart function. Some experts believe hot flashes and profuse perspiration are a result of an alteration in blood vessel control in the periphery of the body. This theory explains why women commonly report that their heart pounds. In fact, clinical measures show that heart rate does increase during a hot flash. Because the heart is beating faster, blood pressure can rise, and headache and dizziness can occur. While core temperature doesn’t increase, you could feel intense warmth throughout your upper body, with flushing of the neck, face, and chest, and in some cases, profuse perspiration followed by chills. The chills are your body’s way of trying to conserve body heat.

You could be part of the majority of perimenopausal women who suffer from hot flashes. Only about 15% to 25% of these hot flashes are severe or frequent (more than 10 a day). The duration of a hot flash varies from a few seconds to minutes. The average number of hot flashes is 10 a day, with the majority occurring at night, but frequency also varies from person to person and even in the same woman.

When pressed, the American Medical Association admitted that only 5% of women suffer any major menopausal problem, but because of increasing advertising and medical research paid for by drug companies, many women are being brainwashed into thinking that temporary discomforts are serious. Other experts believe that expecting problems at menopause can lead to actual difficulties. For sure, getting uptight about hot flashes can increase them because one of the common triggers for hot flashes is stress.

The medical community has not conducted any controlled prospective trials on the menopause experience of healthy women who exercise regularly, eat a proper diet, don’t smoke, and lead a healthy lifestyle. This is probably because the cultural focus in the United States is on menopause as a problem and even as a disease.

Some cultures where menopause is not a problem have been studied.Anthropologist Ann Wright found that traditional Navajos exhibited few symptoms, and unlike our society, postmenopausal women gained increased decision-making power and respect as they grew older. Her study suggested that menopause symptoms are related to psychological stress, not physical stress. Kung women in Africa have increased status after menopause. There isn’t even a word for hot flash in their language. Either Kung women don’t experience hot flashes or maybe they accept them as normal and don’t view them in a negative light. In contrast, 65% to 90% of American women can experience hot flashes, and a large number complain of vaginal dryness and loss of interest in sex.

Insomnia/Sleep Problems

Melatonin, a hormone secreted by the pineal gland, helps set your biological clock, which dictates the smooth running of your body on a daily basis. When this mechanism falls out of sync, insomnia is one result. Melatonin tends to decline with age. Recent evidence suggests that melatonin levels are lower if you’re overweight and postmenopausal.

Night sweats can interfere with efficient sleep patterns, and so can tight muscles, hot flashes, and other menopause changes. All can lead to daytime fatigue, irritability, memory loss, nervousness, and anxiety. Lack of vitamins and minerals can also interfere with sleep, as can emotional reactions.

Joint and Muscle Pain

Joint and muscle pain can be due to deficiencies in vitamins, minerals, or fluids. If you’re not eating foods that contain the vitamins and minerals you need or taking a good multivitamin and a good multimineral, and if you’re sweating a lot due to hot flashes or night sweats, you may need additional nutrients and water.

Memory Loss and Foggy Thinking

Memory loss and foggy thinking may be related to estrogen reduction, but they may not. Estrogen may stimulate the growth of nerve cells and increase the levels of acetylcholine, an important transmitter of nerve messages in the brain. One study showed that women who suffered surgical menopause and who were given estrogen after surgery had better scores on tests of memory and abstract reasoning compared to other women who were given a placebo (sugar pill).

Other experts maintain that memory loss and fuzzy thinking are part of normal development and are usually self-limiting. Studies have provided evidence that thinking and memory loss occur no more frequently at menopause than at other times in a woman’s life.

Some researchers have reported that both chemotherapy and tamoxifen (an antiestrogen drug with many adverse reactions) can cause fuzzy thinking. Researchers at Rush University Medical Center in Chicago found that forgetfulness is not caused by menopause. In fact, the hormone supplement industry was built partly on the premise that estrogen pills could keep women’s minds sharp. That idea has been challenged by this research. The participants were not taking hormone supplements, which were recently linked to an increased risk of dementia in older women. Instead, the women were given two standard memory tests every year and were followed for an average of a little more than 2 years. Scores declined only slightly for postmenopausal women but no more than would be expected with normal aging, according to Peter M. Meyer, the lead researcher and a biostatistician. The researchers claimed that if women are sometimes forgetful, it is probably not because of any harmful hormonal changes in their brains but because they are busy, distracted, and stressed out dealing with the ordinary pressures of midlife.

Fuzzy thinking can also be due to a sluggish thyroid, which in turn can be caused by deficiencies of zinc, selenium, and copper. As you age, your digestive enzymes and hydrochloric acid are reduced. Both are critical for the proper breakdown of food and the nutrition your mind and body need. All these situations can affect your ability to think clearly.

Menstrual Bleeding

Bleeding during perimenopause can be erratic and scary. You think you’re approaching menopause, then suddenly you have a heavy-flow period.

Hormonal fluctuations lead to fluid retention, which affects circulation, reducing the amount of oxygen reaching your uterus, ovaries, and brain. Heavy marijuana use decrease the amount of hormones released, which can cause irregular bleeding.

Eating red meat and dairy products may cause or contribute to hormonal imbalance. Unstable blood sugar levels are an important factor, too. Food allergies, vitamin and/or mineral deficiencies, and depressed mood can also lead to hormonal fluctuations.

Think of your body as a unit. When one part gets out of sync, the whole process can get sidetracked. The more balance you can bring to your body, mind, and spirit, the easier your menopause will be.

Osteoporosis

Osteoporosis is one of the most common and disabling conditions affecting women after menopause. The amount of bone in your skeleton is a function of your genetic inheritance, how much calcium you take in, your vitamin D consumption, your peak amount of bone mass, your rate of bone mass loss, and what drugs and medications you take.

A 2003 study in the Archives of Internal Medicine examined the risk of bone fractures in more than 8,000 women over age 65. All of the women were taking some type of medication that affected the nervous system, such as the most commonly prescribed antidepressants. Over a period of 5 years, researchers found that the women had a significantly greater chance of sustaining fractures compared to women who didn’t take these types of drugs. When the data were broken down more specifically, women who took antidepressants were found to be 70% more likely to suffer disabling hip fractures. Researchers suspect that reduced alertness prompted by the drug use was to blame for the higher incidence of fractures.

Some experts believe the principal determinant of skeletal status is your ovary function. The precise way that estrogen influences bone remodeling is not known, but specific receptors for estrogens have been identified in cells of bone tissue.

Estrogen reduction may have a negative influence on your ability to use calcium. Calcium absorption through the intestine decreases and calcium loss from the kidney increases, resulting in an increased use of skeletal calcium to maintain calcium in the blood. Other factors that increase your risk for osteoporosis include:

• Taking glucocorticoids (cortisone, Decadron, Dexameth, Dexon, Cortef, Medrol, Delta-Cortef, Prelone, Deltasone, Orasone, Panasol, Meticorten, Aristocort, Atolone, Kenacort)

• High consumption of caffeine, animal proteins, and sodas

• Alcohol consumption

• Cigarette smoking

• Prolonged bed rest or lack of weight-bearing exercise

• Taking thyroid and/or parathyroid hormones

• Family history of osteoporosis

During the climacteric, women show a 2% to 5% loss in bone mass a year, but reduced estrogen is not the only factor involved because women lose up to 50% of their total bone mass before menopause. From the ages of 25 to 34, between 6% and 18% of women exhibit low bone density. Hip fracture rates are also high before menopause even occurs. Other factors that can lead to osteoporosis include smoking, excessive alcohol intake, a mother who suffered severe osteoporosis, lack of exercise, a high-fat, high-carbohydrate diet, never having given birth, feeling depressed, a history of ovulatory disturbances, low body fat, and deficiencies in calcium, magnesium, and other minerals.

Sex Drive Reduction and Intercourse Discomfort

It’s on the TV screen and in the movies. Sex is everywhere except in the bedroom. Sociologists at the University of Chicago asked 3,159 women and men chosen to represent the larger U.S. population about their sex lives. They found that 43% of the women and 31% of the men reported some persistent sexual dysfunction such as inability to become aroused or to achieve orgasm.

If you were interested in sex and enjoyed intercourse when you were younger, you’ll probably feel the same way after menopause. If you were never able to achieve orgasm, you may be able to now that you can relax and not worry about becoming pregnant. You may never have explored your body sufficiently or participated in enough foreplay to become aroused.

The opening to your vagina is shielded by the mons veneris (the fatty tissue at the base of your abdomen that becomes covered with hair at puberty), the labia (folds of tissue that extend downward on either side of the vagina), and the clitoris (located at the top of your vulva where the labia meet; it becomes erect when you’re sexually aroused). The external organs of generation in the female are the mons, veneris, the labia majora and minora, the clitoris, the meatus urinaries or opening to the bladder, and the opening to the vagina. The term vulva or pudendum includes all these parts. Between the clitoris and vagina is your urethra, a 11⁄2-inch passageway that leads to your bladder, where urine is stored.

The process that takes place in your body during sexual intercourse remains the same no matter what your age. It consists of four stages:

1. Excitement. In response to touch, visual images, or fantasy, cells in your vagina and nearby glands begin to secrete lubrication fluid, and your heart rate and blood pressure may rise. The clitoris fills with blood and enlarges, your nipples become erect, and your breasts may increase in size. Your vagina lengthens and expands while the fleshy lips that surround your vaginal entrance swell. You may develop a rosy flush that begins over the upper abdomen and spreads over the breasts.

2. Plateau. Tissues in your vagina continue to swell. Your clitoris retracts under the folds of tissue that surround it.

3. Orgasm. If orgasm occurs (and it doesn’t happen each time you have intercourse) a series of intense and pleasurable contractions takes place in the muscles of your vagina, uterus, and sometimes your rectum. The number of orgasmic contractions ranges from 3 to 5 per minute to 8 to 12 per minute.

4. Resolution. In the next 30 minutes, muscle tension decreases and the swelling of tissues subsides. Your heart rate and blood pressure return to normal.

While age doesn’t alter these steps, reduced interest in sex and intercourse discomfort after menopause can be related to vaginal dryness, irritation, and thinning, which can be due to decreased estrogen levels. Depression and anxiety can also interfere with sexual interest. During the climacteric, thinning of the walls of the vagina can lead to dryness, infections, burning, itching, pain with intercourse, discharge, and occasional bleeding unless you take steps to counter these changes.

Once you’ve reached menopause, you should report any bleeding that you have to your health care practitioner. Uterine bleeding after menopause could be a sign of fibroids, a hormonal imbalance, or noncancerous growths in the lining of the uterus, among other health problems.

As estrogen decreases, vaginal secretions are altered in quantity and composition. The possibility of vaginal infection increases because your normal protective lactobacilli that assist with digestion decrease, permitting overgrowth of organisms from the vagina and surrounding area. Burning and irritation can be caused by a chronic discharge because of the change in the composition of secretions. Itching can occur because of the thinning and inflammation of the vagina.

The cells of the vagina and urethra contain high concentrations of estrogen receptors. Within 5 years of estrogen decrease, changes occur in the vagina, urethra, and bladder. Since estrogen increases blood flow in arteries, when estrogen decreases, there is a decrease in blood flow to the vagina and vulva, resulting in atrophy of the vaginal walls, flattening of lubrication glands, and loss of water-retaining ability. These changes can reduce lubrication and shorten and narrow the vaginal wall, which can lead to pain during intercourse.

Between 30% and 50% of women complain of a problem in one or more aspects of sexual functioning, probably due to reduced vaginal lubrication, atrophy of the vagina, and frequent infections. In a study of 887 menopausal women, pain during intercourse was the most common sexual problem, followed by decreased sexual desire, partner problems or dysfunctions, vaginal spasms, and lack of orgasms. The researchers found that the lower the level of estradiol, the greater the discomfort during intercourse.

Low estradiol levels correlate with decreased blood flow to the vagina. This makes vaginal engorgement, which is necessary for comfortable sexual intercourse, impossible. A catch-22 syndrome can develop: discomfort with intercourse, apprehension about intercourse, decreased frequency of intercourse due to fear of pain. Women who stop having intercourse, whether it’s due to loss of sexual desire, discomfort during intercourse, or another reason, develop even more vaginal thinning than women who continue to be sexually active.

Some experts claim that loss of interest in sex is not related to estrogen levels and shouldn’t necessarily occur at menopause. They present statistics to show that more than 40% of menopausal women report no decline in sexual interest. Less than 20% report any significant decline, but women who’ve had oophorectomies, hysterectomies, chemotherapy, or radiation usually have a loss of interest in sex.

Skin Problems

Wrinkles are largely due to cross-linking of proteins. You can reduce them by retarding oxidative damage and free-radical destruction. Dehydration is another cause of dry skin. If you don’t drink enough water, your skin can look dry and saggy. Skin thickness declines just as bone density does after menopause. To have beautiful skin, you must eat healthy foods and drink enough water to feed your skin, and use products that protect it.

Urinary Symptom

Urinary symptoms can include difficulty urinating, frequent and urgent urination, frequent nighttime urination, dribbling of urine, and frequent urinary tract infections. Some experts claim these symptoms will worsen over time.

Other experts claim vaginal and urinary complaints are highly individual and subjective. A physician’s diagnosis of atrophic vaginitis may not always be accompanied by symptoms and vice versa. Urinary frequency and bladder infections sometimes are associated with vaginal thinning and thinning of the urinary apparatus but not always.

Weight Gain

If you don’t exercise daily and don’t watch what you eat, it is easy to gain weight after menopause because you are losing muscle—another reaction to hormonal changes. Don’t talk yourself into thinking weight gain is okay. Being overweight puts you at risk for even more chronic conditions. Obesity contributes to high blood pressure, which is a significant and independent risk factor for heart disease.

Being overweight is also a significant factor in diabetes, which accelerates the laying down of fat in your blood vessels and decreases blood flow through the heart. High blood pressure, obesity, and diabetes often occur together and can contribute to an overall high-risk profile postmenopause.