1. What causes menopause?
   
2. When does menopause begin?
   
3. What can induce or cause early or artificial menopause?
   
4. What are the symptoms of menopause?
   
5. How long does menopause take to become fully realized?
   
6. What is Perimenopause?
   
7. What is Postmenopause?
   
8. Do I need to take a test to diagnose menopause?
   
9. Do I need treatment?
   
10. Am I more susceptible to other diseases during menopause?
    
11. What can I do to deal with menopause symptoms?
    
12. How will my body change as menopause approaches?
    
13. What are hot flashes?
    
14. How long will I have hot flashes?
    
15. I’m having trouble sleeping and I’m tired all the time. Is this due to menopause?
    
16. I’ve been having headaches lately. Can this be due to menopause?
    
17. My memory is not as good as it used to be. Is this aging or is it menopause?
    
18. Does menopause cause moodiness and depression?
    
19. Is menopause causing my feminine dryness?
    
20. Is menopause causing my decrease in sexual desire?
    
21. Does menopause cause urine leakage?
    
22. Is menopause causing my weight problem?
    
23. Is there anything I can do to relieve the aching in my knees?
    
24. Why has my skin started to sag? And what can I do about it?
    
25. Is there anything I can do to stop my hair from thinning?
    
26. My eyes itch and sometimes tear. How can this be treated?
    
27. My gums are starting to recede and it hurts my teeth to eat anything cold. Is this normal?
    
28. What is Hormone Therapy?

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1. What causes menopause?
Normal changes in your reproductive and hormone systems (usually brought on around age 50) cause menopause. As your egg supply ages, your body begins to ovulate less often and this causes your hormone levels to fluctuate, causing changes in your menstrual periods and other symptoms. Over time, your estrogen and progesterone levels drop enough that the menstrual cycle stops.

2. When does menopause begin?
Typically, menopause occurs in the very early fifties. Yet, it must be remembered that each woman’s body follows her own internal rhythm. Consequently, some women experience menopause in their mid-to-late forties while others may continue to have their menstrual periods well into their 50s.

3. What can induce or cause early or artificial menopause?
Your body has its own timeline for when menopause will start and how long it will last. In fact, it's likely that your timeline will be much like your mother's was. However:

Some medical treatments or surgical interventions in which both the ovaries are permanently damaged (radiation therapy, chemotherapy or removal of the pituitary gland) or removed (oophorectomy) and some genetic or autoimmune diseases can cause your periods to stop before age 40 and trigger early menopause. When ovaries cease to function and periods stop prematurely, the condition is known as premature ovarian failure (POF).

Sometimes various lifestyle factors such as diet, stress levels, intake of medication or even excessive exercising can cause the menstrual periods to stop. Lifestyle-induced stoppage of menstrual periods is usually temporary, with periods likely to resume normally once appropriate adjustments are made.

• Smoking: on average, women who smoke reach menopause 1.5 years earlier than those who don't. The longer you have smoked and the more you smoke, the stronger this effect is likely to be.
• Living at high altitudes.
• A vegetarian diet.
• Low body fat (body mass index of 25 or less).
  

4. What are the symptoms of menopause?
Some women have only a few mild symptoms. Others have severe symptoms that disrupt their sleep and daily lives. Symptoms tend to last or get worse the first year or more after menopause. Common symptoms include:

• Irregular periods. (Some women have light periods. Others have heavy bleeding. Your menstrual cycle may be longer or shorter or you may skip periods) (Obviously, these symptoms only apply to perimenopause. Menopause itself doesn’t “officially” begin until your periods have permanently ended.)
• Hot flashes
• Insomnia (trouble sleeping)
• Emotional changes. Some women have mood swings or feel grouchy, depressed or worried.
• Headaches
• Heart palpitations (feeling that your heart is beating too fast or unevenly)
• Problems with remembering or thinking clearly
• Vaginal dryness

Over time, hormones even out at low levels and many symptoms improve or go away. Then you can enjoy being free from periods and birth control concerns.

5. How long does menopause take to become fully realized?
As with most age-related phenomena, menopause happens over a period of time and can be structured into three distinct phases:

• Perimenopause
• Menopause
• Postmenopause

6. What is Perimenopause?
Perimenopause (literally meaning “around menopause”) is the transitionary phase leading up to menopause which can start as early as your 30s or begin well into your 50s. It is said to be complete one year after the final menstrual period and lasts anywhere between 2 to 8 years. This phase is characterized by irregular menstrual periods and/or other symptoms.

7. What is Postmenopause?
The period beyond menopause, whether natural or induced, is referred to as postmenopause. During this state, when a woman has completely stopped ovulating, women may face certain menopause-related symptoms like vaginal dryness. Women should also safeguard against diseases/ ailments associated with diminished estrogen levels.

8. Do I need to take a test to diagnose menopause?
No. You don't need to be tested to see if you have started perimenopause or reached menopause. You will most likely be able to tell based on irregular periods and other symptoms.

If you have heavy, irregular periods, your doctor may want to do tests to rule out a serious cause of the bleeding. Heavy bleeding may be a normal sign of perimenopause. But it can also be caused by infection, disease or a pregnancy problem.

You may not need to see your doctor about menopause symptoms. But it is important to keep up your annual physical exams. Your risks for heart disease, cancer and bone thinning (osteoporosis) increase after menopause.

9. Do I need treatment?
Menopause is a natural part of growing older. You don't need treatment for it unless your symptoms bother you. If your symptoms are upsetting or uncomfortable, you don't have to suffer through them. There are remedies that can help, including, of course, Estrofil.

To assess the impact of menopause symptoms on your quality of life, download and take this standard self-scoring Quality of Life Questionnaire.

The first step is to have a healthy lifestyle. This can help reduce symptoms and also lower your risk of heart disease and other long-term problems related to aging.

• Make a special effort to eat well.
  • Choose a heart-healthy diet that is low in saturated fat and includes plenty of fish, fruits, vegetables, beans and high-fiber grains and breads.
• Include plenty of calcium in your diet to help your bones stay strong.
  • Get 1,200 mg a day after age 50 (plus at least 400 IU of vitamin D to help your body use the calcium).
  • Low- or nonfat dairy products are a great source of calcium.
• Get regular exercise.
  • Exercise can help you manage your weight, keep your heart and bones strong and lift your mood.
• Limit caffeine, alcohol and stress.
  • These things can make symptoms worse.
  • Avoiding them may help you sleep better.
• If you smoke, stop.
  • Quitting smoking can reduce hot flashes and long-term health risks.
    
    

If lifestyle changes are not enough to relieve your symptoms, you can consider other measures, such as:

• Estrofil: the all-natural herbal supplement proven to reduce most menopausal symptoms.
• Meditative breathing exercise (“paced respiration”). Studies have shown that it can help reduce hot flashes and emotional symptoms.
• Yoga or biofeedback to help reduce stress. High stress is likely to make your symptoms worse.
  If you have severe symptoms, you may want to ask your doctor about prescription medicines. Choices include:
• Low-dose birth control pills before menopause.
• Low-dose hormone replacement therapy (HRT) after menopause.
• Antidepressants.
• A medicine called clonidine (Catapres) that is usually used to treat high blood pressure.

Remember that all prescription medicines for menopause symptoms have possible risks or side effects. A small number of women develop serious health problems when taking Hormone Replacement Therapy. Be sure to talk to your doctor about your possible health risks before you start a treatment for menopause symptoms.

Remember, it is still possible to become pregnant until you reach menopause. To prevent an unwanted pregnancy, keep using birth control until you have not had a period for 1 full year.

10. Am I more susceptible to other diseases during menopause?

Heart disease
Many women think of heart disease as a man’s disease. In reality, cardiovascular diseases (diseases of the heart and circulatory system) are the number one killer of women in North America. After age 55, more than half of all deaths in women are caused by cardiovascular disease. Risk for this disease increases after menopause.

Other important precautions that post-menopausal women can take are to engage in regular physical activity, avoid getting overweight and stay away from habits such as smoking and excessive intake of alcohol.

Diabetes
A serious health problem that afflicts over 30 percent of women worldwide, diabetes is a silent killer as many people ignore it until it is too late. The risk from diabetes has increased manifold over the years due to increasing levels of obesity in several societies. With age, the probability of developing the most common type of diabetes – Type 2- increases, although it is preventable with proper care. Women approaching menopause are specially required to pay greater attention to their lifestyle, get themselves duly screened and also control their weight.

With diabetes, either the body doesn’t produce enough insulin or the cells aren’t able to use the insulin or a person is so overweight that normal insulin production is inadequate. Insulin transports the glucose from circulating blood into the cells. This is necessary for the body to utilize glucose – sugar - the basic fuel for the cells. When glucose doesn’t go into the cells, it builds up in the blood. If a fasting blood glucose level is above 126 mg/dL (7.0 mmol/L), diabetes is diagnosed. 

Osteoporosis
It is common knowledge that human bones weaken with age. In the case of women, bone strength weakens even further post-menopause. Bones get more fragile and are more vulnerable to fractures. Postmenopausal osteoporosis, however, is a skeletal disorder in which bone strength has weakened to a point where the bone is fragile and at higher risk for fractures. Bone strength and thus fracture risk are dependent on both bone quality and bone mineral density. Risk for this disorder increases after menopause. Osteoporosis results in bone fractures, including that of the spine and causes chronic back pain. In extreme cases, osteoporosis leads to hip fractures which in some cases results in permanent disability or even death.

For additional information on osteoporosis from the National Institutes of Health, click here.

Cancer
Menopause is not associated with increased cancer risk. However, some cancer rates typically increase with age so postmenopausal women should be informed about the most common cancers that may affect them. Also, some of the therapies used to treat menopause symptoms are associated with an increased or a decreased risk for certain types of cancer.

Breast cancer is the most common amongst women. Endometrial (Uterine) cancer, Cervical cancer, Ovarian cancer, Lung cancer and Colon & Rectal Cancer are the other common types that post-menopausal women may develop. With timely detection and treatment, most of these are curable. Women who are going through perimenopause or those who have already reached menopause should undergo at least an annual breast and pelvic examination.

It must also be remembered that certain therapies used in treating menopausal symptoms also increase chances of cancer.

11. What can I do to deal with menopause symptoms?
These options for overcoming menopausal symptoms include alternative therapies such as traditional Chinese medicine (TCM), prescription drugs as well as lifestyle changes. Other than basic lifestyle changes, women are advised to consult with their doctors before starting ‘treatment’; after all, treating menopause is tantamount to resisting a natural process.

Lifestyle modifications
Simplistic though it may seem, a healthy lifestyle is often one of the best deterrents, if not a total cure, for various problems. It is no different with menopausal symptoms either; women leading a healthy lifestyle tend to encounter fewer problems and are also able to cope much better.

Basically, a healthy lifestyle entails good, healthy food, an optimum level of exercise, adequate sleep/ rest, staying stress-free and away from addictive, undesirable habits.

Following a strict regimen of Yoga / similar exercise method –Tai Chi, for example, can be a great stress-reliever, which will go a long way in overcoming some of the recurring symptoms of menopause. Meditation and breathing exercises are also quite helpful in not only providing much-needed emotional calmness but also mitigating hot flashes.

Consuming higher quantities of soy may reduce menopausal symptoms, although there are contradictory studies on this. Another advantage of soy consumption is that it helps keep the bones strong and acts against the natural decline in bone density, a common issue of concern for post-menopause women.

Alternative Medicine/Therapy
Even after making lifestyle adjustments, if the menopausal symptoms are too persistent and cause for discomfort, women can seek recourse in alternative medicine/ therapy. For example, traditional Chinese medicine (TCM) offers some good options.

Estrofil, an all-natural TCM nutritional supplement, has proven effective in reducing most menopause symptoms with virtually no side effects.

Regular prescription drugs
Those who find their symptoms unbearable have the choice of consulting a licensed medical practitioner and taking prescription drugs. Generally, the ‘treatment’ offered by a doctor for menopausal symptoms would include a low dosage of birth control pills (during the perimenopause stage), anti-depressants, or a medicine to counter high blood pressure. In the post menopause stage, some doctors might also recommend Hormone Replacement Therapy (HRT). Since the probability of getting pregnant exists until a woman attains menopause, women are advised to take appropriate birth control measures during perimenopause if they wish to avoid getting pregnant.

Taking prescription drugs or medical treatment for menopause should be the last resort, as these are likely to have some undesirable long term side effects, particularly with Hormone Replacement Therapy

12. How will my body change as menopause approaches?
Each woman’s menopause experience is different. The greatest differences observed are between women who have natural menopause and those whose menopause is early or induced, which typically requires specialized care. Many women who have natural menopause report no physical changes at all during the perimenopausal years except irregular menstrual periods that eventually stop when menopause is reached. In addition to irregular menstrual periods, some women experience symptoms of hot flashes, difficulty sleeping and/or vaginal dryness. The severity of these changes varies from woman to woman, but for the most part, they are perfectly natural and normal. In fact, some experts and women prefer not to call perimenopausal changes “symptoms,” a term usually reserved to describe diseases.

13. What are hot flashes?
The most common menopause-related discomfort is the hot flash (more accurately called a hot flush). Although their exact cause is still a matter of speculation, hot flashes are thought to be the result of changes in the hypothalamus, the part of the brain that regulates the body’s temperature. If the hypothalamus mistakenly senses that a woman is too warm, it starts a chain of events to cool her down. Blood vessels near the surface of the skin begin to dilate (enlarge), increasing blood flow to the surface in an attempt to dissipate body heat. This produces a red, flushed look to the face and neck in light-skinned women. It may also make a woman perspire to cool the body down. An increased pulse rate and a sensation of rapid heart beating may also occur. Hot flashes are often followed by a cold chill. A few women experience only the chill.

14. How long will I have hot flashes?
Hot flashes typically stop on their own over time and may not require any treatment. If treatment is needed, hot flashes can usually be reduced or eliminated completely. 

15. I’m having trouble sleeping and I’m tired all the time. Is this due to menopause?
Some women experience sleep disturbances (insomnia) around menopause, especially if hormone changes provoke hot flashes during the night. Sleep is adequate when one can function in an alert state during desired waking hours. Most adults require 6 to 9 hours of sleep each night. Treatment of sleep disturbances should first focus on improving sleep routine with good sleep habits. When lifestyle changes fail to alleviate sleep disturbances, a clinician should be consulted to discuss other options and to rule out sleep disorders, such as thyroid abnormalities, allergies, anemia, restless leg, depression, or sleep apnea (breathing problems).

16. I’ve been having headaches lately. Can this be due to menopause?
Studies suggest that hormones may play a role in headaches. Women at increased risk for hormonal headaches during perimenopause are those who have already had headaches influenced by hormones, such as those with a history of headaches around menstrual periods or when taking oral contraceptives. Hormonal headaches typically stop when menopause is reached and hormone levels are consistently low. Most headaches do not require treatment or can be treated with nonprescription pain medications. Some headaches, however, can be serious. More serious headaches, including migraines, may require prescription drugs. 

17. My memory is not as good as it used to be. Is this aging or is it menopause?
There is no firm evidence that memory or other cognitive skills actually decline because of natural menopause. However, difficulty remembering and concentrating are common complaints during perimenopause and the years right after menopause. More research is needed to determine the cause of these complaints. Although studies are lacking to prove the association, sleep disturbances and hot flashes may contribute to these symptoms, as well as dealing with various midlife stressors. Remaining physically, socially and mentally active may help prevent memory loss. Women who are concerned about declining cognitive performance are advised to consult with their healthcare provider.

18. Does menopause cause moodiness and depression?
Few scientific studies support the belief that menopause contributes to true clinical depression, severe anxiety or erratic behavior. However, some perimenopausal women report symptoms of tearfulness, mood swings, and feeling blue or discouraged.
It is unclear whether these mood symptoms are related to the gradual decline in ovarian hormone levels but sleep deprivation associated with night sweats often results in fatigue, irritability and moodiness. Abrupt hormonal fluctuations during perimenopause may have an impact on these symptoms as well. During their reproductive years, most women become accustomed to their own hormonal rhythm. During perimenopause, this rhythm changes and the erratic hormonal ups and downs — although normal — can create a sense of loss of control that can be upsetting.

Sometimes, coping skills and lifestyle changes are not sufficient to relieve symptoms of stress. These symptoms may be a side effect of medication, a symptom of a medical condition, or the result of clinical depression or anxiety. A healthcare provider can help determine the cause of mental health stressors, assess options, and prescribe appropriate treatment.

19. Is menopause causing my feminine dryness?
During their life, at least one-third of all women will experience some troubling symptoms in the vulvovaginal area (external female genitals and vagina). These symptoms range in severity from mildly annoying to debilitating—and include vaginal discharge, irritation, burning, dryness, itchiness and pain (both with and outside of sexual activity). There are many possible causes of vulvovaginal symptoms. Women around the time of menopause should not assume that vulvovaginal problems are due to reduced estrogen levels. Symptoms should be investigated by a clinician to identify the cause and possible treatment. A thorough, regular evaluation of vulvovaginal health is recommended to all women at menopause and beyond, regardless of whether or not they have symptoms or are sexually active.

20. Is menopause causing my decrease in sexual desire?
Sexual feelings and activities are a natural part of living. Many women remain sexually active throughout their postmenopausal years. In general, sex drive decreases with age in both sexes but each individual is different. Although some experience a significant decline in desire, a few have increased interest, while others notice no change at all. Research shows, however, that sexual problems are common for both women and men of all ages, with women being two to three times more likely than men to be affected by low desire. Low sexual desire is especially common in relationships of long duration. A clinical evaluation can help to identify any underlying medical or psychological causes of low sexual desire, which can then be treated as appropriate for each individual woman.

21. Does menopause cause urine leakage?
Urinary symptoms, including incontinence (persistent, involuntary leaking of urine), become more common with aging. Women are much more prone to the occasional episode of urine leakage than men. These symptoms may be partially affected by menopause. As menopause approaches and during the years that follow, lack of estrogen can cause thinning of the lining of the urethra, the outlet for the bladder. With aging, the surrounding pelvic muscles may weaken. As a result, women are at increased risk for urinary incontinence.

22. Is menopause causing my weight problem?
In their 40s and 50s, women often gain weight and they sometimes attribute this gain to menopause. Midlife weight gain appears to be mostly related to aging and lifestyle, but menopause also contributes to the problem. In general, fewer calories are needed after midlife because less energy is expended. Whether weight gain is linked to menopause itself and/or age, the important thing is that studies shows that weight gain around menopause years can be prevented by exercise and diet — by minimizing fat gain and maintaining muscle, thereby reducing body size and burning more calories. Estrofil may support menopausal weight control.

23. Is there anything I can do to relieve the aching in my knees?
Sometimes the joints are just achy or stiff from overuse, but a woman’s healthcare provider should be consulted to rule out arthritis, a more serious joint disease. Maintaining a healthy weight will help with achy knees. Mild pain can often be managed with acetaminophen (Tylenol), while more severe pain may require an anti-inflammatory drug such as ibuprofen (Advil, Motrin), although long-term use of anti-inflammatory drugs may lead to ulcers. In addition, long-term use of the supplement glucosamine has been shown to relieve joint pain in some studies with no serious side effects (although women with seafood allergy should avoid it). Estrofil has also proven effective in relieving joint pain.

24. Why has my skin started to sag? And what can I do about it?
Aging skin undergoes normal loss of collagen and elasticity, which creates slight sags and wrinkles. It also becomes more dry and flaky. Hormones play an important role in skin health. Diminished levels of estrogen at menopause contribute to a decline in skin collagen and thickness, which is more rapid in the years right after menopause than in later ones. Estrogen therapy may have beneficial effects on skin, but it cannot reverse genetic aging or sun damage, or change any risk of skin cancer. Estrogen therapy has significant risks and should never be used solely for its beneficial effect on skin. Estrofil has been reported to improve skin tone.

25. Is there anything I can do to stop my hair from thinning?
Aging increases the likelihood that hair will become gray and more brittle. In addition, excessive hair growth (hirsutism) may occur in areas of the body where hair follicles are especially androgen-sensitive, such as the chin, upper lip, and cheeks. The menopause-related shift in the balance between androgen and estrogen can also result in the opposite effect—hair loss. Eating a healthy diet, adding a daily multi-vitamin or herbal supplement such as Estrofil and avoiding harsh chemicals and sunlight that dry the hair will help keep hair healthy. For mild hirsutism, treatments include plucking, waxing, shaving, bleaching, electrolysis and laser treatment. Treating severe hirsutism or hair loss can be more of a challenge because the cause is often difficult to determine. Consulting a dermatologist is advised.

26. My eyes itch and sometimes tear. How can this be treated?
After menopause, some women report chronically dry and scratchy eyes, often along with light sensitivity, blurred vision, increased tearing, or swollen or reddened eyelids—a condition called chronic dry eye. This condition can occur in climates with dry air as well as from certain diseases (such as Sjögren’s syndrome) and with the use of some drugs (such as allergy medications and antidepressants). Consult your healthcare provider about the therapies available to help provide relief. 

27. My gums are starting to recede and it hurts my teeth to eat anything cold. Is this normal?
With aging come increased dental problems, including tooth loss, need for dentures, gum recession, higher risk of gum tissue injury, “burning” mouth and tongue, general hot and cold tooth sensitivity, and decreased bone mineral density (BMD) in the jawbone. While some of these problems are related to estrogen decline at menopause, other causes include advancing age, inadequate intake of calcium and vitamins, medication side effects, and medical conditions such as anemia or diabetes. Practicing good oral hygiene is extremely important. Brushing and flossing daily, regular dental checkups, and professional dental cleaning twice yearly are all recommended. A woman’s primary healthcare provider should be advised of any changes observed by her dental professional, as some of these changes can be indicators of serious health problems elsewhere in the body.


28. What is Hormone Therapy?
Hormone therapies are the prescription drugs prescribed to treat menopause symptoms such as estrogen or progesterone.

Estrofil is estrogen and hormone-free, so it is exempt from the dangers and side effects of these regimens.