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LONG-TERM EFFECTS OF MENOPAUSE
Cardiovascular disease is the major cause of death in post-menopausal women. Smoking, family history, obesity, hypertension, diabetes, and high cholesterol levels increase your risk of developing cardiovascular disease.
Cardiovascular disease is still the number one killer of Canadian women, causing 45% of all deaths, as compared to death due to breast cancer at 4%. 25% of women will have a heart attack or stroke between the ages of 70 and 80. We know that the incidences of heart disease, angina, heart attacks and strokes are more common in men than in women up to the menopause. Thereafter, women catch up to men in their risk of cardiovascular disease when they are estrogen-deficient and post-menopausal.
Scientific studies suggest that hormone replacement therapy (HRT) can reduce the risk of cardiovascular-related deaths by 40-50%. This reduction of personal risk can be further reduced by improving one's lifestyle by eating a low fat, low cholesterol diet, regular exercise, cessation of smoking and reduction of stress.
| The majority of scientific studies agree that hormone therapy protects against cardiovascular disease |
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Also, small physiological doses of hormones, such as are used in HRT, keep blood vessels dilated, and therefore nourish vital areas such as the heart and brain. This also ensures adequate nourishment for other tissues, such as joints and skin. The majority of scientific studies agree that HRT protects against cardiovascular disease. It is estimated that proper HRT is effective in reducing the risk of cardiovascular-related deaths by 40 to 50%. In other words, almost half of the deaths attributed to this disease can be avoided.
Therefore, estrogen is especially vital for women at increased risk for heart disease including the risk factors mentioned above. Obviously life style is vitally important, including a low fat diet, physical fitness, cessation of smoking, decreasing stress and timely treatment of high blood pressure and high cholesterol.
"A disease characterized by low bone mass and microarchitectural deterioration of bone tissue leading to enhanced bone fragility and a consequent increase in fracture risk"--World Health Organization
Osteoporosis is characterized by a reduction in bone mass at a rate of 2-4% per year, after menopause. Osteoporosis often leads to vertebral compression and excessive curvature of the spine as well as loss of height, especially during the post-menopausal years. Three times more women than men suffer from osteoporosis. 50% of women will suffer from osteoporosis by the age of 75. 25% of women over 60 years of age suffer from compression fractures. In women, the loss of bone mass is more closely related to the decline of ovarian function than to age.
Osteoporosis can also occur prematurely in young women who have had their ovaries surgically removed, or in those who experience a naturally early menopause, before the age of 40.
| It is important to safeguard against osteoporosis, because even if there are no visible signs, it can often lead to fractures |
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Other factors that can significantly contribute to this disease in certain women are: a family history of osteoporosis, lack of physical activity, excessive consumption of cigarettes and alcohol, having a small, thin body build, eating foods lacking in calcium, and taking certain medications long-term, such as cortisone or even thyroid supplements if the dose is too high.
There is a high social cost of hip and vertebral fractures. These fractures cause pain, deformity and loss of mobility/independence. Moreover, secondary complications from hip fractures can result in an important loss of autonomy and increased mortality. 15 to 25% of patients die secondary to osteoporotic hip fractures or its complications (surgical; pneumonia; cardiac; blood clots). The survivors may also be seriously disabled and up to 30% never walk again.
Gynecological Issues:
The drop in estrogen production results in a thinning of the vagina and a loss of elasticity of the mucous membranes of the vulva, vagina and other tissues (eg the breasts). The decrease in levels of estrogen can lead to vaginal dryness, itching, and sometimes discomfort and pain during sexual intercourse. Vaginal moisturizers can relieve this.
Urinary Issues:
The bladder and the urethra (the channel through which you urinate) also responds to estrogen, and when this is deficient, symptoms such as slowing of the urinary stream, difficulty in urinating and increase in urination both during the day and especially at night, occur. There may also be recurrent episodes of bladder infections and urinary incontinence (loss of urine and poor control when coughing or running).
Loss Of Lidibo
With the onset of menopause, a drop in estrogen and testosterone occurs. A woman often feels a decrease or loss of sexual drive. This can be improved by supplementing these low hormone levels with estrogen and occasionally testosterone.
There is an acceleration in the aging of the skin due to environmental factors such as sunlight, chemical exposure and stress. A drop in estrogen after menopause speeds up this process, resulting in a decrease of elasticity and turgor. The skin becomes more dry; wrinkles and fine lines appear to be more significant. Hair can become finer and more dry as well.
These symptoms can be improved with good skin care, chemical skin peels and hormone replacement therapy.
Vaginal moisturizers replenish the lost moisture and restore the elasticity within the vagina, which may be caused by the decreased level of estrogen. With prolonged use they can also help normalize vaginal pH. Products such as Replens are effective due to the length of time that they remain in the vagina. This is possible due to their bioadhesive (biological - adhesive) properties, which help such products adhere to cells lining the vaginal walls, and thereby allow for the absorption of water into these
cells.
We know that a common complaint of perimenopausal women is change in their mood and mental well-being. This can continue and even progress in some women. A decrease in estrogen may lead to a blunting of cognitive function and memory loss.
More severe mood swings can at times progress to clinical depression. This can result in a woman feeling so depressed that she cannot function, lacks energy and interest in day to day activities, and may become suicidal. This becomes a medical condition that requires immediate attention.
Some studies have suggested that in certain women with a family history of Alzheimer's disease, the onset of menopause can result in the development of this disorder. Thus, it has been postulated that estrogen replacement therapy may delay the onset of the disease; however, a recent study has not supported this idea.
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