Menopause For Dummies E-Book

Sarah Brewer

• Herausgeber: John Wiley & Sons
• Kategorie: Ratgeber
• Sprache: Englisch

Seitenzahl: 524

Veröffentlichungsjahr: 2011

Beschreibung

Every woman experiences the menopause in different ways, so you need to know what to expect in order to help yourself. This book explains the various stages of the menopause, including the perimenopause, and helps you understand how it can affect your body and your emotions. It evaluates all the options available--including HRT and explains what treatment and lifestyle changes will help you stay healthy and happy. With in-depth coverage of HRT, covering new developments and weighing up the risks and benefits, advice on adopting an holistic approach to managing the symptoms and side effects including conventional medicine, and alternatives, diet and lifestyle changes, Menopause For Dummies will help you make the right decisions and stay in control.

Leseprobe

Menopause For Dummies®

by Dr Sarah Brewer, Marcia L. Jones, PhD, and Dr Theresa Eichenwald

Menopause For Dummies®

Published by John Wiley & Sons, Ltd The Atrium Southern Gate Chichester West Sussex PO19 8SQ England

E-mail (for orders and customer service enquires): [email protected]

Visit our Home Page on www.wiley.com

Copyright © 2007 John Wiley & Sons, Ltd, Chichester, West Sussex, England

Published by John Wiley & Sons, Ltd, Chichester, West Sussex

All Rights Reserved. No part of this publication may be reproduced, stored in a retrieval system or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, scanning or otherwise, except under the terms of the Copyright, Designs and Patents Act 1988 or under the terms of a licence issued by the Copyright Licensing Agency Ltd, 90 Tottenham Court Road, London, W1T 4LP, UK, without the permission in writing of the Publisher. Requests to the Publisher for permission should be addressed to the Permissions Department, John Wiley & Sons, Ltd, The Atrium, Southern Gate, Chichester, West Sussex, PO19 8SQ, England, or emailed to [email protected], or faxed to (44) 1243 770620.

Trademarks: Wiley, the Wiley Publishing logo, For Dummies, the Dummies Man logo, A Reference for the Rest of Us!, The Dummies Way, Dummies Daily, The Fun and Easy Way, Dummies.com and related trade dress are trademarks or registered trademarks of John Wiley & Sons, Inc. and/or its affiliates in the United States and other countries, and may not be used without written permission. All other trademarks are the property of their respective owners. Wiley Publishing, Inc., is not associated with any product or vendor mentioned in this book.

LIMIT OF LIABILITY/DISCLAIMER OF WARRANTY: The contents of this work are intended to further general scientific research, understanding, and discussion only and are not intended and should not be relied upon as recommending or promoting a specific method, diagnosis, or treatment by physicians for any particular patient. The publisheR, the author, AND ANYONE ELSE INVOLVED IN PREPARING THIS WORK make no representations or warranties with respect to the accuracy or completeness of the contents of this work and specifically disclaim all warranties, including without limitation any implied warranties of fitness for a particular purpose. In view of ongoing research, equipment modifications, changes in governmental regulations, and the constant flow of information relating to the use of medicines, equipment, and devices, the reader is urged to review and evaluate the information provided in the package insert or instructions for each medicine, equipment, or device for, among other things, any changes in the instructions or indication of usage and for added warnings and precautions. Readers should consult with a specialist where appropriate. The fact that an organization or Website is referred to in this work as a citation and/or a potential source of further information does not mean that the author or the publisher endorses the information the organization or Website may provide or recommendations it may make. Further, readers should be aware that Internet Websites listed in this work may have changed or disappeared between when this work was written and when it is read. No warranty may be created or extended by any promotional statements for this work. Neither the publisher nor the author shall be liable for any damages arising herefrom.

For general information on our other products and services, please contact our Customer Care Department within the U.S. at 800-762-2974, outside the U.S. at 317-572-3993, or fax [phone].

For technical support, please visit www.wiley.com/techsupport.

Wiley also publishes its books in a variety of electronic formats. Some content that appears in print may not be available in electronic books.

British Library Cataloguing in Publication Data: A catalogue record for this book is available from the British Library

ISBN: 978-0-470-06100-8

Printed and bound in Great Britain by Bell & Bain Ltd., Glasgow

10 9 8 7 6 5 4 3 2 1

About the Authors

Dr Sarah Brewer qualified as a doctor in 1983 from Cambridge University. She was a full-time GP for five years and now works in nutritional medicine and sexual health. Sarah is currently completing an MSc in Nutritional Medicine at the University of Surrey, Guildford.

Although her first love is medicine, her major passion is writing. Sarah writes widely on all aspects of health and has written over 40 popular self-help books. She is a regular contributor to a number of newspapers and women’s magazines, and appears regularly on TV and radio. She was voted Health Journalist of the Year 2002.

Marcia L. Jones, PhD, had life experience in fertility treatment, perimenopause, and menopause. In 1991, while attempting to start a family at the age of 38, she scoured bookstores searching for down-to-earth information on the likely problems and how to proceed. Her doctor directed her to the only information available at the time, photocopies of technical articles from medical journals and pamphlets written by pharmaceutical companies trying to sell product. Today, many women are delaying childbirth, so the issue of fertility fits nicely into a discussion of perimenopause and menopause. These experiences served as her primary motivation for writing this book. She became certain that women in their mid-thirties to late forties need current, unbiased, reliable information on perimenopause and menopause written for a layperson.

Thanks to the efforts of her doctor, Jane Chihal, MD, a contributor to this book and a recognised expert on menopause and fertility, Dr Jones became the proud mother of two girls.

Dr Jones received her PhD from Southern Methodist University in anthropology. She led many research expeditions in the Middle East and served as an associate professor of anthropology at the University of Tulsa.

Growing weary of academia, Marcia shifted her career focus and entered the fast-paced world of software, achieving the rank of chief operating officer and co-owner of Criterion, a company that developed human-resource software for Fortune 1000 organizations. She grew Criterion from a $1.5 million company to a $10 million company and recently sold it to Peopleclick. Over the past 18 years, she wrote many articles on people in the workforce and taught courses in the use of human-resource technology as an adjunct professor in the Graduate School of Management at the University of Dallas.

Dr Theresa Eichenwald has extensive experience caring for menopausal women as an internist at hospitals in New York, Washington D.C., Philadelphia, and, most recently, Texas. She has taught at Albert Einstein School of Medicine and Mount Sinai Medical Center in New York.

In addition to teaching and caring for patients, Dr Eichenwald has authored a number of articles for professional journals, covering topics such as breast cancer and ovarian tumours as, well as patient education pamphlets. She is a member of the American Medical Association, the American College of Physicians, and in medical school participated in the American Medical Student Association Task Force on Aging.

Authors’ Acknowledgements

From Sarah: I’d like to thank Marcia L. Jones and Theresa Eichenwald, authors of the original US version of Menopause For Dummies. The quality of their original script made my job easy, as I had so very little to do when adapting their excellent book for the UK market.

From Marcia: I am so grateful to the many talented people who have helped create this book. Special thanks to Dr Theresa Eichenwald for her contributions, collaborations, and review of early versions of this document. Thanks also to her husband Kurt Eichenwald and their three young sons for letting Theresa take the time to author this book.

Acknowledgement is due the Cooper Institute in Dallas for their continuing contributions in the field of preventative medicine.

Thanks to my women friends who insisted that this book was not only needed, but long overdue.

This book would never have gotten to Wiley Publishing if not for Richard and Ginger Simon.

Publisher’s Acknowledgments

We’re proud of this book; please send us your comments through our Dummies online registration form located at www.dummies.com/register/.

Some of the people who helped bring this book to market include the following:

Acquisitions, Editorial, and Media Development

Development Editor: Simon Bell

Commissioning Editor: Samantha Clapp

Developer: Colette Holden

Copy Editor: Kim Vernon

Proofreader: Lesley Green

Content Editor: Steve Edwards

Executive Editor: Jason Dunne

Executive Project Editor: Martin Tribe

Cover Photo: Getty Images/David Lees

Cartoons: Ed McLachlan

Composition Services

Project Coordinator: Jennifer Theriot

Layout and Graphics: Claudia Bell, Joyce Haughey, Stephanie D. Jumper, Laura Pence

Proofreaders: David Faust

Indexer: Aptara

Special Help

Brand Reviewer: Janet Sims

Publishing and Editorial for Consumer Dummies

Diane Graves Steele, Vice President and Publisher, Consumer Dummies

Joyce Pepple, Acquisitions Director, Consumer Dummies

Kristin A. Cocks, Product Development Director, Consumer Dummies

Michael Spring, Vice President and Publisher, Travel

Kelly Regan, Editorial Director, Travel

Publishing for Technology Dummies

Andy Cummings, Vice President and Publisher, Dummies Technology/General User

Composition Services

Gerry Fahey, Vice President of Production Services

Debbie Stailey, Director of Composition Services

Contents

Title

Introduction

About This Book

Foolish Assumptions

How This Book Is Organised

Conventions Used in This Book

Where to Go from Here

Part I : The Main Facts about Menopause

Chapter 1: Reversing Puberty

Defining Menopause

Anticipating Menopause

Experiencing Menopause

Making Time for Menopause

Treating Menopause

Promoting Longevity

Chapter 2: Talking Biology and Psychology: Your Mind and Body During Menopause

Setting the Stage

Making the Menstrual Cycle and Hormone Connection

Surveying the Role of Hormones

Acting Out the Stages of Menopause

Prepping for Surgical Menopause

Chapter 3: Getting in Sync with the Symptoms

Kicking Things Off with Perimenopausal Symptoms

Meeting the Menopausal Symptoms

Unravelling the Mystery of Menopause

Part II : The Effects of Menopause on Your Body and Mind

Chapter 4: Boning Up on Your Bones

Homing In on Bone Health

Keeping Pace with Bone Reconstruction

Understanding Osteoporosis

Preventing Osteoporosis by Managing Your Risk Factors

Finding Out whether You Have Osteoporosis

Treating Osteoporosis

Chapter 5: Taking Heart

Connecting Cardiovascular Disease and the Menopause

Considering Your Cardiovascular System

Understanding Cardiovascular Diseases

Recognising Risk Factors of Cardiovascular Disease in Women

Being Smart about Your Heart

Chapter 6: Making Sense of Vaginal and Urinary Changes

Doc, Can We Talk?

Vaginal Atrophy and Other Issues

Hold It! We Need to Talk about Urinary Problems

Chapter 7: Surveying Surfaces and Sinuses: Your Skin, Hair, and Nasal Cavities

Getting the Skinny on Skin

Sniffing Out Nasal Changes

Handling Hairy Issues

Chapter 8: Spicing Up Your Sex Life

Looking at Menopause and Your Libido

Talking about Testosterone

Keeping Sex Sexy

Focusing on Fertility and Beyond

Chapter 9: Thinking through Mental and Emotional Issues

Understanding the Mental and Emotional Stresses of Menopause

Separating Menopausal Symptoms from Psychological Disorders

Dealing With the Head Games

Sorting Out the Commotion in Your Emotions

Managing Your Family

Retiring, gracefully or not

Part III : Treating the Effects

Chapter 10: Homing in on Hormone Replacement Therapy

Defining Hormone Replacement Therapy

Ticking through the Treatments

Pondering Pills, Patches, and Pomades: A Smorgasbord of Delivery Options

Searching for Sources

Doing the Dosing

Chapter 11: Focusing on HRT and Your Heart

Meeting the Players: Hormones and Your Heart

Understanding the Significance of the Women’s Health Initiative Study

Skimming the Fat: HRT and Your Blood

Keeping the Pipes Clean: HRT and Your Blood Vessels

Oiling the Pump: HRT and Your Heart

Chapter 12: Balancing HRT and Breast Cancer

Beginning with Breast Basics

Defining Breast Cancer

Taking Care of Your Breasts

Establishing Oestrogen’s Role

Assessing Your Risk of Breast Cancer

Evaluating the Facts about HRT Risks

Finding the Right HRT Programme for You

Chapter 13: Talking About HRT and Other Cancer Risks

Colorectal Cancer

Endometrial (Uterine) Cancer

Cancers Unaffected by HRT

Chapter 14: Revealing the Links between HRT and Other Health Conditions

Dealing with Deep-Vein Thrombosis and Other Impeding Issues

Dissecting Diabetes

Facing the Facts about Fibromyalgia

Getting the Goods on Gall Bladder Disease

Looking at Lupus

Monitoring Migraines

Chapter 15: Making the Decision about HRT

Outlining Attitudes about HRT

Weighing the Benefits and Risks of HRT

Summing Up the Studies

Presenting the Options for Perimenopause

Quitting HRT

Finding Your Comfort Zone

Chapter 16: Taking an Alternative Route: Non-Hormone Therapies

Ploughing through the Pros and Cons of Herbs

Relieving Your Symptoms with Plants

Avoiding Problems with Plants

Getting Touchy about Acupuncture

Soothing Symptoms with Relaxation Therapies

Slip Sliding Away with Topical Treatments

Chapter 17: Treating Common Menopause-Related Conditions without Hormone Therapy

Battling Bone Loss and Osteoporosis with Medication

Controlling Cardiovascular Disease

Part IV : Lifestyle Issues for Menopause and Beyond

Chapter 18: Eating for The Change

Eating to Promote Good Health

Eating to Prevent or Contain Problems

Weighing in on the Weight Issue

Chapter 19: Focusing on Fitness

Exercising to Enhance Your Menopausal Years

Focusing on the Fundamental Facets of Fitness

Creating a Personal Fitness Plan

Exercising to Overcome Osteoporosis

Exercising to Protect Your Heart

Part V : The Part of Tens

Chapter 20: Exposing (More than) Ten Menopausal Myths

You’re Too Young for the Menopause in Your Thirties and Forties

Menopause Is a Medical Condition that Needs Treatment

Menopause Isn’t a Disease, So You Don’t Need to See a Doctor

You Lose the Urge to Have Sex after the Change

Irregular Vaginal Bleeding Always Means Cancer

Humps Accompany Old Age – End of Story

Only HRT Can Relieve Your Symptoms

Women Don’t Need to Worry about Heart Attacks

Most Women Get Really Depressed During Menopause

You Break a Bone if You Exercise too Hard

A Blood Test Can Determine whether You’re Going through Menopause

Chapter 21: Meeting More Than Ten Medical Tests for Menopausal Women

Pelvic Examination and Cervical Smear

Rectal Examination

Colonoscopy

Bone-Density Screening

Mammogram

Cholesterol Screening

Fasting Blood-Glucose Test

Thyroid Screening

CA125 Test

Ovarian Hormone Screening

Stress Test

Chapter 22: Running Through Ten Terrific Fitness Programmes for Menopausal Women

Core-Stability Training

Cycling

Elliptical Training

Pilates

Running

Swimming

T’ai Chi

Walking

Water Aerobics

Yoga

Part VI : Appendixes

Appendix A: Glossary

Appendix B: Resources

Brilliant Books about Menopause, Health, Fitness, and Related Issues

Cracking Contact Details for Women

: Further Reading

Introduction

We wrote this book to give women of all ages a clear view of the physical, mental, and emotional changes related to menopause. For generations, women of all ages have wandered blindly into menopause without knowing what to expect. Oh, you probably knew that menopause and hot flushes went hand in hand, but even that information isn’t always true. The truth is that you may never have a hot flush, and if you do, it will probably be years before you’re menopausal. Common knowledge about menopause is sparse and often wrong. (The medical community didn’t even officially recognise the link between oestrogen and hot flushes until 1974!)

If menopause only concerned a small group of people on a desert island, this lack of information might be understandable. But over half of the world’s population will become menopausal one day. Menopause has been the ugly family member of the research community for years. Even medical textbooks pay scant attention to the topic. Today, one group is paying attention to menopause. The pharmaceutical industry sees great opportunity in the field of menopause, and more research is under way. If you’re looking for books to help reasonably intelligent women navigate the jungle of menopause (menopause is uncharted territory), your options are largely limited to pretty, glossy pamphlets published by drug companies (now that’s what we call unbiased information) that you can find at your doctor’s surgery. If you’re really persistent, you may find some academic articles in medical journals, but your eyes will glass over as you try to pick out straightforward answers to your practical questions. We hope this book can fill that void. Our goal is to help you digest the research so you can make better and objective health decisions.

Menopause is not a disease – that’s true. No one is going to die from menopause or its symptoms, but every day, women die from the medical effects of low oestrogen levels. Your risks of certain diseases and cancers rise after menopause. Some people may respond to that statement with one of their own, ‘Well, that’s because women are older when they go through menopause.’ True again, but it’s also true that oestrogen plays a role in an amazing number of functions in your body, some of which protect your organs, increase your immunity, and slow degeneration. This transformation we call menopause impacts our health in very significant ways. This book helps you understand the story behind the symptoms and the diseases.

Some women choose to use hormone therapy to relieve symptoms associated with menopause and protect their body from disease. The choice of whether to take hormones or not is quite controversial because hormone therapy has its own set of risks. The debate goes on in the medical community and media concerning the risks of hormone therapy. If you’re like many women, your confusion only grows as you read more on the subject. Each new study seems to contradict the findings of the last one. You’re an intelligent person. But how can you know which study you should believe? In this book, we try to provide enough information to enable you to make informed decisions about your health.

About This Book

We have no agenda in writing this book. We’re not trying to sell you medications, alternative health strategies, or remedies. This book presents accurate and up-to-date information from the most credible sources. It contains straightforward information based on reliable medical studies without the academic lingo common to medical journals. When no clear-cut answers exist and when quality research shows mixed conclusions, we let you know.

Everyone’s time is limited, so we cut to the chase. We cover the questions that are important to you during this phase of your life. If you want more detail, we provide an appendix full of resources to help with your personal research. We also try not to stray too far from the topic at hand. For example, during the years leading up to menopause, women may have difficulty getting pregnant. The same hormonal changes that cause those annoying symptoms prior to menopause also stifle fertility. Many women in their late thirties who are trying to get pregnant rely on hormone supplements. Despite the overlap in hormonal terms, fertility is not a concern for many women going through the change, so our discussion is limited.

Whether you’re going through the change, have already been there, or are about to start off down that road, you’ll find the information you need between these snazzy yellow and black covers. We cover all the health issues and therapy choices that confront women during the menopausal years.

Foolish Assumptions

Every author has to make a few assumptions about her audience, and we’ve made a few assumptions about you:

You’re a woman. (Sorry, guys, but menopause is a girls-only club.)

You want to understand what’s going on with your body.

You’re looking for straight talk for real people as opposed to scientific jargon and Medicalese (though we have a Medicalese icon to warn you when we stray into this territory).

You want to evaluate your risks of disease as you pass through midlife and move into your menopausal years.

You don’t want a book that claims to let you diagnose yourself or figure out what medications you need. You have a medical advisor to discuss these things with.

You want to be able to ask intelligent questions and discuss treatment alternatives with your healthcare providers.

You want to feel more confident about the quality of your healthcare.

You buy every book that has a black and yellow cover.

If any of these statements apply to you, you’re in the right place.

How This Book Is Organised

We’ve organised this book into five parts so you can go directly to the topic that interests you the most. Here’s a brief overview of each part:

Part I: The Main Facts about Menopause

The journey to menopause often catches women by surprise. You may not have been expecting to take the journey, or you may have been wondering when you would begin. In this part, we give you a quick overview of what your hormones are doing before, during, and after menopause. If you haven’t thought about things like hormones and follicles for a while, don’t worry; we refresh your memory. Your secondary school biology course probably never finished the story. In this part, you get the whole story from how the egg makes its journey from the ovary to the uterus to what happens when the ovary goes into retirement.

Part II: The Effects of Menopause on Your Body and Mind

Want to know how hormones affect the health of your body and mind? You can find the answers in Part II. We devote each chapter in this part to a specific body part or health issue. In each chapter, you get an overview of how hormones function in relation to this part of your body and the types of conditions that can develop, how to recognise them, and what you can do about them.

Part III: Treating the Effects

You may want to evaluate the pros and cons of hormone therapy (HT) from time to time during your journey through menopause. This part of the book brings you up to date on what the medical community knows about HT. We discuss the effects of HT so that you can make informed decisions. Reading these chapters provides added benefits as well: You’ll probably find it easier to evaluate the news about hormone research that comes out in future years.

We also include information about non-HT drugs and alternative treatments.

Part IV: Lifestyle Issues for Menopause and Beyond

Part IV is chock full of great ways to stay healthy and enjoy a long and active life during and after menopause. Staying healthy and active is simpler than you think. We discuss healthy eating habits and simple ways to stay fit. Whether you’re looking for natural ways to lower your risk of specific diseases or for ways to slow the ageing process, you can find the information you need right here.

Part V: The Part of Tens

If you’re a fan of For Dummies books, you probably recognise this part. These are short chapters with quick tips and fast facts. In Part V, we debunk (more than) ten menopause myths, review some common medical tests you may encounter, and suggest ten terrific exercise programs for menopausal women.

Part VI: The Appendixes

A glossary of menopause-related terms and a list of menopause-related resources cap the book.

Conventions Used in This Book

We use our own brand of shorthand for some frequently used terms, and icons to highlight specific information. The following sections help you get used to these conventions.

Taking in shorthand

As you read this book, you’ll discover that menopause is a process, with different stages characterised by similar symptoms. These stages are referred to as perimenopause, the 3 to 10 years prior to menopause when you may experience symptoms; menopause itself, which you know you’ve reached only after you’ve reached it because the definition of menopause is the absence of periods for a year; and postmenopause, which is your life after you’ve stopped having periods. In this book, we use perimenopause to describe the premenopause condition, and we use menopause to refer to everything after that just because the term postmenopause isn’t commonly used.

A major part of this book – the whole of Part III as well as sections in other chapters – talks about hormone therapy (HT), which is used to alleviate symptoms and address health concerns prompted by menopause. In literature and on Web sites, you can see hormone therapies referred to and abbreviated any number of ways, including hormone replacement therapy (HRT) and estrogen replacement therapy (ERT). But we stick pretty closely to using HT because we feel that it’s the most inclusive and accurate term. Just be aware that HT means essentially the same thing as HRT.

And, speaking of hormones, a couple of the more important ones for menopausal women have several subcategories:

Types of oestrogen include oestriol, oestradiol, and oestrone.

Progesterone is the class of hormone; the form used in hormone therapy is often referred to as progestin.

We sometimes use these terms interchangeably and only refer to the specific hormone as necessary for clarity.

Eyeing the icons

In this book, we use icons as a quick way to go directly to the information you need. Look for the icons in the margin that point out specific types of information. Here’s what the icons we use in this book mean.

The Tip icon points out practical, concise information that can help you take better care of yourself.

This icon points you to medical terms and jargon that can help you understand what you read or hear from professionals and enable you to ask your healthcare provider intelligent questions.

This fine piece of art flags information that’s worth noting.

When you see this icon, do what it tells you to do. It accompanies info that should be discussed with an expert in the field.

The Technical Stuff icon points out material that generally can be classified as dry as a bone. Although we think that the information is interesting, it’s not vital to your understanding of the issue. Skip it if you so desire.

This icon cautions you about potential problems or threats to your health.

Where to Go from Here

For Dummies books are designed so that you can dip in anywhere that looks interesting and get the information you need. This is a reference book, so don’t feel like you have to read an entire chapter (or even an entire section for that matter). You won’t miss anything by skipping around. So, find what interests you and jump on in!

Part I

The Main Facts about Menopause

In this part . . .

T he first act of Dance of the Hormones probably occurred three decades or so ago for you. You remember that one don’t you? The bittersweet tale of teenage angst and joy that we call puberty. And now, intermission (the menstrual years) may be coming to a close as the hormones once again take the stage for the second act – menopause. Well, take your seat and get ready to peruse your programme . . . well, Part I of this book, anyway.

In Part I, we provide you with an outline to your menopausal years. We define menopause, review the biology, introduce you to the actors – your hormones – and briefly review the related symptoms and health conditions (physical, mental, and emotional). Get to it before the usher dims the lights.