Menopause

Menopause is the cessation of menstrual cycles.

Perimenopausalis a term used to denote the period during

which menopausal changes occur. Postmenopausaldescribes

the time of life following the final menses. The age range at

which menopause occurs is wide, between approximately 40

and 55 years of age with a mean age of 51.3.

The age at which menopause symptoms begin appears to

be genetically influenced or at least is not associated with age

of menarche. Women who smoke tend to have earlier

menopause (Baram & Basson, 2007).

An older term to describe menopause was “change of life,”

because it marks the end of a woman’s ability to bear chil-dren and the beginning of a new
phase of life. Such a role

change can produce psychological stress, although, through

health teaching, nurses can help a woman appreciate that her

role in life is greater than just bearing children; loss of uter-ine function may make almost no
change in her life; and, for

a woman with dysmenorrhea (painful menstruation) or with

no desire for more children, menopause can be a welcome

change. Menopause can cause physiologic stress as ovaries are

a woman’s chief source of estrogen. When ovaries begin to

atrophy, reducing estrogen production, “hot flashes,” vaginal

dryness, or osteoporosis (lack of bone mineral density

[BMD]) occurs. Urinary incontinence from lack of bladder

support can also occur (Freeman et al., 2007).

Hot flashes can be accompanied by heart palpitations

and can occur up to 20 to 30 episodes a day; episodes com-monly last for 3 to 5 minutes at a
time. An immediate aid

in reducing this sudden overheated feeling is to sip at a cold

drink or use a hand fan.

At one time, hormone replacement therapy (HR) was pre-scribed extensively to decrease
menopause symptoms because

it was believed that this therapy reduced cardiovascular com-plications such as

atherosclerosis or heart attacks as well. HR

is no longer prescribed routinely as such therapy does not ap-pear to reduce cardiac risk or
prevent osteoporosis and may

be associated with endometrial cancer, cerebrovascular acci-dents (strokes), and perhaps

breast cancer (Gabriel-Sanchez,

et al., 2009).

HR may be prescribed on a short-term basis (1 to 2 years)

if a woman has symptoms so severe that they interfere with her

life plans but women should not receive estrogen replacement

therapy indefinitely because of the possible adverse effects.

Women who notice excessive vaginal dryness can be ad-vised to use a lubricating jelly such
as KY Jelly prior to sexual