Menopause A to Z.pdf - Medwords.com.au

MENOPAUSE A to Z
The only practical treatment for polymenorrhoea is the oral contraceptive pill, as this can hold the hormone levels at
an artificially high level until the period is desired (usually every 28 days). If the woman objects to the use of the pill,
other hormones may be used, but they are not generally as effective.
See also OVARY; PITUITARY GLAND
MENSTRUAL PERIODS HEAVY
Excessive blood loss during a menstrual period (menorrhagia or flooding) is uncomfortable, distressing and may
lead to anaemia and other health problems. In most women it is a constitutional problem in that there is no specific
disease or condition causing the problem, but it is the way that their body deals with the monthly hormonal changes. In
a few cases though, there is an underlying medical problem. This is more likely if the periods have changed to become
heavier over a few months.
The menopause occurs in the late forties and early fifties in most women. Instead of cycling smoothly and evenly
through the monthly changes, sex hormone (oestrogen and progestogen) levels start to change suddenly, irregularly
and inappropriately. This causes the symptoms of menopause which include irregular menstrual periods that can vary
from very light to very heavy, hot flushes, headaches, irritability, personality changes, breast tenderness, tiredness and
pelvic discomfort.
Inappropriately high levels of oestrogen being prescribed for hormone replacement therapy may cause heavy
periods.
Psychological disturbances (eg. severe stress, shock or anxiety) may affect oestrogen production and irregular
heavy periods may follow.
Intrauterine contraceptive devices (IUD) may irritate the lining of the uterus to cause heavier and more painful
periods in some women.
Other causes of menorrhagia include fibroids (hard balls of fibrous tissue that form in the muscular wall of the
uterus), cysts in an ovary, ulcers and erosions of the cervix (opening of the uterus into the vagina), endometriosis, a
miscarriage (may cause abnormal bleeding before a woman is aware that she is pregnant), an ectopic pregnancy
(development of a growing foetus in the fallopian tubes instead of the uterus), salpingitis (infection of the fallopian
tubes), hypothyroidism (an underactive thyroid gland) and tumours, polyps or cancers of the uterus or cervix may
cause irregular heavy bleeding, that may not be related to the menstrual cycle, but be caused by direct bleeding from
the growth.
Uncommon causes include the Stein-Leventhal syndrome (multiple cysts in the ovaries affect their function) and
thrombocytopenia.
See also MENSTRUAL PERIODS PAINFUL; VAGINAL BLEEDING ABNORMAL
MENSTRUAL PERIODS, LACK OF
Women expect their menstrual periods to occur regularly every month, and become concerned when this does not
happen. The obvious causes for periods to stop are pregnancy and menopause, and every woman between 15 and
50 who misses a period should be considered pregnant until proved otherwise. Breastfeeding will delay the return of
regular menstrual periods. There are also a number of medical conditions that may be responsible for amenorrhoea (a
lack of menstruation) or oligomenorrhoea (infrequent menstruation).
Any significant emotional trauma (eg. loss of job, death in family), physical stress (eg. vigorous athletic training),
serious illness (eg. major infection) or poor nutrition (eg. lack of food, vomiting and diarrhoea) can affect the menstrual
cycle. This is a very common phenomenon.
Significant weight loss as a result of deliberate dieting, disease (eg. cancer) or psychiatric disturbance (eg. anorexia
nervosa) will also stop menstruation.
The oral contraceptive pill may cause menstrual periods to become lighter and lighter until they disappear
completely. Some women take the pill constantly, without a monthly break off the pill or taking sugar tablets, and stop
their periods for the sake of convenience. This practice is completely safe and causes no long-term harm.
Uncommon causes include tumours, cysts or cancer in an ovary that affect the regular cyclical production of
oestrogen, a lack of thyroxine (hypothyroidism), Asherman syndrome, Addison's disease and the Stein-Leventhal
syndrome.
See also MENSTRUAL PERIODS
MENSTRUAL PERIODS PAINFUL
In more than 8 out of 10 cases, there is no serious cause for painful periods (dysmenorrhoea). Although distressing,
they are merely the way in which a woman, and her uterus, copes with menstruation.
The uterus mainly consists of powerful muscle fibres, which should only come into use during the delivery of a baby,
and to a minor extent when blood and the unused lining of the uterus is expelled in the monthly menstrual period.
Period pain is usually caused by excessive spasms of these muscles in the uterus, but sometimes may be due to other
medical problems.
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