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| Doctor, Are these symptoms of Menopause? | ||
| Question:
I hope you can help me.
I am 45 years old and have had frequent problems with perimenopausal
symptoms. I have been on organic and non organic hormone
replacement therapies, gone off and have been fine for about six or so
months. My biggest issue is with the feeling like I am having an
adrenal rush at about 4AM every morning. This is the only
symptom that I need help with. I can live with the hot flashes,
crabby moods, hair loss. I also break out a lot on my chin.
Any advice? Answer: I cannot give you any advice. Your story is not clear to me. I have no idea what kind of hormone replacement therapy is "organic and non organic'' and an adrenal rush is unknown to me. |
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| Question:
I am 53 year old and up until December
have had regular periods. My last period was the first week in
December. Lately I do not sleep well. For the past two nights
I have experienced severe leg pain that radiates from the back of my
upper thigh down to my heels. The pain is severe enough to wake me
and cause me to get up for several hours at night. I take over
the counter sleeping pills every night and also get up 3 or 4 times
at night to urinate. For the sleep problem, my physician first
prescribed Sonata and the Ambien, but I get just as much sleep
relief from over the counter medications at a much lesser cost.
I also take medications for glaucoma. I perform moderate exercise
and am not overweight (5'6 and 145 lbs). My concern is the
frequent urination, sleepless nights and leg pain. Are these
common symptoms of menopause? Answer: Not all symptoms originating during the menopausal transition are menopausal symptoms. Leg pain is not, sleeplessness is not unless caused by hot flashes and night sweats. Frequent urination can be caused by cystitis, or especially nightly frequency by cardiac failure. Frequent urination is also not a perimenopausal symptom. |
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| Question:
How would you treat a 40 year old woman who
has had surgical menopause a year ago who has lost libido and cannot take oral
or patches as HRT? Gels will be the
way, but how to figure precisely the amount I need? Blood test or
saliva test? Who does the interpretation, the lab or the doctor?
Please guide me.
Answer: Libido has to do with androgens. Both estrogens and androgens are available in some countries as implants. Patches with androgens are in pipeline. When implants are not available, and swallowing tablets or using patches is not possible, there is no way to supplement androgens. Estrogens are also available in gels or in nasal spray. In gels 1-2 mg estradiol is advised, with nasal spray 300 micrograms. No lab test available to check the amount. Usual, enough is administrated when hot flashes disappear, and to much is used when side effects such as mastopathy appear. |
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| Question:
I
have been menopausal for over 5 years. I suddenly stopped having
my period one day and never had another until just a few weeks ago.
The doctor took a biopsy and nothing showed up. Now she is
recommending Provera for three months to see what it will do before
going in and burning out the lining. I have never taken hormones of
any kind. Will this progesterone throw me out of balance?
I also have many of the problems that the side effects say you may
acquire, i.e.. hair loss, overweight, fluid retention. Thank you for
your attention to this problem. Answer: Postmenopausal bleeding requires investigation. With a negative biopsy the risk of endometrial cancer is extremely low. Usually, an ultrasound investigation is done to measure endometrial thickness. With a thickness of less than 5 mm no action is required, because hardly never malignancy is seen with that measure. With endometrial thickness of 5 mm or more, also an endometrial polyp can be the cause of bleeding and further diagnostics can be done (saline infused sonography or hysteroscopy) to rule out endometrial disorders. |
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| Question:
I am currently taking prometrium
prescribed for eighth days to try and clear my uterine lining
since my last period was 10/00. My lab work states that I
am post menopause. I've had an ultra sound everything
seemed to be normal. I have had no spotting with the
prometrium. When can I just be in menopause and
not worry about uterine cancer? Answer: As long as your ovaries produce estrogens, a growth of the endometrium lining occurs. With progesterone, the lining is transformed and shed. A withdrawal bleeding will start after the end of the progesterone course. When no withdrawal occurs, there is no endometrial growth and the risk of endometrial cancer becomes extremely rare. |
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| Question:
I have a problem with
high FSH level, which later I was diagnosed with "POF." Is
there a cure for this problem and is it hereditary problem? Answer: POF is premature ovarian failure, defined as menopause before the age of 40. Sometimes a cause can be found (immunological disorder, genetic aberration). There is no cure for it, because the follicles in the ovaries are scarce and the high FSH can not stimulate them any more. Please see the Premature Ovarian Failure Support Group they offer support and information for women with Premature Ovarian Failure (POF), often called Premature Menopause. |
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| Question: I am 37 years old and have
been going through Premature Menopause for almost two years now (my
sister and grandmother went through it at the same
age). My FSH level was 120 when last tested. My hot flashes have
subsided somewhat over the last year or so, although I still have mood
swings and some trouble sleeping. I can live with that but my main
concern is Osteoporosis and heart disease. My mother has Osteoporosis
and my father heart disease. I am 5'7" and only weigh 109 lbs. and have a small, delicate bone structure. I am also a former smoker, with very pale skin and am a vegetarian (but was vegan for a long time). Because of all of this I know that I'm at a risk for Osteoporosis and because of a high fat diet, for heart disease as well. But I am afraid of HRT, I really don't want to take it. The one time I tried Progestrone in pill form was for Endometriosis, but it made my Raynaud's Syndrome much worse and I had to stop. Any advice you can give me would be greatly appreciated. Answer: Premature menopause is menopause (last menstrual period) before the age of 40 years. It is not possible to go through menopause during several years. You are still menstruating or you are not. When you have had no menstruation during 12 months with high FSH, you are postmenopausal. With premature menopause the risk for osteoporosis and for cardiovascular diseases increases. With premature menopause, your rather low weight and a mother with osteoporosis, there is a strong reason to diagnose the amount of bone mass. With DEXA or CT-scan it is possible to measure bone mass accurate and to estimate your risk. With high or normal bone mass risk is low and preventive medication is not necessary. With low bone mass (osteopenia or osteoporosis) preventive therapy consists of either bisphosphonates, raloxifene or estrogens. Bisphosphonates have no other benefits than bone. Raloxifene (Evista) has probably also a beneficial effect on heart and blood vessels, but it can increase your hot flashes. Estrogens are beneficial for bone and cardiovascular system. Increase of Raynaud symptoms are sometimes seen with unopposed estrogens, but not with a combination of estrogens with progesterone. The best therapy to try with Raynaud symptoms is: transdermal estrogens (50 micrograms) with oral natural progesterone (Prometrium), either in continuous combination (daily 100 mg) or in a sequential regimen (200 mg during 10-14 days every month). With a history of endometriosis, I advice the continuous combined regimen. Lifestyle can influence both the risk of osteoporosis and cardiovascular disease. Regular exercise, healthy food (especially not to much unsaturated fat) and no smoking can reduce the risks considerable also without additional medication. |
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| Question: You say usually menopause
does not effect the libido. Why or how does it effect the libido
sometimes? Why are you so sure, none of the women's libido has
been effected that ask questions about this subject? If the
answer is usually that means it is possible, right? Please explain? Answer: Menopause per se does not effect the libido. Libido problems can be influenced by bad feelings because of night sweats, or by the experience of painful intercourse because of insufficient lubrication. So, indirect menopause can influence libido. And I am so certain because of the evidence in the medical literature. Please check-out this great article called, "Decreased Libido," by D. Ashley Hill, MD |
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| Question:
I'm a 33 year old female that
had my uterus removed in 1996 and my ovaries removed in October 2000.
I kept getting reoccurring pain - when they finally opened me up to
remove my ovaries they found cysts and hemorrhaging from same
throughout both ovaries, also endometriosis. When I first left
the hospital they gave me an estrogen shot that was to last for up to
four weeks - after the first two I started get hot flashes. Then I
switched to "a red pill .625mg" that didn't do
anything for me as I was still flashing and depressed etc. Then
I tried the patch which seemed to work on the first day but not the
second or third (and I hated the black circles it left). Now I
am taking 1mg of ESTRACE daily (since Jan 11,2001) and I still have
hot flashes, am very moody, depressed and have headaches all the time,
some migraines. What do I do next? Answer: 1 mg Estrace is not always enough to combat hot flashes. Higher dosage is sometimes necessary: 2 mg Estrace, sometimes even more. Or premarin 1,25. When headache becomes a problem, transdermal estrogens with patches give more stable estrogen levels and are to be preferred. With recurrence of endometriosis, rare but possible, a continuous combination of estrogens with progesterone or progestagens is advisable also after hysterectomy. |
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| Question: I have been going through
menopause for about 5 years. I have not had a period since March 2000.
I would like to know if it is normal to have a period after not having
one for that long.
Answer: Yes, it can. You are perimenopausal. Menopause (the last menstrual period) is diagnosed retrospective after 12 months of amenorrhoe. So you have to start counting again. |
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| Question:
I am almost 46 years old and have been told by my
doctor that I am perimenopausal. I have been experiencing pain
during sex irregular bleeding and loss of sexual desire. I have been with my husband for the last seven years
and have had the most enjoyable sex life ever and now this is
happening. Will my sexual desire come back after a
hysterectomy. Answer: Sexual desire and hysterectomy has nothing to do with each other. Why to perform a hysterectomy? The cause of pain and bleeding pattern has to be investigated and diagnosed. Of course you have loss of sexual desire when intercourse is painful. Please check-out this article called, "Painful Intercourse" by D. Ashley Hill, MD |
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| Question:
Why do humans have a menopause?
Do any other animals have it and of so which? Answer: A philosophical question. Maybe because a human child needs maternal coverage during at least 15 years. And a woman has to live at least that time after the last birth. Menopause is also present in several kinds of apes. |
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| Question:
Is there any information out there in reference to seizures and
early menopause. I recently had two grand mal seizures with no
previous indication of having any before. any correlation? Answer: Seizures can be provoked by estrogens, whereas progesterone has inhibitory effect. It is possible that a lack of progesterone (in annovulatory cycles) with persistent and high estradiol levels induce seizures. There is no proof of a relation like this but the hypothesis is accepted by many. |
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