Menstrual Stages - Peri-Menopause

Peri-Menopause is defined as a condition in which women are experience the irregular menstrual cycledue to the hormonal decline gradually, including shorter, longer, heavy, light peroid and some menopause symptoms. Perimenopause, in fact is a transition stage to menopause, and the length of this transition can be 3-10 years or longer. Once you have no menstrual period in 12 consecutive months, you have officially entered 12 months of menopause already.

Symptoms
1. Irregular period
In the early of peri menopause, the ovaries are in the stage of irregular response to the follicle stimulating hormone that can lead to anovulation, causing irregular menstruation.

2. Follicle stimulating hormone
The rise of FSH as a result of no response of ovaries in production of estrogen for the production of mature egg.

3. Hot flash and irregular sleep hour
As the result of hormonal change, and a woman is experience some symptom of peri menopause. Statistic showed that approximately over 65% of women in the stage of peri menopause are experience hot flashes.

4. Mood swing and irritability
It can be the result of hormone imbalance or the diminishing of sex hormone, including estrogen and progesterone. Some researchers suggested that it may also be caused by fatigue due to symptoms of irregular sleep and hot flash.

5. Vaginal and bladder problem
As the levels of sex hormone decrease, it can lead to the change in the acidic environment of vagina, causing bacteria infection that affect the health of vagina and bladder.

6. Decrease fertility
It is due to the ovaries no longer response instantaneously to the hormone follicle stimulating hormone in releasing estrogen for mature eggs.

7. Bone loss
AS the levels of estrogen decrease, it causes the lost of calcium in the bone, leading to lower bone density and increasing the risk of fracture. According to the study of "Characterization of perimenopausal bone loss", a prospective study, byRecker R, Lappe J, Davies K, Heaney R., researchers concluded that menopausal bone loss is a composite of loss caused by estrogen deprivation and age per se for the hip and total body, but is caused by estrogen deprivation alone for the spine.

8. Cholesterol
Low levels of estrogen increase the levels of bad cholesterol LDL and decrease the levels of good cholesterol HDL In a sudy of "EXOGENOUS ESTROGEN EFFECT ONLIPID/LIPOPROTEIN CHOLESTEROL IN TRANSSEXUAL MALES" by M.D. Damewood, J.J. Bellatoni, P.S. Bachorik, A.W. Kimball Jr. and J.A. Rock, researcher found that The total cholesterol to HDL cholesterol ratio may be predictive as to the development of coronary artery disease. The calculated risks for cardiovascular disease in the transsexual groups of males studies was 3.49 and 4.05, below the range of standard risks for men (5.0) and slightly lower than the standard risk for women .

9. Etc.

Causes
Perimenopause is a natural and biological process as a result of aging. In tradition Chinese medicine, the transition of the women menstrual conditions from the years of active reproduction to perimenopause is necessary to slows down the aging process by retaining the body’s kidney energy, to avoid the depletion of the women kidney essence that can lead to death.

1. High levels of follicle stimulating hormone FSH

When a woman enters the stage of peri menopause, the levels of FSH start to rise as a result of irregular response of ovaries in hormone estrogen production.

2. Certain medical diseases

Premature ovaries failure can lead to fast approaching of perimenpause to menopause.

3. Smoking

According to the article of Smoking May Cause Early Menopause posted in Ygoy, the author indicated that Dr. Thea F. Mikkelsen of the University of Oslo and her colleagues have done the research study among a group of 2,123 women 59 to 60 years old. They came up with these findings. The women who smoke were 59% more likely to have undergone early menopause than non-smokers. In case of the women who smoke heavily the risk of early menopause was nearly doubled.

4. Family history

Risk of early peri menopause increase if a woman has a family history of early perimenopause.

5. Chemo and radio therapy in childhood

Chemo and radio therapy in the childhood for cancer treatment are higher risk of early peri menoipause. In the article of " Long-Term Side Effects of Chemotherapy" post on Susan G. Komen for the cure, the author indicated that Some chemotherapy drugs can damage the ovaries and stop regular menstrual cycles .

5. Hystertomy

The removals of uterus can cause prei menopause to start early.

6. Etc.

Diagnosis
After recording your family history and a general physical exam, in most cases, urinary test may be necessary to rule out the change of pregnancy, if you are experience amenorrhea.
1. Blood for Follicle stimulating hormone
The normal of levels of follicle hormone is usually under 10, if you are experience certain symptoms of peri menopause, the levels of FSH is much higher.
2. Estradiol
Blood test of estradiol will show low levels of estrogen.
3. Thyroid Stimulating Hormone (TSH)Testing of the levels of thyroid stimulating hormone to rule out TSH cause of symptoms of menopause.
4. Etc.

Prevention
Since entering the stage of peri menopause is natural and biological process, no one can prevent but delay
A. How to delay peri menopause
Since the causes of perimenopause are due to low levels of female sex hormone, including estrogen and progesterone. Intake of foods which contain phytoestrogen and progesterone will be beneficial in releasing the symptoms of menopause without causing side effects. Other than that, due to wear and tear of the internal organs over the years, diet with organic foods to provide extra nutrients to the body and enhance the body organs function is considered absolutely necessary. One must understand that intake of artificial ingredient, alcohol, cold and hot foods are posted more dangerous to the cells and organ as a result of weakened immune system. We are not dying because of aging but diseases. Elder is susceptible to foreigner and bacteria invasion.

1. Healthy diet

By providing your body with maximum nutrients and phytochemicals are the best way to a optimal health and reducing the symptoms of peri menopause.

2. Moderate exercise
Moderate exercise can increase the blood flow to the body that can stimulate the production of energy by increase the function in metabolism and get rid of waste. It also tire you out and therefore improve sleep and mood.

3. Avoid Alcohol
According to the article of Alcohol - Menopause- Alcohol's Effect on Menopause by June Russell's Health Facts, the author wrote "Approximately 30 percent of American women are older than age 50, the average age of menopause, and approximately 50 percent of these women consume at least moderate quantities of alcohol. Therefore any adverse effects of alcohol among this population could have a significant effect on public health. Approximately 25 percent of postmenopausal women take supplemental estrogens to alleviate unpleasant symptoms of menopause. Even moderate alcohol consumption may increase estrogen levels in postmenopausal women receiving HRT, potentially affecting their risk for various adverse health effects." {Alcohol, Hormones and Postmenopausal Women," NIAAA, 1998}.

4. Avoid Smoking
According to a Norwegian research researchers showed that women who smoke are likely to go through menopause much earlier than women who do not smoke.
According to Dr. Jeanne Morrison in answering the question of How does smoking affect health during menopause? posted at sharecare, smoking can trigger symptoms of menopause such as hot flashes. Also, smoking increases your chance of cancer, heart disease, stroke, and other serious illnesses.

5. Mediation and yoga
Mediation and yoga can help a woman to calm and relax, thus reducing or lessening the occurrence of the symptoms due to stress.

6. Avoid Sugar and artificial sweetener
According to Foods to Avoid or Limit," excerpted from "The Women's Health Companion," Susan Lark, MD, healthy.net - Feb. 2002, the author indicated that alcohol and sugar can actually intensify almost every type of menopause symptom,... No artificial sweetener is without drawbacks or potential health hazards.

7. Etc.

B. Diet
1. Whole grain
Whole grain are cereal grains containing cereal germ, endosperm, including Wheat, Oat, Barley, whole wheat, Maize, etc.

2. Fruits
Fruit is a structures of a plant which is containing seeds as the tree grows them for the survival of the species, including squash, pumpkin, cucumber, tomatoes, peas, beans, corn, eggplant, etc.

3. Vegetables
Vegetable is an edible plant contained edible parts, especially leafy or fleshy parts, other than a fruit or seed, including broccoli, cauliflower, globe artichokes , corn, peas, beans, etc. For more information of healthy foods benefits, please read 100+ Healthy Foods Classification

4. Soy
Many women in Asian countries consume 10 times the amount of soy products as their Western counterparts, Tofu and soa products for what ever reson are considered as the wome fravorite foods (and the Asian men hate them). Soy contains high amount of phytoestrogens, plant base estrogen similar to chemical structure to estradiol that has proven to alleviate menopause symptoms. According to the study of "Effect of high-dose isoflavones on cognition, quality of life, androgens, and lipoprotein in post-menopausal women" by Basaria S, Wisniewski A, Dupree K, Bruno T, Song MY, Yao F, Ojumu A, John M, Dobs, researchers found that women experienced significant reductions in hot flashes and nights sweats, compared to their starting baseline levels, with daily Revival Soy use (just one serving per day). Typical reduction was nearly 40% in just 12 weeks in a study funding in part by Physicians Laboratories. It's that simple and delicious.

5. Wolfberry
Wolfberry contains high levels of phytoestrogen that can help to relieve the symptoms of peri menopause and menopause. According to the article of Lycium Barbarum, Wolfberry Plant

Lycium Barbarum have long played important roles in traditional Chinese medicine, where they are believed to strengthen immune system functioning, better eyesight, protect the liver and meliorate blood circulation, among other effects post in the menopause defeated, the author wrote that at the laboratory of Neurodegenerative Diseases, Department of Anatomy, of the University of Hong Kong, Hong Kong there have been a research analyzing the effects of Lycium barbarum on against anti-aging process of humans.

6. Etc.

C. Nutritional supplement
Nutritional supplements used in peri menopause are not much difference in menopause, but may be different in volume, depending to differentiation
According to Steven G. Ottariano, a registered pharmacist, vitamins and minerals can provide particular benefits to menopausal women. These include Vitamin E (400 to 800 IU daily) to help reduce hot flashes and night sweats; Calcium (1500 mg daily)--the best type of calcium is not calcium carbonate which may not be fully absorbed, but microcrystalline calcium hydroxyapatite calcium (MCHC) or calcium citrate; Magnesium (500 mg to 750 mg daily) is essential to help with the absorption of calcium; Vitamin C (1,000 mg to 2,000 mg daily) helps absorption of Vitamin E and decreases capillary fragility.

1. Antioxidants

Antioxidants enhance the immune system and are important to prevent the forming of free radicals and fight against the invasion of bacteria and virus, as a woman age, she is susceptible to all kind of diseases.

2. Isoflavones
According to the article of Isoflavones posted on Isoflavones.info, the author indicated that The benefits of soy go beyond reducing long-term cancer risk. Recent studies have found that soy isoflavones can reduce menopause symptoms such as hot flushes and increase bone density in women. Indeed, many menopausal and post-menopausal health problems may result from a lack of isoflavones in the typical Western diet. Although study results are not entirely consistent, isoflavones from soy or red clover may be helpful for symptoms of menopause. A study carried out by "Health Test" in 2004 investigated the prescription behaviour of 27 doctors for women with menopause symptoms. It showed that isoflavones were recommended twice (44%) as often as hormonal treatment (22%).

3. Vitamin E
According to the article of Harvard Medical School Researcher Recommends Soy & Vitamin E as Alternative to HRT, Washington DC, 15 November 2002, Both soy and Vitamin E, which in its natural form is made from soybeans, have long been seen as helping reduce hot flashes, night sweats, and disturbed sleep for women going through menopause. In the wake of adverse findings for hormone use in the Women's Health Initiative study, both soy and Vitamin E are receiving renewed attention.

4. Vitamin B6
According to the article of Vitamin B6 and Overall Health - Importance of Vitamin B6 in maintaining the body posted on menopause infocentre, vitamin B6 is needed for more than 100 enzymes involved in protein metabolism. It is also essential for red blood cell metabolism. The nervous and immune systems need vitamin B6 to function efficiently, and it is also needed for the conversion of tryptophan (an amino acid) to niacin (a vitamin).

5. Vitamin C and bioflavonoids
In a study of 94 patients were studied, of whom 36 were surgically induced (also called castrates) and 58 who had undergone physiologic (natural) menopause (6). Their symptoms were catalogued as severe, moderate, and mild. The test substance consisted of 200 mg of bioflavonoids and 200 mg ascorbic acid in each tablet administered six times per day. And so, each subject received 1200 mg of both the bioflavonoids and ascorbic acid daily, researchers found that An analysis showed the bioflavonoid/vitamin C (line 1) to be markedly superior to all the other test substances in the relief of this single complaint. Actually, 67% reported complete relief, 21% partial making an overall 88% success factor.

6. Calcium
Beside calcium is important to prevent the loss of bone sensitive if taking together with vitamin D, in an article of Menopause and Insomnia: The Calcium Link, 2011-07-20 21:51:13 - (Research journals and nutritionists continue to clarify the relationship between declining levels of estrogen and lowered calcium levels in women) wrote that during the menopause, the lack of ovarian hormones (estrogen and progesterone) can cause severe calcium deficiency symptoms to occur, such as irritability, hot flashes, night sweats, leg cramps and insomnia.

6. Magnesium
In a study of Magnesium And Calcium Levels In Early Surgical MenopauseSREEKANTHA, SATISHA T G, AVINASH S S, MANJUNATHA GOUD B K, REMYA, SUDHAKAR G K, RANGASWAMY R, RAGHAVENDRA VIKRAM TEY, researchers found thatAfter hysterectomy, the levels of magnesium, calcium and phosphorus were found to be dysregulated, which might be due to a hormonal imbalance. This proves the imporance of the said minerals during the stage of nmenopause.

7. Etc.

Treatments
A. In conventional medicine
The aims of treatment is to reduce the symptoms of peri menopause
1. Low dose of oral contraceptive pill
In a study of "Oral Contraceptive Use During the Perimenopausal Years" by JO T. VAN WINTER, M.D., and MATTHEW E. BERNARD, M.D., researchers indicated that Estrogen supplementation in the form of low-dose oral contraceptive pills taken during the perimenopausal years may not be appropriate in everyone, but in many women it can ease the emotional and physical transition into the menopausal years, while at the same time providing some of the noncontraceptive benefits of hormonal contraceptives.

2. Progestin therapy
Progestin is the generic name for synthetic progesterone similar to the progesterone produced by the ovaries> it is beneficial for women in the peri menopause to regulate your periods and relive the symptoms of heavy bleeding.

3. Endometial ablation
Endometrial ablation is a procedure to burn the limning of the uterus by laser beam, electrical energy or heat, it is beneficial for women with heavy bleeding during the stage of perimenopause.

4. Etc.

B. Herbs
Herbs used in the perimenopause are similar to the menopause but difference in volume, some herbalists may replace them by some other herbs, depending the the differentiation
1. Chaste berry tree
In a series of animal experiment by German researcher, Gerhard Madaus, he found that extracts of the leaves, fruits, and bark retarded estrus (heat) in female rats, without evidence of adverse effects on reproductive performance, including the stage of menopause.

2. Black cohost
Black cohosh is used to relieve symptoms of menopause including hot flashes, irritability, mood swings, and feelings of depression. According to the trials have been conducted on the effects of black cohosh on hot flashes, mood swings and depression, researchers suggested that the phytoestrogen in black cohosh may help to restore the hormonal imbalances of menopause.
But according to a new study reported by the Drug Information Journal. although there have been at least 20 positive trials, recent studies have shown consistently negative results.

3. Licorice
Ofir R, Tamir S, Khatib S, Vaya J., Hatzeva Research and Development Center, Jacob Blaustein Institute for Desert Research, Ben Gurion University of the Negev, Beer Sheva 84105, Israel, researchers found that the licorice root derivatives glabridin and glabrene inhibited serotonin re-uptake by 60% and 47%, respectively. The ability for these licorice root constituents to reduce serotonin re-uptake demonstrates their benefits in treating mild to moderate depression in menopausal women.

4. Asian ginseng
Asian ginseng may be used by menopausal women to reduce stress, improve general well-being, decrease feelings of depression, and enhance memory. In 37 clinical studies published between 1968 and 1990, ginseng improved physical and cognitive performance, mood, or metabolism. Still other studies suggest a plethora of ginseng actions, according to the article Ginseng, Asian posted in drug area.

5. Red clover
Red clover contains high quantities of plant-based estrogen called isoflavones that may improve menopausal symptoms, reduce the risk of bone loss, etc,. In article red clover, posted in the university Maryland medical center, the author wrote, researchers also think that isoflavones, like those found in red clover, might help reduce symptoms of menopause because of their estrogen-like effects. But so far studies have not been conclusive. Several studies of a proprietary extract of red clover isoflavones suggest that it may significantly reduce hot flashes in menopausal women. The largest study, however, showed no such effect.


6.Etc.

C. Chinese herbs
Zhi Bai Di Huang Wan, also known as Eight Flavor Rehmannia Teapills, is a Traditional Chinese Medicine whose formula was 1st listed in "Pattern, Cause, Pulse, and Treatment" (Zheng Yin Mai Zhi) by Dr. Qin Jing-Ming in 1702 AD. You can find information of the above formula in the PHARMACOPOEIA OF THE PEOPLE'S REPUBLIC OF CHINA (English Edition) The English edition of Chinese Pharmacopoeia compiled by the Pharmacopoeia Commission of the Ministry of Public Health, is an official andauthoritative compendium of drugs. It covers almost traditional Chinese medicines, most of west medicines and preparations, giving information on the standards of purity, description, test, dosage, precaution, storage, and the strength for the drug.
Ingredients
1. Anemarrhena Asphodeloides (Zhi Mu)
Main use; Clears Heat, Disperses Fire, Nourishes Yin, Moistens Dryness.
2. Phellodendron (Huang Bai)
Main use; Clears Heat, Dries Dampness, Disperses Fire, Expels toxins.
3. Rehmannia Glutinosa (Shu Di Huang)
Main use; Nourishes Yin and Blood, Tonifies the Essence, Strengthens the Marrow.
4. Cornus Officinalis(Shan Zhu Yu)
Main use; Tonifies the Liver and Kidneys, Benefits the Liver and Kidneys.
5. Paeonia Suffruticosa (Mu Dan Pi)
Main use; Clears Heat and Blood Stasis, Cools Blood, Clears Fire of Yin Deficiency.
6. Discorea Opposita (Shan Yao)
Main use; Tonifies Qi, Lung, Spleen and Kidneys and Nourishes Yin.
7. Poria Cocos (Fu Ling)
Main use; Eliminates Water, Strengthens the Spleen, Calms the Mind.
8. Alisma Orientale (Ze Xie)
Main use; Eliminates fluid, Clears Heat and Diuretic.

According to the study of The effects of Zhi Bai Di Huang Wan and Jian Pi tang to release the symptoms of menopause by Shun Bin, posted at JOURNAL OF SHANDONG UNIVERSITY OF TRADITIONAL CHINESE MEDICINE, researcher found that the formulas have been effectively releasing the symptoms of menopause with great success.

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