Menopause and women is a hot topic that concerns women today.  Often times dubbed as the "Big M, menopause is the time at "mid life" when a woman has her last period. It happens when the ovaries stop releasing eggs.  It is usually a gradual process but sometimes it can happen all at once.  The average age for a woman's final period is 51 but it can occur at age 40 and as late as 60.   

This phase is considered "dreadful by some, joyful phase by some (freedom from sanitary pads, dysmenorrhea, uncomfortable "bleeding periods" and hopefully freedom from pregnancy).  For most of us who are clinicians, we could have understood this change in our lives and I believe at some point each one of us could have explained and sympathized with anyone who is undergoing this "change"…  However, not until one is in the same boat so to speak, one can never honestly experience the "pause". 

There are however other changes before the final pause.  Peri-menopause is the period of gradual changes that affect the woman's hormones, body and feelings.  Peri-menopause means literally "around menopause" and represents the physical state.  Perimenopausal changes can result in a variety of signs and symptoms, including reduced fertility, irregular menstrual periods, hot flashes, vaginal symptoms, urinary symptoms, and more.  No woman can predict what symptoms she will experience and how severe these symptoms could be.  Al

though for the most part of the community, changes are considered a natural progression, some medical experts can sometimes describe it as disease process and sometimes can be diagnosed as adult onset ovarian failure.  That sounds ominous especially for clinicians just us.  No matter what the definition of this condition, it could remain perplexing to some.  This is followed by the next phase known as "climacteric". "Climacteric" is another word for the time when a woman passes from reproductive to the non-reproductive years of a woman's life. 

One of a more common reported symptom is reduced fertility.  It is important however to remember that fertility is not only determined by the woman's hormones and health but also by a woman's partner as well.  Perimenopause is not the time to be careless about birth control because at this stage of a woman's life pregnancy can be a complicated health challenge.

Irregular menstrual period is due to ovarian production of estrogens and progesterones fluctuations which regulate the normal process of menstruation.  Hot flashes is caused by fluctuating estrogen levels that can cause circulation changes in a woman's body.  Hot flashes often have triggers like warm rooms, stress, spicy foods, alcohol, caffeine and more.

Vaginal dryness and irritation are common on women experiencing this phase. Other vaginal symptoms could include dryness, itching, and sexual discomfort.  Thinning of the urethral lining and weakening of the pelvic muscles

which can result to urinary tract problems like urinary incontinence is another common manifestation.  Other symptoms are manifested as headaches, occasional sleeplessness and mood swings.

Pharmacological treatment such as Hormonal Replacement Therapy (HRT) is one of the  alternatives in controlling the symptoms and discomfort.  However for women who cannot take HRT, there are other options available.  If osteoporosis is a concern, there are other drugs that can be used to prevent and treat.  For vaginal dryness, there are many types of lubricants that can be helpful. 

A healthy lifestyle is important whether you use HRT or not.  Eat healthy food.  The diet should be low in fat, rich in fruits and vegetables, and rich in calcium and vitamin D.  A multivitamin and calcium supplement can be helpful.  Plenty of exercise is a must.  Avoid smoking and alcohol.  For weakening pelvic muscles, Kegel exercises can be helpful.  For hot flashes, adjust the room temperature and clothing.

Some women turn to herbal remedies and other alternatives. These herbal remedies are estrogen-like chemical in plants called "phytoestrogen".  These products however are not regulated by the same government system that regulates drugs.  Some of the herbal products can have harmful effects or can interact with other drugs.  There

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