Menopause is the cessation of monthly menstrual cycles. This generally occurs between the ages of 45 and 55 years. Levels of reproductive hormones decline, and egg cells in the ovaries gradually degenerate. Some women experience unpleasant symptoms, such as hot flashes, headaches, insomnia, mood swings, and urinary problems. There is also some atrophy of the reproductive tract with vaginal dryness. Most importantly, decline in estrogen is associated with weakening of the bones (osteoporosis).
Hormone replacement therapy (HRT), usually consisting of estrogen in combination with progestin, has been recommended to alleviate menopausal symptoms. Replacement hormones also seem to reduce loss of bone tissue associated with aging. Recent concerns about the safety of HRT, however, have caused reconsideration of this therapy beyond the early postmenopausal years. As always, exercise and a balanced diet with adequate calcium are important in maintaining health. Addition of soybeans to the diet, as found in products such as soy nuts, tofu, and soybean oil, has been recommended for the protective estrogen-like compounds they contain. There are also nonhormonal drugs available to build bone mass if needed.
Contraception is the use of artificial methods to prevent fertilization of the ovum or its implantation in the uterus. Methods can be used to block sperm penetration of the uterus (condom, diaphragm), prevent implantation (intrauterine device [IUD]), or prevent ovulation (hormonal methods). Surgical sterilization for the male is a vasectomy; for the female, surgical sterilization is a tubal ligation, in which the fallopian tubes are cut and tied on both sides (Fig. 15-4). The preferred method for performing this surgery is through the abdominal wall with a laparoscope (Fig. 15-5).
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Are Menopause Symptoms Playing Havoc With Your Health and Relationships? Are you tired of the mood swings, dryness, hair loss and wrinkles that come with the change of life? Do you want to do something about it but are wary of taking the estrogen or antidepressants usually prescribed for menopause symptoms?