The World Health Organization has defined the perimenopause as the period preceding the cessation of menopause, and lasts for a year following the last cycle of spontaneous bleeding. On average, this period has a duration of 3 years.

Still no known biochemical findings that reliably indicate the onset of menopause. However, blood levels of the hormone tend to increase in women who are still menstruating normally about the end of the premenopausal (42-50 years), and there are changes in the rate of secretion and the availability of other hormone, LH. The secretion of estrogen in perimenopause is, meanwhile, variable, and includes intervals of increased secretion, probably caused by increased stimulation by FSH.

The “heat” may precede the onset of anovulatory cycle in perimenopause. Physical symptoms, such as tension in the breasts, irregular menstrual bleeding, “hot flashes”, and dyspareunia (painful intercourse) and emotional symptoms such as disrupted sleep, fatigue, tension, and irritability are regularly present in all menopausal women.

Individual variations in aging female

Even identical twins can have 12 to 14 years of discordance in the age at menopause, although fifty percent of twins are concordant within two years.

Therefore, the aging female reproductive tract depends not only on genetic factors but also. This could arise from non-uniformity between different people in prenatal survival rates of oocytes (cells that give rise to eggs) and follicles, and highlights the importance of the ovarian reserve of oocytes.

In other words, all women do not come into the world with the same amount of potential ova, and this is a factor in the age at onset of menopause: the greater the amount of oocytes, later age of onset of menopause.

The aging of the ovary

Women have a limited, non renewable, oocytes. Therefore, the lower control oocytes is critical in determining the length of the female reproductive life. It is estimated a maximum population of 7 million oocytes, at 20 weeks gestation. Two million persist until birth, and about 400,000 until the onset of puberty. Only 400 oocytes, some are actually ovulated during a woman’s reproductive years. Understanding the mechanisms regulating oocyte depletion is critical to develop strategies to extend the reproductive life, speaking in premature ovarian failure, and preserving gonadal function in women treated with chemotherapy for cancer.

In the preservation or destruction of the oocytes play a pivotal role a group of substances called modulator of apoptosis (esfingomilinasa, ceramide, Bcl-2, Bax protein, etc.).. For example, Bax promotes the “loss” of oocytes by acting on the primordial follicles. The decline of this Bax in experimental conditions, results in a marked expansion in the reproductive life in mice. Furthermore, the gonadotropins (other hormones) rescued more mature follicles, opposing the destruction of other different follicle cells of oocytes, granulosa cells.

Finding drugs that promote the protection follicular could, for example, limiting premature menopause in women receiving chemotherapy.

Hormonal factors in developing breast cancer after menopause

The incidence of breast cancer increases with age. A large study (the National Surgical Adjuvant Breast and Bowel Project) evaluated 13,000 women treated for 5 years with placebo or tamoxifen. Tamoxifen is a drug that acts as an antagonist of estrogen action in breast tissue. Patients receiving tamoxifen achieved an 50% reduction in invasive breast cancer development.

This is because estrogens bind to a receptor on the surface of breast cells, which induces the action of substances called growth factors (GF) and possibly also of genes that stimulate the growth of cancer cells.

However, the clinical data available so far, found no relationship between treatment with growth hormone (HGH) and the development of breast cancer.

Menopause for women mark the end of her reproductive capacity, the “critical age”, but does not occur just at the time of the last menstrual period, but before they appear on a gradual and progressive organic manifestations, such as changing the frequency and duration of menstrual cycle, which account for the change that is taking place at the body. This process involves a psychologically correlate well, there are different emotional reactions such as mood swings, insecurity, fear of the future, sadness, anxiety, depression, and so on.

So far I have mentioned what every woman, minimally informed, know about this very special period of life. The question is: if all women suffer necessarily and inevitably some of these disorders, how to face that change and get that instead of prevailing feelings of loss and emptiness we find new possibilities for personal fulfillment?.

Each person is unique and unrepeatable individuality and the way they respond to life situations is the joint result of several factors: personal (individual story) social and cultural rights. It will not be the same for women that motherhood has made her feelings for disappearing his biological mother can be, for he has put all his energy on family formation, which also usually starts to divide in that time as children leave more independent than for that which has developed other interests. The one that has managed to become a stable partner will be more satisfactory than that contained not have the support of a partner.

From a socio-cultural aspect, an environment in which the “non motherhood is seen as a stigma (and although not explained, this is still very refined), increases the experience of failure in the woman who has not been able they turned their creative potential in other planes beyond the biological.

The relationship of women with your body and how this affects their personal assessment (self), an image “forever young” is another of the many aspects to consider in understanding the situation of each one in particular.

While irreversible evolutionary process, menopause requires each woman (and consequently his psyche), find adaptive resources that allow transit nontraumatic. Alone or with professional counseling, must perform a complex task that involves connecting with itself, its history, accepting loss, draw duels, make their own personal achievements and meet with their creative sides. In a time of balance, the opportunity to evaluate, to learn from the lived, to project what remains to be done …

Not long ago a woman was considered old at 40 years, today we find successful and active women aged 60 and over … You can get back the ability to procreate but not to create, enjoy and love.

2 .- Dry and atrophy of the urinary and genital mucosa: the reduction in the production of estrogen causes the walls of the vagina are weak, fragile, delicate and reduces their natural moisture. This can produce a feeling of itching or dryness, tension or affect sex. They are also frequent urinary incontinence, vaginal infections and urine, dysuria and frequency.

3 .- psychological disorders: These may occur in mood disorders, irritability, insomnia, anxiety, headaches. These symptoms are not due only to the decreased level of estrogen, but also on other factors specific to each individual woman and sociocultural. Women in this stage of life experiencing various losses that are related to the ideals of femininity, such as loss of the ability to be a mother, loss of the maternal role, separation from children in the house. These symptoms can also be experienced in a positive way: the fear of pregnancy disappears, the majority of children do domestic work that is smaller and has more time for other activities.

4 .- Osteoporosis: It consists in the decrease in bone mass. this decline in women is a more abrupt than in men. The most serious consequence of osteoporosis is the weakness of the bones, increasing the risk of fractures. Risk factors for severe osteoporosis are short, thin, consumption of toxic substances (caffeine, snuff, alcohol, etc..), Early menopause, nulliparity, sedentary lifestyle, family history and high frequency of hot flashes.

5 .- Cardiovascular Disorders: Loss of estrogen on the risk of ischemic heart disease, there is an average increase of blood pressure. In general, increasing the LDL (cholesterol aggressor or low density) and lowers HDL (protective cholesterol or high density). During the women’s fertile life is better protected than men, estrogen increases the fraction of the protective cholesterol (HDL). Menopause and the decline of estrogen causes the risk of coronary disease is greater.

Care to reduce the symptoms of menopause:

1 .- To reduce hot flushes and hot flashes : Not too warm, Lower heat, Use cotton clothes, Use the fan, Replace coffee, tea, cola beverages by natural juices, No smoking, Learn to relax, Exercise on a regular basis helps to reduce anxiety, Take plenty of fluids.

2 .- To reduce vaginal dryness : In sexual relations while devoting more time loving (necking) as this will increase vaginal lubrication naturally. Using specific lubricants that are sold in pharmacies, Vaseline or oil.

3 .- To control urinary incontinence : Exercises to strengthen pelvic muscles: When the bladder is empty, try to cut the flow of urine for a few seconds (the muscles are contracted) and then relax. Perform this exercise several times a day.

4 .- To prevent osteoporosis : Physical exercise moderately and regularly, where all the joints work and thus hinders the process of decalcification of bone. A diet rich in calcium, by increasing the intake of dairy products (especially for skimmed not gain weight), some Ca-rich fish such as sardines, anchovies, anchovy, tuna. Healthy diet low in fat and rich in fruits and vegetables. Sun to create enough vitamin D, which is required for proper calcium absorption. Avoid snuff, alcohol and stimulant beverages (coffee, tea and cola drinks) and that interfere with calcium metabolism.

5 .- Preventing psychological disorders : Keep a positive attitude in life. Teach a relaxation technique to reduce stress and anxiety. Using their own chores to relax. Have more time for the couple.
Teach him how to overcome the losses (fertility, loss of roles, leaving the house by the children, lost parents, relatives and friends, etc … The promotion of social relationships (friends, women’s groups, associations), to avoid isolation and loneliness.  Mental health referral if you look at some pathology such as anxiety, stress, etc …

6 .- To prevent the Gynecologic Cancer : Autoexploraciones perform breast.  Annual clinical examination, mammography every two years. Exfoliative cervicovaginal cytology.

7 .- cardiovascular disorders : Fat diet rich in olive oil helps regulate cholesterol. Healthy diet rich in fruits and vegetables. Control of blood pressure to rule out hypertension. Exercise. Hormone replacement therapy.