M ENOPAUSE ANDROPAUSE

1. MENOPAUSEANDROPAUSE

2. Before Menopause

3. The transition to menopause is called • Perimenopause • Typically symptoms can begin up to 10 years prior to the last menstrual period • Natural menopause happens gradually • ovaries don't abruptly stop; they slow down

4. Ovulation doesn’t necessarily occur on a monthly basis • Periods may become more unpredictable • Women’s childbearing years are winding down • But, it’s still possible to get pregnant

5. Then Menopause Appears • A milestone • 12 months in a row since a woman's last period

6. What is Menopause?

7. A reproductive hormone plunge, resulting in the permanent end of menstruation a turning point, not a disease, which brings a big impact on a woman's wellbeing a physical upheaval from hot flashes, night sweats, and other symptoms but it’s also the start of a new and rewarding phase of a woman's life a golden opportunity to guard against major health risks like heart disease and osteoporosis.

8. What is Andropause?

9. Andropause is the term given to a combination of symptoms that can lead to the male menopause • A controversial term • Medical opinion is split as to whether this phenomenon actually occurs • Controversy emerges because there is no clear physical symptom to match the end of menstruation in women

10. Many doctors use the term "andropause" to describe aging-related hormone changes in men • Also described as a decrease in testosterone levels or a reduction in the bioavailability of testosterone related to aging

11. Other terms for male menopause : • *testosterone deficiency syndrome - TDS * • androgen deficiency of the aging male • late-onset hypogonadism

12. What Causes Menopause?

13. Age is the leading cause of menopause • brought on by the ovaries gradually slowing down their function • Certain surgeries and medical treatment can induce menopause: • chemotherapy • pelvic radiation therapy • surgical removal of ovaries • Having a hysterectomy ,without removing the ovaries does not lead to menopause, although you will not have periods anymore

14. What Causes Andropause?

15. decreasing testosterone levels or a reduction in the bioavailability of testosterone related to aging. • hormone production and testosterone bioavailability decline more gradually

16. How is Menopause/ Andropause Diagnosed?

17. MENOPAUSE • hormone levels are not a reliable method for diagnosing menopause • no single blood test reliably predicts the menopausal transition. • Therefore, there is currently no proven role for blood testing regarding menopause except for tests to exclude medical causes of erratic menstrual periods other than menopause.

18. THE ONLY WAY TO DIAGNOSE MENOPAUSE • Absence of menstrual periods for 12 months in a woman (excluding other medical causes)

19. ANDROPAUSE • Physical exam • Symptomatic • Diagnostic tests – to rule out other medical problems contributing to condition such as: • Hypogonadism • Diabetes • Htn • Blood work; including testosterone levels

21. Testosterone levels vary greatly among men • Older men tend to have lower testosterone levels than do younger men • Testosterone levels gradually decline throughout adulthood • 1 % a year, after age 30, on average • around 70yrs of age - as much as 50 %

23. When Does Menopause/ Andropause Start?

24. on average, women are 51 at natural menopause,but menopause can start earlier or later. • some as young as 40 • Premature: under 40: induced or natural • very small percentage as late as 60 • smokers tend to go through menopause a few years earlier than non-smokers • there is no proven way to predict menopause age • only after a woman has missed her periods for 12 straight months, without other obvious causes, that menopause can be confirmed.

25. Unlike menopause in women, when hormone production stops completely, testosterone decline in men is a slower process. • The testes, unlike the ovaries, do not run out of the substance it needs to make testosterone. • A healthy male may be able to make sperm well into his eighties or longer. • However, as a result of disease, subtle changes in the function of the testes may occur as early as 45 to 50 years of age, and more dramatically after the age of 70 in some men.

26. Menopause/ Andropause What to Expect

27. Menopause isn't a one-size-fits-all event • Some women reach natural menopause with little to no trouble • Others experience severe symptoms that drastically hamper their lives • Forced menopause, secondary to surgery, chemotherapy, or radiation • = tough adjustment, physically and mentally

28. SIGNS & SYMPTOMS

29. Typically Menopause has three main types of symptoms Physical - Emotional - Sexual • Symptoms can include • profuse sweating • headaches • anxiety • Forgetfulness • problems with concentration • Plus others, such as ….

30. Period Changes

31. periods may get shorter or longer, heavier or lighter, with more or less time between periods • The National Institute on Aging recommends seeing a doctor if: • periods come very close together • heavy bleeding or spotting • periods last more than a week

32. Hot Flashes

33. Brief feeling of heat • May make the face and neck flushed • cause temporary red blotches to appear on the chest, back, and arms • Sweating and chills may follow • vary in intensity • typically last between 30 seconds and 10 minutes

34. ANDROPAUSE Physical Changes From This ….

35. To This!!!!

36. Physical changes can include: • Increased body fat • Reduced muscle bulk • Reduced strength and endurance • Decreased bone density • Swollen or tender breasts (gynecomastia) • Loss of body hair • Rarely: hot flashes

37. Sleep Issues

38. Night-time hot flashes can hamper sleep and cause night sweats.

39. Try these sleep tips: • Use a fan in your bedroom. • Avoid heavy bedding. • Choose light cottons or sheer materials for your nightclothes. • Keep a damp cloth nearby to cool yourself quickly if you wake up feeling hot and sweaty. • Keep pets out of your bedroom; they can give off heat. • Consult your doctor if menopause sleep problems persist.

40. Decreased Testosterone sometimes causes: • Insomnia • Increased sleepiness

41. Sex Problems

42. Painful intercourse, secondary to … • Vaginal Atrophy: lining of vagina becomes thinner, drier, light pink to bluish in colour, and less elastic • Libido may also change, for better or worse • TIPS • *Try using a water-soluble lubricant • *Kegel exercises

43. Erectile Dysfunction • Reduced sexual desire • Fewer spontaneous erections (ie: during sleep) • Infertility • Testes many become smaller

44. Factors besides Menopause or Andropause • for Decreased Libido • medications • depression • stress • poor sleep, or • relationship problems • So ………………

45. Don’t settle for a so-so sex life • Talk to your MD/ NP/ RN if sex problems occur • Remember … • Sexually transmitted diseases (STDs) don't end with Menopause & Andropause • "safe sex “still counts

46. EMOTIONAL CHANGES

47. IRRITABILITY

48. DEPRESSION

49. Managing Severe Symptoms

50. Medical Interventions • low-dose birth control pills if you're perimenopausal; • antidepressants, • blood pressure drugs, • other medications to help with hot flashes Such as ….