There are many stages to aging and menopause is one of the things women go through as they become older. Menopause is a normal condition that women experience as they age, and it is a term used to describe the many changes they go through. It is a period where they stop menstruating and it marks the end of their reproductive period. This is something that typically happens around the age of 40, but it can happen sooner or later depending on the individual. If it does happen before the age of 40 it is still considered normal aging but it is referred to as premature menopause. This can occur if there is an ovarian failure, autoimmune disorders, or medical procedures. There are three known stages to menopause which include perimenopause, menopause, and post-menopause. Perimenopause lasts up until menopause and it will usually begin years before menopause when the ovaries begin to make less estrogen. In the last years of this stage is when the drop in estrogen levels drops very quickly and where women begin to experience menopause symptoms. This continues on with menopause which is the point when it has been a year since a woman last had her menstrual period. In this stage the ovaries stop releasing eggs and stop making most of their estrogen as mentioned before. The last known stage is post-menopause and this is all after menopause. During this stage most menopausal symptoms are at ease for most women such as hot flashes, but unfortunately health risks related to the loss of estrogen rise as women age. Women cope with menopause in different ways depending on their culture, and their symptoms tend to vary depending not only on culture but where they are living as well. For example, in a cross-cultural comparison of women’s midlife symptoms in China revealed that they suffer from more symptoms than American women do. Their symptom checklist consisted of many things such as; headaches, backache, and aching joints– which were connected with a Japanese notion of midlife transition. Overall, ten of the symptoms, including hot flashes, night sweats, trouble sleeping, feeling depressed, irritability, headache, dizziness, backache, aching joints, and feeling tired, were either associated with menopause or the ‘‘climacteric’’ on Western checklists and/or again with a Japanese notion of midlife transition. The remaining six – diarrhea or constipation, persistent cough, shortness of breath, sore throat, upset stomach, and poor appetite – were not typically associated with either. (Shea, 2006) In addition the women in China required special attention for something we would see as minor symptom such as a hot flash. Another example includes the patterns of menopausal symptoms and adaptive ability in a rural population in South-east Nigeria. Their symptoms included; sweating, irritability, vaginal dryness, lack of concentration, decreased libido, insomnia, depression, palpitations, joint aches, night sweats, skin itchiness, and dysuria. (Agwu, 2008) Interestingly, in Nigeria they reported the hot flashes as the most unbearable symptom in comparison with all the other symptoms present. In addition to that, none of the women were under any treatment for menopause nor had they consulted a doctor for it. In this particular culture, menopause is something big to deal with therefore dealing with it alone; no children, no relatives, or widowed, seemed to suffer more than those who had people surrounding them. None of the women questioned about menopause had ever heard of the hormone replacement therapy which explained why none of them were getting any treatment and none of them reached out for help even if they felt like they needed it. It is interesting to see how things change from culture to culture even with something like menopause. According to the studies in both China and Nigeria, women did not seem to be as informed about menopause as the women in our culture. Some women even mentioned not feeling educated on the subject and only remember it being brought up by their mothers. The mothers would not even go into details about it with them, they would simply say that they would eventually age and grow old and that along with aging, they would suffer from things that would not be pleasant. In their culture it is something they just deal with alone and some do not even consult a doctor to make sure that no other problems have affected them. Women suffer from several symptoms due to menopause. Every individual is different and it affects everyone in different ways. Some of these symptoms include the well-known hot flashes, which are described as a sudden feeling of warmth that spreads over the body which is accompanied with some blushing and sweating. The severity of these hot flashes does vary from person to person and it just depends on the individual. Other symptoms during this time of menopause include irregular or skipped periods, insomnia, mood swings, fatigue, depression, irritability, racing hearts, headaches, joint and muscle aches and pains, changes in sex drive, vaginal dryness, and bladder control problems. Not all women get all of these symptoms, but these are the common ones known for women to go through. There are ways to deal with these menopausal symptoms. According to the Women’s Health Initiative, there are natural therapies that help cope with the changes as well as some modifications that can be made in order to make the transition flow easier. Avoiding alcohol, smoking, and for some women even spicy foods, can help them cope much better. Switching over to foods like soy, lentils, flaxseed, and just an overall diet rich in plants is said to help women. There is also what is known as the hormonal replacement therapy which is a treatment with estrogens with its ultimate goal being to alleviate menopausal symptoms. HRT is given to some women whose estrogen and progesterone levels drop due to menopause and in addition to that for some women there is a drop in the amounts of hot flashes they have and a decrease in the severity of the symptoms. Some women might choose to take HRT because of the benefits linked to it and for its approval for the relief of the symptoms and the prevention or treatment of osteoporosis which becomes very common among this age group of women. Some of those benefits include the improvement of muscle function, the reduction in heart failure and heart attack risk, it decreases mortality in younger postmenopausal women, and its protection against brain aneurysms. Those are only benefits, but there are also some women who choose to not take HRT because of the risks found. According to “Facts about Menopausal Hormonal Therapy,” beginning in July 2002, they found that a long term use of HRT poses a threat to the health of the individuals who use this medication. It may increase the risk of heart attack and stroke. Not only are there risks to the HRT, but there are also side effects to taking it. Some of these include bleeding, bloating, breast tenderness or enlargement, headaches, mood changes, and nausea. We can see why some women would decide not to take the medication if this is all they would have deal with. There are alternative methods for women other than HRT such as other medications or simply changing one’s lifestyle. They can follow a healthy eating plan, prepare foods with less salt, maintaining a healthy weight and staying physically active. In addition there are designated medications that help with a particular symptom such as hot flashes, mood swings, insomnia, etc. and some foods that help with the problems as well. The Women’s Health Initiative is one of the largest studies which began in 1991. “It consists of a set of clinical trials, an observational study, and a community prevention study, which altogether involves more than 161,000 healthy post-menopausal women.” They conducted clinical trials in order to test the effects of HRT, diet modification, and calcium and vitamin D supplements on heart disease, osteoporotic fractures, and breast and colorectal cancer risk. (Sweeney, 2014) The trial was eventually stopped because cancer risks increased and the risks from the use of the hormones outweighed benefits. This does not necessarily mean that women on the hormone will develop a type of cancer or suffer other side effects. As mentioned in the article one also has to consider the family medical history and other factors that play a role such as your lifestyle and other influences. In my opinion I would not take the hormone replacement therapy. I don’t know what the symptoms feel like, but I personally feel like it is not necessary. As mentioned in one of the articles there are other ways to deal with the symptoms. The individual can treat the specific symptom with a medication or change of lifestyle that can target jus that one thing causing the issues. For example, if one is suffering from mood swings they can take anti-depressants, they can increase their level of physical activity and try getting enough sleep. For hot flashes they can reduce stress, eat healthier, sleep in a cool room and take anti-depressants as well. We must keep in mind that everyone’s body does function differently and what works for one individual may not work for another. In addition to that, I would also abstain from taking HRT because of all the risks found to affect some women. Increased risk for stroke, heart disease, cancer, etc. all sound like scary things and I would just prefer to either try other medications after consulting a doctor about them, or simply changing my lifestyle. A women’s identity is bound to change after going through menopause. They suffer from hormonal changes and going from having a menstrual period to all of a sudden no menstrual period at all is a big change for the body. Not only that but knowing that one cannot reproduce at this point anymore is probably a lot to take in for some women and some may handle it better than others. This is why some women suffer from depression shortly after menopause because of the big physical changes going on with the body and at times it can be a lot to take in. Their roles change because at this point they might even go from being a mother, to now being a mother and grandmother due to the old age. Not necessarily saying that menopause marks old age because in some cases it has been found that it strikes some women in their earlier years, but in most cases it does happen in the later years. Menopause should not mark the end of a woman’s life as some of them might feel this way. It is simply the beginning of a new stage in life where they have to cope with sudden physical changes. It may be difficult to handle, especially in the beginning, but it is not something the women cannot handle and take on with the help of those around them. The women need to know that just because they are no longer menstruating it does not make them any less than any other women who is. It is all part of aging and it is a normal process that all women go through when the time comes. Aging and growing old is a beautiful thing and it just shows us how we are alive and still able to experience everything that we are supposed to as humans.

References
Agwu, U. M., Umeora, O. J., & Ejikeme, B. N. (2008). Patterns of menopausal symptoms and adaptive ability in a rural population in south-east Nigeria. Journal Of Obstetrics & Gynaecology, 28(2), 217-221. doi:10.1080/01443610801915637
Foran, T. (2010). Managing menopausal symptoms. Australian Prescriber, 33(6), 171-175.
Shea, J. L. (2006). Cross-cultural comparison of women’s midlife symptom-reporting: a china study. Culture, Medicine & Psychiatry,30(3), 331-362. doi:10.1007/s11013-006-9020-4
Sweeney, E. E., Ping, F., & Jordan, V. C. (2014). Molecular Modulation of Estrogen-Induced Apoptosis by Synthetic Progestins in Hormone Replacement Therapy: An Insight into the Women's Health Initiative Study. Cancer Research, 74(23), 7060-7068. doi:10.1158/0008-5472.CAN-14-1784