Menopause-when?

What doctors officially call menopause is an event - namely, the point at which you get your last menstrual period. This permanent cessation of menstruation is usually marked by 12 consecutive months of having no periods. Most women experience menopause from 40 to 58 years of age, with a median age of 51.4 years.

Perimenopause usually lasts three to five years but it can take as few as two years or as many as eight years for some women. The changes in the body that occur during menopause last for the rest of a woman's life. However hot flashes usually improve over time, becoming less frequent and less severe

Estrogen taken as a pill or applied to the skin as a patch can reduce hot flashes, sleep disturbances, mood changes and vaginal dryness. Estrogen can be prescribed alone when a woman no longer has her uterus. A combination of estrogen and progesterone is used when a woman still has her uterus. Progesterone is necessary to balance estrogen's effect on the uterus and prevent changes that can lead to uterine cancer.

Medications such as venlafaxine (Effexor) and paroxetine (Paxil) are often the first choice for women with hot flashes who are not on hormone replacement therapy. They relieve the symptoms of hot flashes in 60% of women.

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Under our skin

In zootomy and dermatology, skin is an organ of the integumentary system composed of a layer of tissues that protect underlying muscles and organs. As the interface with the surroundings, it plays the most important role in protecting against pathogens. Its other main functions are insulation and temperature regulation, sensation and vitamin D and B synthesis.

Skin has pigmentation, provided by melanocytes, which absorbs some of the potentially dangerous radiation in sunlight. It also contains DNA repair enzymes which reverse UV damage, and people who lack the genes for these enzymes suffer high rates of skin cancer. One form predominantly produced by UV light, malignant melanoma, is particularly invasive, causing it to spread quickly, and can often be deadly. Human skin pigmentation varies among populations in a striking manner. This has sometimes led to the classification of people on the basis of skin color. See the article on human skin color.

Skin is composed of the epidermis and the dermis. Below these layers lies the hypodermis(subcutaneous adipose layer), which is not usually classified as a layer of skin.

Skin can be dividided into thick and thin types. Thick skin is present on the soles of the feet and the palms of the hands. It has a larger stratum corneum with a higher keratin content. Thick skin does not grow hair; its purpose is to help grip. Thin skin is present on the bulk of the body and has a smaller stratum corneum and fewer papillae ridges. It has hair and is softer and more elastic. The characteristics of the skin, including sensory nerve density and the type of hair, vary with location on the body.

The skin must be regularly cleaned. Unless enough care is taken it will become cracked or inflamed. Unclean skin favors the development of pathogenic organisms.

The constantly peeling off dead cells of the epidermis mix with the secretions of the sweat and sebaceous glands and the dust found on the skin to form a filthy layer on its surface. If not washed away the dirt and dead skin slurry begins to decompose emitting a foul smell.

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Impotence

Physical factors include drugs (alcohol, nicotine, narcotics, stimulants, antihypertensives, antihistamines, and some psychotherapeutic drugs); injuries to the back, problems with an enlarged prostate gland, problems with blood supply, nerve damage (as in spinal cord injuries); or disease (diabetic neuropathy, multiple sclerosis, tumors, and, rarely, tertiary syphilis); failure of various organ systems (such as the heart and lungs); endocrine disorders (thyroid, pituitary, or adrenal gland problems); hormonal deficiencies (low testosterone, estrogen, or androgens); and some birth defects.

For both men and women, these conditions can manifest as an aversion to, and avoidance of, sexual contact with a partner. In men, there may be partial or complete failure to attain or maintain an erection, or a lack of sexual excitement and pleasure in sexual activity.

Psychological issues such as depression, anxiety, guilt or fear can sometimes cause sexual problems. At one time, these factors were thought to be the major cause of erectile dysfunction. Doctors now know that physical factors are present in most men with erectile dysfunction. However, embarrassment or "performance anxiety" can make a physical problem worse. Erectile dysfunction caused only by psychological causes is found most commonly in young men.

Many medications cause problems with sexual function, including drugs for high blood pressure, depression, heart disease and prostate cancer.

A man with erectile dysfunction has either a problem getting an erection or difficulty maintaining one. This usually interferes with sexual activity by preventing penetration during intercourse.

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