SYMPTOMS AND SIGNS OF THE MENOPAUSE
The terms 'symptoms' and 'signs' are often used interchangeably, but strictly speaking a symptom is a complaint of which the patient is herself aware whereas a sign, in medical terms, is determined by medical examination: for example, raised blood pressure, or altered cholesterol level.
As ovarian follicles become fewer in number so the amount of circulating 17B-oestradiol, the isolated form of oestrogen produced by the granulosa cells, falls, and symptoms of oestrogen deficiency become more evident. In overweight women, however, such symptoms are lessened (although not prevented) by the presence of oestrone, a weaker oestrogen which is produced by conversion of androstenedione in fatty tissues.
Oestrogen deficiency is linked with, but not always entirely responsible for, the various symptoms and signs which occur around the menopause. However, about 20 per cent of women may experience few or none of these symptoms, which may be considered as physical, psychological or sexual.
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Womens health
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ANTE-NATAL TESTS
Cervical smear Most cervical cancer can be prevented, which is why the majority of women will have a cervical smear test at the first ante-natal visit. It entails the insertion of a speculum into the vagina and an almost painless scraping of the surface of the cervix for a sample of cells which will be examined under a microscope in the laboratory. This test, looking for pre-cancerous cells, is widely advocated for all women pregnant or not, particularly if they're over thirty-five , have had more than one (male) sexual partner and if they have three or more children. There is no special reason for testing pregnant women and it is probably not an essential test, but if you are undergoing a vaginal examination anyway, there is virtue in having it done.
Chest x-ray If you have a history of chest illness you may be offered a chest x-ray to check for TB. Avoid it if you possibly can. X-rays are known to damage the foetus, particularly in the early months of pregnancy. A woman's body should be heavily screened during a chest x-ray to prevent the x-rays affecting the foetus, but despite the most careful precautions there is some evidence that some rays may still get through to the foetus.
Ultrasound A few hospital clinics like to perform an ultrasonic scan at this stage in order to confirm dates. Ultrasound - which uses high-frequency sound waves to form on a TV screen a picture of a foetus inside the womb - is now widely used in ante-natal care and is assumed to be safe even though this has never been verified. Since, theoretically at least, any possible effects of ultrasound are more likely to affect the foetus when it is tiny, it is perhaps particularly important that it should not be used unnecessarily at this stage. Women are anyway commonly well aware of the age of their pregnancy. In one survey, sociologist Ann Oakley found that over ninety per cent knew their dates exactly, and the rest knew to within a week.
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Women's Health
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