The team at Women’s View, lead by Dr. Richard Buyalos – one of the worlds leading experts on endocrinology, obstetrics, and gynecology – has compiled a comprehensive list of 181 definitions related to menopause, perimenopause, and postmenopause. Choose a letter below to take you to the definition you’re looking for. You can also scroll through the list to find the term you are looking for. These definitions are also available in the free Menopause View™ smart phone app.


ABCDEF • G • HI • J • KLMNOP • Q • RSTUVW • X • Y • Z


A

Abnormal Uterine Bleeding (previously known as Dysfunctional Uterine Bleeding) – Menstrual cycles that are longer than 35 days or shorter than 21 days are considered abnormal. Abnormal uterine bleeding may include any of the following situations:
• Spotting or bleeding anytime between expected menstrual cycles (metrorrhagia)
• Bleeding after sex (post-coital bleeding)
• Bleeding which is heavier or lasts more days than normal (menorrhagia)
• Bleeding after menopause

Adipose Tissue – the majority of this connective tissue is made up of fat cells. It is located under the skin but can also be found between muscles, intestines, around the heart and elsewhere. The stored fat in adipose tissue comes primarily from dietary fats. It acts as a reserve or storehouse of energy to protect the body from starvation and aids the body in extreme exertion. The fat also pads the organs to protect them from trauma and it contributes to regulating and conserving body heat.

Alzheimer’s Disease – named after German neurologist, Alois Alzheimer for his medical contributions on neurohistology, this degenerative brain disease predominates in women. The cause is unknown and symptoms usually begin in late middle age or old age. Symptoms include; progressive memory loss, difficulty with comprehension, impaired thinking, disorientation, changes in personality or mood including but not limited to paranoia and loss of social control. Advanced cases show a profound decline in cognitive and physical function. The risk for contracting Alzheimer’s is 10-30% greater if a first-degree relative suffers from the disease. While no dramatic breakthroughs in treatment have occurred, the overall management is becoming increasingly sophisticated and it is widely believed this trend will continue.

Analgesic – There are two classes of this pain-relieving drug. Narcotic analgesics act on brain receptors to inhibit pain impulses. Most physicians are hesitant to prescribe narcotics due to the risk for drug addiction. Non-narcotic analgesics include NSAIDs (Aspirin and Ibuprofen) and Acetaminophen work by inhibiting the synthesis of Prostaglandins, the molecules involved in the peripheral perception of pain.

Androstenedione – The outer part of the adrenal glands, referred to as the cortex, and the ovaries release this hormone into the bloodstream. Once released the body converts it to testosterone and estrogen. After menopause, the level of androstenedione circulating in the blood stream is about one half of what it was prior to menopause.

Anemia – Due to the hormonal changes that occur during perimenopause some women experience heavy bleeding that can lead to anemia. Coupled with poor diet women are at an increased risk for anemia. Fatigue, rapid heart beat, dizziness, shortness of breath, insomnia and leg cramps are common symptoms. Iron supplements are generally prescribed and in extreme cases of excessive bleeding uterine ablation may be performed.

Atherosclerosis – a condition in which plaque builds up inside the arteries resulting in hardening and thickening, which may partially or completely block blood flow. Plaque consists of cholesterol, fatty substances, cellular waste products, calcium and a clotting material in the blood called fibrin. Some diseases commonly associated with atherosclerosis include coronary heart disease, angina, carotid diseases, peripheral artery diseases (PAD) and chronic kidney disease. A diet high in fat, elevated blood pressure and smoking all contribute to the growth of atherosclerosis. The risk for women increases with menopause because the level of estrogen is depleted. Estrogen helps keep arteries free from plaque by improving the ratio of LDL (low-density lipoprotein) and HDL (high-density lipoprotein) cholesterol. Estrogen also helps keep the lining of blood vessels strong and pliable, further reducing the risk of atherosclerosis.

Atrophic Vaginitis (also known as vaginal atrophy or urogenital atrophy) – is an inflammatory condition of the vagina and the outer urinary tract caused by thinning and shrinking of the vaginal tissues. These symptoms are due to chronic estrogen deficiency that occurs with menopause or the loss of ovarian function. Symptoms included decreased lubrication, painful intercourse, vaginal dryness and itching.

Abdomen (less formally called the belly, stomach, tummy or midriff) – constitutes the part of the body between the chest and pelvis.

Amenorrhea – is the absence of a menstrual period in a woman of reproductive age.

Androgen (from andro, the Greek prefix meaning masculine) – is the broad term for any natural or synthetic compound that stimulates or controls the development and maintenance of male characteristics. Androgens are produced by both men and women. Female androgen production is primarily from the ovaries and adrenal glands.

Antidepressants – are medications used for the treatment of depression and other conditions, including anxiety disorders, obsessive compulsive disorders, eating disorders, and chronic pain. They have also been used to treat snoring, migraines, attention-deficit hyperactivity disorder (ADHD), substance abuse and sleep disorders. They can be used alone or in combination with other medications.

Antihypertensive Medications – are a class of medications that are used to treat hypertension (high blood pressure).

Anti-inflammatory Drugs – medications that are used to reduce inflammation or swelling. These medications include aspirin, NSAID’s like ibuprofen, and acetaminophen.

Anxiety – disorders that involve repeated episodes of sudden feelings of intense fear, worry, and uneasiness. These feelings interfere with daily activities and are often difficult to control. Symptoms may start in childhood, adolescence, or adulthood. Examples include separation anxiety, social anxiety disorder common, and various phobias.

Aromatase Inhibitor – are a class of medications which block the conversion of androgens to estrogens. They are frequently used in the treatment of breast and ovarian cancer, particularly in postmenopausal women.

Aromatase – the enzyme that converts androgens to estrogen. See aromatase inhibitor.

Arthritis – is inflammation of one or more joints. The principle symptoms include pain and stiffness which are generally worse with increasing age. While there are multiple forms of arthritis, the most common types of arthritis are osteoarthritis (degenerative joint disease) and rheumatoid arthritis (an autoimmune disorder that effects the joints).

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B

Basal Metabolic Rate – refers to the amount of energy that the body expends when at rest. The higher your BMR, the more calories you burn on a daily basis. There are several factors that affect an individual’s BMR such as; genetics, gender, age, weight, diet, exercise, thyroid and temperature. Women tend to have a lower BMR to start with and the rate decreases with age. This contributes to weight gain, especially when coupled with the fluctuating hormones occurring during menopause.

Benign – refers to a condition, tumor, or growth that is not cancerous and does not invade surrounding tissue or spread to other parts of the body.

Bilateral Oophorectomy
– removal of both ovaries during a surgical procedure. When the surgery involves removing of only one ovary, it’s called unilateral oophorectomy.

Biofeedback – is a mind-body technique that helps teach patients how to influence their autonomic nervous systems – the part of the body that controls involuntary physical functions such as blood pressure, heart rate, muscle tension, and brainwave frequency. This is done by attaching an electronic “cue” (usually a beep, tone or visual image on a screen) to a measurable physiologic process. A person can thus monitor his or her internal responses and develop a sense of how to control them in positive ways.

Bioidentical Hormones – hormones that are chemically identical to those your body produces. There is no scientific support for an advantage of these compounds over commercially produced preparations. Both biodentical hormones and those produced by the body bind to the same receptors and tissue.

Biopsy – a tissue sample taken from the body for a more careful examination. Biopsies are used to help diagnose and/or remove areas of tissues in the body that aren’t normal. These abnormal tissues may be called a lesion, a tumor, or a mass.

Bisphosphonates – A class of medications that prevent the loss of bone mass and are used to treat osteoporosis and similar diseases. They are available in both oral and intravenous formulations.

Birth Control – is any method used to prevent pregnancy. There are many different methods of contraception including condoms, IUDs, oral contraceptives, the rhythm method, vasectomy, and tubal sterilization procedures.

Bisphosphonates – the most commonly used class of medication in the treatment of osteoporosis.

Black Cohosh – is a perennial woodland plant that is a member of the buttercup family. It grows in the eastern United States and Canada. Black cohosh grows from 4 to 8 feet tall and has feathery white flowers. The root is used in herbal remedies. Some studies have reported black cohosh may improve menopausal symptoms for up to one year, although the beneficial effects have not been scientifically validated.

Bladder – is a muscular sac in the pelvis, just above and behind the pubic bone. When empty, the bladder is about the size and shape of a pear. The bladder stores urine, allowing urination to be infrequent and voluntary. The bladder is lined by layers of muscle tissue that stretch to accommodate urine. The normal capacity of the bladder is 400 to 600 mL. During urination, the bladder muscles contract, and two sphincters (valves) open to allow urine to flow out.

Bladder Prolapse (cystocele) – occurs when the bladder is no longer supported by the anterior (front wall) of the vagina, and descends into the vagina. This may cause urinary difficulties, discomfort, and stress incontinence (urine leakage caused by sneezing, coughing and/or exertion). Principle risk factors include childbirth and a low estrogen environment such as menopause.

Body Mass Index (BMI) – the measure of weight relative to height. BMI is a reliable indicator of total body fat in regards to risk of disease and premature death. A later onset of menopause is not uncommon for obese women because fat can produce estrogen. A normal BMI for women is between 18.5-24.9.

Bone Density or Bone Mineral Density (BMD) – is a medical term referring to the amount of calcium and other minerals (per square centimeter) in an area of bone. Bone mineral density (BMD) tests are useful tools to determine your bone health. These tests can identify osteoporosis, determine your risk for fractures (broken bones), and measure your response to osteoporosis treatment.

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C

Calcitonin – a hormone produced by the thyroid gland that helps regulate calcium concentrations in the body. Synthetic calcitonin may be recommended as a treatment for osteoporosis.

Calcium – maintains bone health and has been shown to slow the rate of bone loss and reduce fracture risk. Calcium supplementation helps prescription therapies work more efficiently.

Cancer – is defined as an uncontrolled growth of abnormal cells in the body. Cancerous are also known as malignant cells.

Candidiasis – a fungal infection caused by yeasts that belong to the genus Candida. There are over 20 species of Candida yeasts that can cause infection. Candida albicans is the most common and usually referred to as a yeast infection when there is an overgrowth of these organisms in the vagina. Symptoms include itching, burning, vaginal discharge that is thick and curd-like and pain after intercourse. 75% of women are reported to have had at least 1 yeast infection in their lifetime. Causes are antibiotic treatment, which disrupts the normal pH or flora in the vagina, diabetes and hormone replacement therapy.

Cardiac Arrhythmias – A normal heart beats in a steady, even rhythm, about 60 to 100 times each minute (that’s about 100,000 times each day). Cardiac arrhythmias are disturbances in the normal rhythm of the heartbeat. An occasional palpitation or fluttering is usually not serious, but a persistent arrhythmia may be life threatening. Diminished estrogen levels can cause over-stimulation of the heart.

Cataract – is a condition where clouding occurs inside the normally clear lens of an eye. Cataracts are caused by a breakdown of proteins in the lens. It can lead to a progressive decrease in vision. Your chance of having cataracts increases with unprotected exposure to ultraviolet (UV) radiation, advancing age and high cholesterol. If needed, cataract surgery is generally a safe and effective procedure.

CAT Scan (also known as CT scans) – a computerized axial tomography used as a diagnostic tool. They are special X-ray tests that produce three dimensional images of the body that helps in the screening, diagnosis, and treatment of tumors, fractures, and infections.

Cervix – the lower part of the uterus (womb) that connects to the vagina which leads to the outside of the body. During menstruation, blood flows from the uterus through the cervix and into the vagina. It is part of the female reproductive system. (ADD TO PERIOD VIEW).

Chemotherapy – (also known as chemo) a type of cancer treatment that uses chemical substances to destroy fast growing cells in the body. Chemo therapy is most often used to treat cancer, because malignant cells multiply more rapidly than most other cells in the body.

Cholelihiasis – is a swelling and irritation of the gallbladder. It increases in frequency with age progression and is more predominant in women of all ages.

Cholesterol
– There are 2 types of cholesterol. LDL stands for low-density lipoprotein and is considered “bad” because it contributes to forming artery clogging plaque, which in turn, puts you at risk for heart attack, stroke and other diseases. HDL, or high-density lipoprotein is considered “good” because it helps remove LDL cholesterol from the arteries.

Chondroitin Sulfate – is a molecule produced naturally in the body. It is commercially manufactured as a supplement, most often used to treat osteoarthritis.

Chronic Condition – is considered a long lasting condition that is not cured, but controlled. The Center for Disease Control (CDC) estimates that 86% of our health care dollars are spent on the treatment of chronic diseases.

Climacteric – refers to the period of time in women when reproductive capabilities gradually diminish as a result of the natural aging process.

Clinical Trials – are prospective biomedical or behavioral research studies on human subjects designed to answer specific questions. These studies evaluate the effectiveness of novel vaccines, medications, treatments, supplements, devices or alternative ways of using known interventions. They are used to generate safety and efficacy data.

Clonidine – is the generic name of a medication designed to treat high blood pressure. It has also been used to reduce hot flushes, migraine headaches, and restless legs syndrome. Brand names include Catapres, Kapvay, Duracion, and Nexicion.

Cognitive Function – refers to a persons ability to process thoughts. This includes memory and speech. Factors such as aging and disease may adversely affect cognitive function resulting in memory loss and difficulties in concentration and speech.

Colonoscopy
– a test that examines the inner lining of your large intestine (rectum and colon). This is done with a thin, flexible tube with a camera. It helps detect and treat ulcers, polyps, tumors, and other lesions in the colon.

Complementary and Alternative Medicine (CAM) – Refers to healing practices and products that work in conjunction with traditional medicine. These techniques include acupuncture, herbal therapy, massage therapy, meditation, movement therapies, relaxation techniques, spinal manipulation, yoga, and tai chi. They are administered by trained practitioners or teachers with expertise in these disciplines.

Congestive Heart Failure – occurs when the heart muscle doesn’t pump blood as well as it should. A variety of conditions, including coronary artery disease and hypertension can gradually weaken the heart muscle. This reduces its ability to circulate oxygenated blood to the body’s tissues.

Contraception – also known as birth control, is any method used to prevent pregnancy. There are many different methods of contraception including condoms, IUDs, oral contraceptives, the rhythm method, vasectomy, and tubal sterilization procedures.

Coronary Artery Disease (CAD) – the narrowing of the major blood vessels that supply blood, nutrients and oxygen to the heart muscle. These vessels usually become blocked and damaged by plaque (cholesterol-containing deposits). Major risk factors for CAD are smoking, hypertension, diabetes, and elevated blood cholesterol levels. See coronary heart disease.

Custom Compounded Hormones – a customized preparation of bioidentical hormones that are prescribed specifically for an individual. See bioidentical hormones.

Cystitis – a medical term for the inflammation of the bladder. This inflammation is usually caused by a bacterial infection and is referred to as a urinary tract infection (UTI). It can become a serious health problem if the infection spreads to the kidneys (pyelonephritis).

Cystocele – is a result of weak pelvic tissues. A cystocele occurs when the bladder drops down into an abnormal position and bulges through the roof of the vagina. Vaginal and pelvic tissues depend on estrogen to maintain their strength and elasticity. If a woman chooses not to take hormone replacement therapy it can result in a worsening of symptoms.

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D

Dementia – covers a broad category of brain diseases that cause long term loss of cognitive abilities and physical function. Dementia becomes more common with age.

Depression – many women experience mood swings related to fluctuating levels of ovarian hormones during the transition to menopause. For mild depression many practitioners recommend life style changes or a low-dose oral contraceptive to provide continuously stable hormone levels. For severe depression there are antidepressant medications that can be prescribed to treat the chemical imbalance.

D&C (dilation and curettage) – a procedure where tissue is removed from inside the uterus. This is done to treat and diagnose a variety of uterine conditions. It is also performed to clear the uterine lining after a miscarriage or abortion.

Diabetes – is a chronic condition in which the pancreas does not make or properly utilize insulin, the hormone needed to convert glucose and other food into energy. Type 1 diabetes is caused by insufficient production of insulin by the pancreas. Type 2 diabetes refers to insufficient insulin production or resistance to insulin. Gestational diabetes refers to the development of diabetes in pregnant women, especially during the third trimester, which is related to pregnancy-induced factors.

Dong Quai – (Angelica sinensis) sometimes called “female ginseng” is a root used for more than a thousand years as a medicine in China, Japan, and Korea. It is often used alone or in combination with other herbs to treat female reproductive problems, including menopausal symptoms, menstrual cycle disorders, and premenstrual symptoms (PMS).

DEXA Scan – Dual-energy X-ray absorptiometry is the most widely used and thoroughly studied technology for the measurement of bone mineral density (BMD). It is typically used for the diagnosis and monitoring of osteoporosis. It may be used to determine spine, hip, or total body BMD.

Dysmenorrhea
– A medical condition in which pain associated with menstruation interferes with daily activities. Also known as menstrual cramps.

Dyspareunia – Pelvic pain during intercourse due to medical or psychological causes.

Dysplasia – An early form of precancerous cells which, if untreated, may or may not develop into cancer at a later date.

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E

Endometrial Ablation – Types of surgical procedures in which thermal (heat energy) is delivered to destroy or inactivate the lining of the uterus (endometrium). This procedure may be used as a treatment for women with abnormal uterine bleeding.

Endometrial Biopsy – The removal of a small sample of endometrial tissue through the cervical opening. The sample is then examined microscopically for the presence of abnormal cells.

Endometrial Cancer – A cancer which begins in the inner lining of the uterus (endometrium).

Endometrial Hyperplasia – An excessive or abnormal thickening of the lining of the uterus. It may be caused by excessive estrogen or insufficient progestin exposure. Although benign, endometrial hyperplasia may be a risk factor for cancer of the uterus.

Enterocele – Essentially a vaginal hernia in which the small intestine drops into the pelvic cavity and bulges into the vagina. If the vaginal wall and pelvic floor weaken, the small intestine loses its support and can fall and bulge into the vagina. Heavy straining during childbirth may weaken the vaginal wall and increase the risk of
an enterocele. Other repeated straining such as during bowel movements or heavy lifting can also increase the risk of a prolapse. As a woman goes through menopause, her estrogen levels fall. This leads to a weakening of the muscles surrounding the vagina, increasing the risk of prolapse.

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F

Fallopian Tubes – Two 4-inch (10 centimeters) delicate tubes lined with ciliated (hair-like) cells that are connected to the top of the uterus. These narrow tubes allow the passage of the egg from the ovary to be fertilized (formation of an embryo), which is later transported to the uterus.

Fibrinogen
– A protein in the blood stream that is involved in the clotting process.

Formication – A medical term for sensation that resembles that of small insects crawling on or under the skin. It is occasionally reported at the onset of menopause due to hormonal withdrawal. Formication can also be the result of alcohol withdrawal in alcoholics, pesticide exposure, diabetic neuropathy, Lyme disease, or herpes zoster.

Fracture – It is the separation of bone into two or more pieces under the action of stress. It can be caused by trauma (such as a fall) or because bone mass declined significantly due to osteoporosis.

FRAX – A diagnostic tool used to evaluate the 10-year probability of bone fracture risk. It was developed by the World Health Organization Collaborating Center for Metabolic Bone Diseases. FRAX integrates clinical risk factors in combination with bone mineral density at the femoral neck to calculate the 10 year probability of hip fracture and the 10 year probability of a major osteoporotic fracture (spine, forearm, hip, or shoulder fracture.

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H

Hormone Therapy (HT) – Prescription medications containing hormones used to replace or supplement those no longer produced by the body. Generally, this refers to estrogen therapy or estrogen plus progestogen therapy. This may also be referred to as hormone replace therapy (HRT).

Hysteroscopy – A surgical procedure to examine the inside of the uterus by inserting a thin, lighted telescope into the vagina and through the cervix. This allows for examination of the uterine cavity and the removal of lesions including polyps and fibroids.

Hypertension – or high blood pressure causes your heart to work harder to pump blood throughout your body, putting you at risk for heart failure. The added strain on your blood vessels damages the artery walls and encourages the formation of cholesterol-filled plaques, leading to heart attacks and strokes. In addition, living with high blood pressure over a period of time contributes to the onset of dementia, vision problems, kidney failure and sexual dysfunction. Post-menopausal women are especially at risk. The CDC reports that 70% of women between the ages of 60-70 have high blood pressure. By age 75 it rises to nearly 80%. Hypertension is a silent and often symptomless condition so it is often left untreated.

Hysterectomy – A partial hysterectomy that removes the uterus but leaves the ovaries in tact usually doesn’t cause menopause. While menstruation will cease, the ovaries still release eggs and produce estrogen and progesterone. A total hysterectomy and bilateral oophorectomy removes both the uterus and ovaries. Without any transition, menstruation stops immediately, other menopausal symptoms like hot flashes are likely to begin as hormonal changes occur abruptly instead of over the course of several years.

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I

Ibandronate – A potent prescription bisphosphonate drug (marketed as Boniva), government approved in the US (but not Canada) for the prevention and treatment of postmenopausal osteoporosis.

Induced menopause – Menopause that occurs as a consequence of either surgical removal of the ovaries (oophorectomy) or the loss of ovarian estrogen production from pelvic radiation or chemotherapy.
Inhibited sexual desire – See Reduced libido.

Insomnia – A persistent disorder that makes it difficult to fall asleep, stay asleep or both. Hot flushes associated with the menopausal transition may also be associated with, and lead to, insomnia.

Incontinence (urinary) – There are two types of urinary incontinence that are most likely to affect women at the onset of perimenopause. Stress incontinence is caused by weak pelvic floor muscles, known as “pelvic relaxtion.” This commonly occurs when urine leaks as a result of sneezing, laughing, coughing and lifting heavy objects. Urge incontinence or “overactive bladder” is the frequent and sudden urge to urinate, with occasional leakage of urine. This is caused by irritated or overly active bladder muscles. Reduced levels of estrogen can cause thinning of the lining of the urethra, while the main risk factors for developing urinary incontinence are vaginal childbirth and increased age. In addition to exercises aimed at strengthening the pelvic floor muscles, there are also a variety of medications and surgical treatments available to alleviate bothersome symptoms.

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K

Kegel Exercises – the practice of contracting and relaxing the pelvic floor muscles for a set period of time and repetitions. The goal is to tone and strengthen these muscles to improve urinary incontinence, prevent or treat pelvic organ prolapse and improve sexual sensation. To identify the correct muscles to contract it is easiest to stop the flow of urine while you are urinating. Once you have identified the muscles always perform Kegel exercises with an empty bladder. Stopping and starting your urination on a regular basis could lead to infection. Try and hold the muscle contraction for 2-3 seconds, then release. Increase the exercises to five sets and repetitions to ten throughout the day. Kegels can be done while you are performing any routine task like sitting at your desk, driving or watching TV.

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L

Lactose Intolerance – The inability of adults to digest lactose, a sugar found in milk and, to a lessor extent, in other dairy products. Lactose intolerant individuals have insufficient levels of the enzyme lactase that metabolizes lactose. This leads to symptoms including abdominal bloating, cramps, diarrhea, gas, and nausea.

Laparoscopy – A surgical procedure to look inside the pelvic cavity by inserting a tubelike instrument through a small cut in the abdomen.

Leiomyoma – The medical term for a fibroid tumor.

Local Therapy – Medications whose effect are limited to the application site. This is in contrast to systemic medications which circulate throughout the body.

Luteinizing Hormone (LH) – A hormone produced by the pituitary gland (located in the base of the brain). LH levels vary throughout the menstrual cycle. It increases rapidly immediately prior to ovulation. This causes the dominant follicle to release the egg from the ovary (ovulation). Metabolites of LH are can be detected in the urine and are the basis for determining ovulation when using a urinary LH prediction kit.

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M

Melatonin – Is a hormone produced by the pineal gland in the brain. It is involved in regulation of the sleep and wake cycles. It has been linked to regulation of the body’s 24-hour (circadian) rhythm. Small amounts of Melatonin are found in foods, including some fruits, grains, and vegetables. It is also widely available as an oral supplement.

Menopause – is defined as 12 consecutive months without a menstrual period. The average age of menopause is 51 years old in the United States and most of the world. Menopause is a natural biological process. The reduced production of ovarian hormones, primarily estrogen, often lead to physical symptoms including hot flushes, sleep disturbances, reduced libido, and decreased energy. Many effective treatments include medications and lifestyle modifications are available to reduce or eliminate these symptoms.

Metabolic syndrome – A constellation of medical disorders including elevated blood pressure (hypertension), high blood sugar levels, excessive body fat around the waist and abdomen, and abnormal cholesterol levels that occur together. Women with metabolic syndrome are at a significantly increased risk for type 2 diabetes (adult onset diabetes), heart disease, and stroke.

Migraine Headaches – Are recurrent moderate to severe headaches often associated with a number of symptoms that may include nausea, vomiting, and sensitivity to light, smell and sound. Typically the headaches affect one half of the head and are described as pulsating in nature. They may last up to 48 hours. The pain is generally made worse by physical activity. They are felt to be caused by a combination of environment and genetic factors, and are 2 to 3 times more common in women then men.

Magnetic Resonance Imaging (MRI) – A test that uses magnetic field and radio wave energy to generate images of internal organs and structures within the body. MRI’s are widely used for medical diagnosis and avoid the use of ionizing radiation.

Mammography – standard mammography produces an X-ray image of the connective tissue and fat in the breasts on film, while digital mammography produces the image on a computer screen. Digital is the preferred method because sections of the image can easily be magnified and examined more closely and the contrast of the image can be adjusted.

Mastalgia
– refers to pain in the breast or mammary gland. Considered a common side effect of hormone changes associated with perimenopuase and postmenpause. It has been associated with the use of estrogen and progesterone hormone replacement therapies.

Menopausal Syndrome – a blanket term for the symptoms women experience during the transitional period when the ovaries stop producing eggs, the body produces less estrogen and progesterone, menstruation becomes irregular, less frequent and eventually stops. The most common symptoms are: hot flashes, night sweats, hair loss, inadequate sleep, decreased sexual desire, vaginal dryness, infections and painful intercourse, irregular heartbeat, hypertension, mood swings, headaches, dizziness, joint pain, urinary incontinence and forgetfulness.

Myomectomy – A surgical procedure to remove fibroid tumors (also known as myomas or leiomyomas).

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N

Night Sweats – Hot flushes that occur at night and are associated with heavy perspiration. These episodes are uncomfortable and may cause disruption of sleeping patterns, that often leads to fatigue.

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O

Off-Label – The use medications for unapproved indications. Both prescription and over-the-counter medications can be used in off-label ways. Off label use is legal unless it violates ethical guidelines or specific safety regulations.

Oophorectomy – The surgical removal of an ovary.

Orgasm – The sudden discharge of accumulated sexual tension. Orgasm (also known as a sexual climax) is associated with a general euphoric sensation and may include other involuntary actions such as muscle spasms, body movements, and vocalizations.

Ovarian Cancer – A type of cancer that originates in the ovaries. Ovarian cancer accounts for approximately 3% of all cancers among women – but it causes more deaths than any other cancer of the female reproductive system.

Ovarian Cyst – A fluid filled sac that forms on, or within, one or both ovaries. The vast majority of ovarian cysts are benign (non-cancerous). Most ovarian cysts resolved spontaneously without medical or surgical treatment.

Ovaries – Organs located on both sides of the uterus which produce eggs and a variety of hormones (primarily estrogen and progesterone).

Ovulation – The release of a mature egg from the ovary. Approximately 90% of reproductive age women will ovulate on a monthly basis.

Obesity – or “overweight” are both terms for weight ranges that are greater than what is considered healthy in relation to an individual’s height. Obesity increases the risk of disease and health problems. An adult who has a BMI (body mass index) between 25 and 29.9 is overweight. A BMI of 30 or greater is considered obese. It is widely accepted that obesity is linked to increased risk of endometrial and breast cancer.

Osteoarthritis
– often occurs shortly after the onset of menopause, and is characterized by joint inflammation that causes pain and swelling. Estrogen helps regulate beneficial cellular processes in joint tissue. When estrogen and progesterone levels decrease during menopause it can result in the deterioration of cartilage and eventually the onset of osteoarthritis.

Osteomalacia – describes the softening of bone that typically occurs with the depletion of calcium. Symptoms may include pain in the lower back, hips, legs and muscle weakness.

Osteoporosis – is a condition in which bone density is compromised, resulting in brittle, porous bones making fractures and broken bones are more likely to occur. Estrogen plays a role in keeping bones healthy and strong. Postmenopausal women are at increased risk for developing osteoporosis because of the reduction in estrogen.

Ovarian Follicles
– The ovaries contain very few follicles at the onset of menopause. The existing follicles have decreased in size, and consist mostly of atretic (shrunken) follicles, some interstitial cells, and fibrous tissue. Estrogen production decreases by 80 percent or more, and this along with the loss of follicles results in marked increases in the secretion of luteinizing hormone (LH) and follicle-stimulating hormone (FSH).

Ovarian Cystectomy – the surgical removal of a cyst on the ovary. This is usually performed via laparoscopy or through an abdominal incision (laparotomy).

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P

Parathyroid Glands – four tiny glands located in the neck that regulate the body’s calcium levels. Parathyroid glands produce parathyroid hormone (PTH) which helps regulate blood calcium levels via the bones, intestines, and kidneys.

Pap Smear – A screening test for cervical cancer named after Dr. George Papanicolaou in which a sample of cells is taken from a women’s cervix using a brush or swab. These cells are then examined microscopically for precancerous changes.

Parathyroid Hormone (PTH) – A hormone secreted by the parathyroid glands that control calcium, phosphorous, and vitamin D levels in the blood. Most people have four parathyroid glands located in the neck near the thyroid gland. PTH is critical for regulating bone growth. Synthetic PTH (teriparatide) is available as a prescription medication which is used for the treatment of osteoporosis.

Pelvic Cavity – The space inside the lower abdomen which contains the reproductive organs, including the uterus, fallopian tubes, and ovaries. This space also contains the urinary bladder, the pelvic colon, and the rectum.

Pelvic Examination – Visual and manual inspection of the external and internal genitalia, including the vulva, vagina, cervix, uterus, and ovaries. Frequently, a speculum is inserted into the vagina to examine the upper vagina and cervix. A pap smear is often done during this examination. Many times, a pelvic ultrasound (vaginal and/or abdominal) is performed concurrently.

Pelvic Ultrasound – Also known an ultrasound or sonogram, this imaging procedure uses sound waves to generate pictures of the inside of the body. A probe is placed directly on the skin or inside the body to generate real-time images, including movement of the body’s internal organs and blood flow.

Pelvis – The ring of bones located in the lower torso that protects and contains the pelvic organs. The bones that form the pelvis include the sacrum, coccyx (tailbone), and the hip bones.

Pelvic Relaxation – One of the most significant losses of muscle tone in perimenopasual women is in the pelvis. The loss of estrogen, along with the normal aging process can weaken the supportive tissues of the pelvic floor. In severe cases the uterus, bladder and bowel may droop into the vagina, or even protrude outside of the vagina. It is also associated with urinary incontinence and difficulty having a bowel movement. While the biggest contributor to pelvic relaxation is vaginal childbirth other factors include multiple deliveries, large babies, chronic cough, obesity and repeated heavy lifting. Kegel exercises have been shown to improve symptoms as well as hormone replacement therapy and surgical options for severe cases.

Phytoestrogens – These compounds are derived from foods, including soy, grains, some vegetables and fruits. The two most studied phytoestrogen groups are isoflavens and lignans. Phytoestrogens have a chemical structure similar to estrogen and possess weak estrogen-like biological activity in the body.

Placebo – An inactive substance used in controlled experiments that test the effectiveness of another substance (such as medications).

Premature Ovarian Failure (POF) – Premature ovarian failure, also known as premature ovarian insufficiency, is the spontaneous loss of ovarian function prior to the age of 40. Approximately 1% of all women will develop POF. Women with POF may demonstrate intermittent ovarian function and approximately 5 to 10% may conceive. POF can be associated with a variety of genetic conditions and may have a familial tendency.

Progesterone – is a hormone produced by the ovaries during ovulation. It prepares the uterine lining for implantation of an embryo. During perimenopause progesterone levels typically decline, while estrogen levels remain stable or even increase. This is a significant issue for most women because many of the early symptoms women feel are due to progesterone levels that are too low, in relation to their levels of estrogen. This ratio of low progesterone-to-estrogen is referred to as “estrogen dominance.” Some of the symptoms that affect women when progesterone declines include: breast swelling and tenderness, mood swings, irritability, trouble sleeping, memory lapse, water retention and weight gain.

Progestins – An umbrella term for progesterone and the related progestins is progestogens, because all have progestational effects in the uterus. The terms “progesterone” and “progestin” are often used interchangeably. Many medical practitioners and scientists do not differentiate between progesterone and progestin, both of which fall into the category of progestogens. However, there are differences both in chemical structure and effect.

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R

Red Clover – A wild plant in the legume family that is rich in phytoestrogens, particularly isoflavones. Although studies are inconclusive, red clover is often prescribed to reduce mild to moderate hot flushes, PMS, reduce serum cholesterol levels and to maintain bone mass.
Reduced libido – also known as low sex drive or inhibited sexual desire. A decreased interest in sexual activities. This may be caused by biological, psychological or social factors alone or in combination. In women, reduced libido occurs more commonly after menopause.

Rheumatoid Arthritis – An autoimmune disorder which causes chronic inflammation of the lining of the joints. This occurs most commonly in smaller joints in the hands and feet. Unlike osteoarthritis, rheumatoid arthritis can eventually result in joint deformity and bone erosion.

Rectocele
– a prolapse of the wall between the rectum and the vagina due to weak pelvic floor muscles. Risk factors include difficult or prolonged vaginal childbirth, hysterectomy and chronic constipation.

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S

Selective Estrogen-Receptor Modulator (SERM) – A class of compounds that bind differentially to estrogen receptors. Although they have a chemical structure similarly to estrogen, these compounds exert an estrogen-like effect on some tissues (bone) and an anti-estrogen effect on others (breast).

Sexually Transmitted Disease – There are more than 30 different types of bacterial, viral and parasitic infections that can be transferred by sexual contact via the vagina, mouth or anus. These include HPV (human papilloma virus), chlamydia, gonorrhea, syphilis, and HIV, among others.

Sigmoidoscopy – A screening or diagnostic procedure used to visualize the inside of the rectum and the lower part of the colon (sigmoid colon). This is generally performed as an office procedure.

Sonogram – Also called an ultrasound, this imaging procedure uses sound waves to generate pictures of the inside of the body. A probe is placed directly on the skin or inside the body to generate real-time images, including movement of the body’s internal organs and blood flow.

Soy – A plant which is used to generate multiple products, including nuts, tofu, and soy milk. These products contain a relatively high percentage of protein. They are often advocated for their health and nutritional benefits. Although research is inconclusive, some individuals may obtain relief from mild hot flushes when on a high soy diet. This benefit is presumed to occur via the action of phytoestrogens.

Speculum – A metal or plastic instrument which is inserted into the vagina to examine the vagina and cervix.

Spontaneous Menopause – Also known as natural menopause. The spontaneous loss of ovarian function not caused by medical or surgical treatment. Although menopause may occur at an earlier or later age, the average age of the menopausal transition is 51.

St. John’s Wort (Hypericum perforatum) – An herb that has been used for centuries to make medicinal products. The most common modern day use is for the treatment of mild to moderate depression.

Statins
– Statins are a class of medications used to lower cholesterol levels by inhibiting the enzyme HMG-CoA reductase, which plays a central role in the production of cholesterol in the liver, where approximately 70 percent of the body’s cholesterol is produced. Elevated cholesterol levels are associated with cardiovascular disease. Statins have been demonstrated to reduce cardiovascular disease and mortality in hight risk individuals.

Surgical Menopause – results from the following:
• The removal of both ovaries (bilateral oophorectomy)
• Trauma or damage to the blood supply of the ovaries resulting in loss of ovarian function
• Loss of ovarian function due to radiation or chemotherapy

Systemic Lupus Erythamateous (SLE) – Also known as lupus. This is a chronic, often disabling, auto immune disease which may involve the skin, heart, kidneys, lungs, joints, and the nervous system. When this condition only involves the skin, it is called discoid lupus. It is 8 to 10 times more common in women than men.

Systemic Therapy
– treatment that reaches cells throughout the body by traveling through the bloodstream.

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Transdermal Therapy – The delivery of medications through the skin into the bloodstream via a patch, gel or cream. This is a common method of delivery for estrogen in hormone replacement therapy.

Testosterone – also known as the “male” hormone, testosterone levels reach their peak in a woman’s 20’s and decline slowly throughout the remainder of life. The ovaries continue to produce testosterone after estrogen production stops. Testosterone plays an important role in estrogen production and contributes to libido. The decline in testosterone in women is isolated to the natural aging process and not menopause related. By the time a woman reaches menopause levels are at half of its peak.

Triglycerides – Total cholesterol and triglyceride levels may go up around the time of menopause. High triglyceride levels can be an indication that you are at risk for diabetes, stroke and heart disease or metabolic syndrome, sometimes referred to as syndrome X. Lifestyle changes can be very effective at reducing your risk. Not smoking and avoiding second hand smoke, exercising for at least 30 minutes daily, and following a healthy, low-fat diet can help prevent heart disease, protect your bones and reduce your risk for cancer.

Turner Syndrome – a genetic disorder associated with absence of all or a portion of an X chromosome. This condition affects approximately 1 / 2,500 females. It is associated with several features, including the early loss of ovarian function, short stature, cardiac issues, certain learning disabilities, and the failure to begin puberty.

Tamoxifen – is a type of selective estrogen receptor modulator or SERM. These medications, including Tamoxifen, acts like an anti-estrogen in breast cells. However, in other tissues, such as the uterus and bones it stimulates the estrogen receptor. Tamoxifen is frequently used for hormone receptor-positive breast cancer in premenopausal women. It may also be used in postmenopausal women, although aromatase inhibitors are frequently administered in that setting.

Thyroid Gland – is one of the largest endocrine glands. It located in the neck, below the thyroid cartilage (Adam’s apple). The principle thyroid hormones are triiodothyronine (T3) and thyroxine (sometimes referred to as tetraiodothyronine (T4). They are regulated by thyroid-stimulating hormone (TSH) which is produced by the pituitary gland. The thyroid gland helps regulate blood pressure, body temperature, heart rate, and the rate in which food is converted into energy.

Tubal Ligation – is a surgical procedure for sterilization in which a woman’s fallopian tubes are clamped, ligated, severed, or clipped. Tubal ligation is considered a permanent method of sterilization and birth control.

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U

Urinary Tract Infection (UTI) – occur much more commonly in women than men. When an infection involves the lower urinary tract it is referred to as simple cystitis (a bladder infection). When the infection involves the upper urinary tract, the ureters and kidneys, it is known as pyelonephritis. Symptoms of lower urinary tract infections include painful and/or frequent urination, an increased urge to urinate, and blood in the urine. Symptoms of pyelonephritis include fever, flank pain, nausea, and vomiting. In the elderly and very young, symptoms may be vague or non-specific. The most common bacteria responsible for UTI’s is Escherichia coli, although other bacteria or viruses may also be the cause.

Urogynecology – A sub-specialty of urology and gynecology involving the diagnosis and treatment of female urinary incontinence and pelvic floor disorders.

Urologist – A physician trained to treat problems of the urinary system, including the bladder, ureters, and kidneys.

Uterine Bleeding – Bleeding from the uterus. This term is usually used to describe abnormal uterine bleeding.

Uterine Fibroids – these benign growths develop from smooth muscular tissue of the uterus when a single cell divides multiple times. Eventually resulting in a firm mass of tissue. Estrogen stimulates the growth of fibroids so it is not uncommon for fibroids to shrink after menopause. However, hormone therapy can cause symptoms to persist. These tumors are fairly common and occur in roughly 70-80% of women by the time they reach perimenopause. They rarely cause symptoms or discomfort and a woman may never become aware of its presence.

Uterine Prolapse – when the pelvic floor muscles are weakened they can no longer support the weight of the uterus. Eventually the uterus slips down into the vagina and may even protrude outside. This condition can occur in women of any age but it is more common in postmenopausal women who have had multiple vaginal deliveries. Treatment usually isn’t needed for mild cases but if it causes pain or discomfort or prohibits you from having intercourse, treatment is available.

Uterus (also known as the womb) – A women’s reproductive organ where the fetus grows and menstrual bleeding originates.

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V

Vagina – A pliable muscular canal, which connects the external genitalia to the cervix (the lower part of the uterus).

Vaginal/Vulvar Atrophy – A progressive thinning of the tissues of the vulva and vagina due to chronic estrogen deprivation. This causes the vulva and vagina to become less pliable, dry and thin. This results in decrease vaginal lubrication, which often leads to painful intercourse and potentially vaginal bleeding.

Vaginal Dryness – Insufficient lubrication of the vagina. This may be caused by low estrogen levels, various medications, lack of sexually arousal or radiation therapy.

Vaginal Estrogen Therapy – A variety of estrogen products applied intra-vaginally as a cream, suppository, tablet, or ring. These prescription products are used to treat vaginal atrophy and dryness.

Vaginal Lubricant – Over-the-counter, water based lubricants that may be used intra-vaginally to reduce discomfort and friction during intercourse. Water based lubricants are recommended and petroleum based products should be avoided.

Vaginal Pessary – a medical grade removable device made of plastic, rubber or silicone, inserted into the vagina to support the uterus, vagina, bladder or rectum. A pessary is fitted to each individual and needs to be removed and cleaned on a regular schedule. This nonsurgical approach in treating symptoms of pelvic organ prolapse show that many women find symptoms greatly improve or even go away.

Vaginismus – described as involuntary spasms or contractions of the muscles at the vaginal opening or in the perineum (the area between the vagina and anus). In addition to making penetration of the vagina difficult or impossible, vaginismus can be painful, causing burning or stinging sensations. Vaginismus may occur for the first time in women as a response to painful intercourse caused by estrogen deficiency and vaginal atrophy. There are a number of treatment options, but vaginal discomfort can arise from a variety of sources so it is important to get an evaluation from your doctor to determine the best course of treatment.

Vaginitis
– inflammation of the vagina can result from estrogen-related vaginal atrophy but it can also be caused by a yeast or bacterial infection or by irritation from soaps or hygiene products. Symptoms include vaginal discharge, itching, burning, and swelling of the vagina and vulva, sometimes accompanied by pain during urination. Once the cause is determined, vaginitis can be treated with medication or by stopping use of the irritating product.

Vaginoisis (bacterial) – is the result of an overgrowth of bacteria, which are normally present in the vagina. Discharge is grayish-white and foul smelling, often described as “fish-like”. Hormonal changes, certain medications, hygiene products and uncontrolled diabetes can increase your risk or vaginitis.

Vasectomy
– A outpatient surgical procedure for male sterilization. This procedure involves severing the vasa defferentia (the tube which connects the testes to the seminal stream).

Vasomotor Symptoms – Also known as hot flushes/flashes, these symptoms are caused by a sudden increase in blood flow to the face, neck, and chest, causing the acute sensation of extreme heat and profuse sweating. When these symptoms occur at night, they are called “night sweats” and often lead to significant sleep disturbances. Vasomotor symptoms usually last between one to three minutes and are associated with flushing, perspiration, chills, anxiety, and potentially heart palpitations.

Vitamin D – an essential vitamin involved in the maintenance of bone mineralization and calcium regulation. It is synthesized in the skin upon exposure to sunlight and is metabolized in the liver and kidney to its metabolically active form. Vitamin D supplementation is widely available.

Vulva – includes the female external genital organs such as the labia majora and minora, clitoris, and vaginal opening.

Vulvodynia – a chronic condition involving pain that may include stinging, burning, irritation, or rawness in or around the vulva. Pain may come and go and may occur with or without touching or pressure. All or only a portion of the vulva may be affected. There are usually no visible signs. Vulvodynia almost always involves pain with intercourse, which may last from minutes to days. Treatments include self-care measures (such as wearing all-cotton underwear or washing the vulva with water only), medication, relaxation exercises, and in severe cases may involve surgery.

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W

Weight-Bearing Exercise – Exercises in which the bones and muscles bear the body’s weight. These include running, brisk walking, cycling, and high impact aerobics. This type of exercise may reduce bone loss and fracture risk particularly in the early menopausal years.

Womb (also know as the uterus) – A women’s reproductive organ where the fetus grows and menstrual bleeding originates.

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