Dr. Blocker received his degree from the University of Miami School of Medicine. He did his internship and residency in Obstetrics and Gynecology at the University of South Florida Affiliated Hospitals. Dr. Blocker is a board-certified in Obstetrics and Gynecology, and is a Fellow of the American College of Obstetricians and Gynecologists. He also is certified by the American Council of Gynecologic Endoscopists and has had advanced training in laparoscopic hysterectomy, reconstructive pelvic surgery, and urogynecology. Dr. Blocker has served as the Chair of the OBGYN Department and then, Chief of Staff at Brandon Regional Hospital. Dr. Blocker is in private practice in Florida.
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
Menopause is the time of life at which a woman's menstrual periods stop. The
medical definition of
menopause is the time at which a woman has not had a
menstrual period for
12 consecutive months.
The time around this point of
menopause has been referred to as the
perimenopause. There is no strict medical definition of perimenopause, but it
typically refers to the time approaching menopause during which a woman starts
to develop symptoms of declining estrogen levels.
Not all women experience all the symptoms of perimenopause to the same
degree, and symptoms vary among women.
Treatment of perimenopausal symptoms includes
hormone therapy and lifestyle
measures such as diet, exercise, and smoking cessation.
Estrogen therapy may decrease the severity of symptoms of perimenopause.
How does the menstrual cycle work?
Every woman is endowed at birth with a set number of eggs within each ovary.
As she enters adolescence, the higher brain centers that are responsible for the
onset of puberty begin to mature and function in a coordinated fashion.
Menstrual cycles begin and once a month, one of the ovaries releases an egg,
which may be fertilized if intercourse occurs during the days when the egg is
viable. If fertilization does not occur, the egg, which is composed of a
single cell, degenerates and dies within the abdominal cavity. Without
fertilization of the egg, the uterine lining is shed off approximately two weeks
after ovulation (i.e. release of an egg by the ovary). This cycle is
repeated monthly unless a pregnancy is conceived. As a woman ages, her
ovaries begin to run out of eggs. At this point ovulation may
become erratic. This results in irregular bleeding episodes that may be
heavy and unpredictable.
Throughout the normal menstrual cycle, hormones are produced from the ovaries
in a rather precise sequence. This can cause numerous side effects (for
example, menstrual cramps,) which may or may not be predictable. As the
ovaries become depleted of eggs and bleeding episodes become more erratic, there
are alterations in the quantity and frequency of ovarian hormone production,
which can lead to numerous physical manifestations. The time period when the
depletion of ovarian eggs results in irregular bleeding and other related
symptoms has been termed "perimenopause."
Some of the most commonly reported symptoms include hot flashes and night sweats. These can be associated with flushing and may be followed by intense sweating.
Other symptoms that are related to lowering of estrogen levels include