Panopause. Natural remedies for hot flashes may help reduce symptoms and it's important to use them safely. Panopause

 
 Natural remedies for hot flashes may help reduce symptoms and it's important to use them safelyPanopause  Gejala atau tanda-tanda menopause dapat berupa: 1

If you take HRT it replaces the oestrogen that your ovaries no longer make after the menopause. Premature Menopause < 40 years. Decreased tooth loss. Chills 5. 1 – 3 It is also associated with dysthymia 4. Menopausal women are also at a higher risk of developing osteoporosis. In contrary to women menopause which is a globally known process with apparent temporal features related. ZRT has tested over 150,000 men experiencing hormone decline. The median age of menopause is 51. Male menopause refers to changes that males may experience when they reach a certain age. Hormone therapy might slightly increase your risk of stroke or blood clots in the legs or lungs (especially if taken in pill form). ), vitamin D, and calcium (dairy products, soya drinks, etc. Menopause symptoms and relief. It makes sense that the term is used for guys in their 50s and upwards, since this. Weight gain. The onset of menopause features the decreasing production of estradiol, as well as increasing levels of follicle-stimulating hormone (FSH). Menopause that happens before age 40 is called premature menopause. Menopause, also known as the climacteric, is the time when menstrual periods permanently cease, marking the end of reproduction. And yet for many women, menopause becomes. Completing menopause before age 40 is called premature menopause. Smoking. The main medicine treatment for menopause and perimenopause symptoms is hormone replacement therapy (HRT), which replaces the hormones that are at low levels. The WHI estrogen-alone clinical trial, launched in 1993, randomly assigned more than 10,739 women between the ages of 50 and 79—all of whom were past menopause and had had a hysterectomy—to take daily estrogen or a placebo. It typically occurs around the age of 45–55 years. Menopause can happen naturally at the expected age or early. On average, there is a one percent annual decline in testosterone levels from the age of 30, and by 70 years. This can increase your risk of bone fractures. However, it's not an official medical term: Dr. abdominal pain or nausea. A loss of muscle mass. Other factors may influence a woman's level of interest in sex during. As you get closer to menopause, you may notice other symptoms, such as pain during sex, urinary problems, and irregular periods. A female executive has said the MeToo movement inspired her to sue her company over a “menopause” jibe. ), omega-3 (nuts, canola oil, salmon, sardines, chia seeds, etc. Common symptoms of. See the video lower within this article for motivation. Menopause is diagnosed. Symptoms like night sweats are common right before,. Learn more. [3] It is the result of a gradual drop in. Menopause. Memory problems. In many ways the resulting symptoms are different from those experienced in the young hypogonadal male, because of the slow nature of testosterone decline in the elderly. Individualization is key in the decision to use hormone therapy. Despite a reduction in testosterone levels, men are still able to produce semen that are viable for fertility. Menopause can also occur if a woman's ovaries are damaged by certain diseases or cancer treatments, or if they are surgically removed. The main benefit of HRT is that it can help relieve most menopause and perimenopause symptoms, including hot flushes, brain fog, joint pains, mood swings and vaginal dryness. If these levels become low enough, andropause will begin to become a problem. Menopause could represent a time when women feel maximum control of our bodies, free at last from the risk of being forced to carry an unwanted pregnancy. Black, Asian, and Latina women on average begin menopause earlier than. Hormone replacement therapy (HRT) is a medical treatment that boosts declining levels of estrogen and progesterone in a person approaching menopause. ♦ Lowered self-confidence. Aged, 80 and over. It usually starts in your mid-40s, but it can start earlier. Depending on your personal and family. There's also no evidence that they're any more effective. Perut buncit. Sleep problems. Education, counseling, and motivation have an essential role in managing menopause and related consequences. Menopause is one point in a continuum of life stages for women and marks the end of their reproductive years. An individual has entered menopause if at least 12 months. increased sexual sensitivity. Premature menopause or early menopause can be spontaneous or induced; if. This article will review the diagnosis and management of andropause. Night sweats 6. Menopause can happen in your 40s or 50s, but the average age is 51 in the United States. 3. Sleep problems are often due to hot flashes or night sweats, but sometimes sleep becomes unpredictable even without them. Side effects. Introduction “The secret to staying young is to live honestly, eat slowly, and lie about your age. Testosterone declines naturally as men age. Menopause is defined as the permanent cessation of menstrual periods. It's diagnosed after you've gone 12 months without a menstrual period. While the symptoms of menopause can significantly impact a woman’s quality of life, not all women experience the same symptoms. Signs and Symptoms As you continue to age, it is normal for men to experience physical, sexual, and emotional changes as a result of a decline in testosterone production. [1] [6] It typically occurs between the ages of 45 and 55, although the exact. However, this name was. However, some men are impacted more than. During the years leading up to menopause (perimenopause), women’s bodies make. Definitely feels like the tide is turning. However, the ability to reproduce is still present in men. dry skin, eyes, or mouth. Summary Menopause officially begins when you’ve gone 12 consecutive months without menstruating. In particular, for women diminished levels of estrogen at menopause contribute to a decline in skin collagen and thickness. In men, however, there’s a more gradual and less drastic decline in testosterone. Weight gain. Pausing to learn more about menopause. In men, there's a gradual decline in hormone levels. Man on Pause: With Engin Günaydin, Tamer Karadagli, Derya Karadas, Turgut Tuncalp. Hormone patches for menopause. Menopause can be a blessing for those with a history of heavy periods and pelvic pain, but it also can be a curse for others with new-onset frequent hot flashes, drenching sweats, sleepless nights, mood swings, vaginal dryness and urinary disturbances. During this stage, menopausal symptoms, such as hot flashes, get milder or go away. Menopause does not happen suddenly; most women experience several years of changes in their menstrual periods. : If a woman is having symptoms of menopause after a (surgery to remove the uterus) or a hysterectomy with bilateral salpingoophorectomy. Medication or healthy lifestyle changes may reduce the risk of these conditions. It has the natural ability to dilate the arteries. Every woman’s experience with menopause is unique. Most women begin menopause between the ages of 45 and 55, with an average age of 51 in the United States. Understanding that this subject is still stigmatised, as menopause and mens mental health was until we all started normalising conversations around it. The term "male menopause" has been used to describe decreasing testosterone levels related to aging. While menopause affects all women at some point in their life, andropause occurs in only a portion of men. [1, 2] Clinical effects. Hormone therapy has also been. Menopause refers to the stage of a person’s life during which their period stops. If you are bothered by your symptoms, talk to your doctor or nurse about ways to relieve them. As we learn more about the pathophysiology of hypogonadism, our perspectives on the risks and. Either mechanism strengthens. The transition phase before menopause is often referred to as perimenopause. Menopause is a natural biological process. In women, menopause usually occurs over a period of a few months or years, but andropause typically occurs over decades, usually between the ages of 48 and 70. Support liver function. 2. 5 Consider using a FSH test to diagnose menopause only: in women aged 40 to 45 years with menopausal symptoms, including a change in their menstrual cycle. HRT can help with this but activity and exercise are the best way to increase your body’s ability to burn calories. Some medical conditions or. Transdermal skin patches are used as a hormone delivery system to treat particular symptoms of menopause such as hot flashes and vaginal dryness, burning, and. It describes an age-related reduction of testosterone in cisgender males. andropause: [noun] a gradual and highly variable decline in the production of androgenic hormones and especially testosterone in the human male together with its associated effects that is held to occur during and after middle age &mdash; called also#R##N# climacteric, male menopause. A holistic patient care model that emphasizes earlier and more robust education about the menopause transition for patients and providers would aid in the normalization of this life transition and improve quality of. Menopause is the time in a woman's life when menstrual periods permanently stop, also called the "change of life. Andropause (Male Menopause) vs Menopause. Because of the associated risks, long-term therapy is no longer recommended. The bloodstream retrieves valuable substances that have been separated out during this second step of urine formation. Post-menopause refers to the final stage of the menopause process, and marks the end of the reproductive stage of life. Menopause is confirmed 1 year (12 months) after the final menstrual period. Women have different symptoms, which can include: Irregular periods; Vasomotor symptoms (VMS) - night sweats and hot flashesAndropause or male menopause causing low libido in a man is due to decreasing level of male hormones, like testosterone. While this is an excellent way to stop cancer from spreading, it does have certain drawbacks. Consideration should be given to the woman's quality of life priorities as. Symptoms of menopause can include hot flashes, irregular periods, mood changes, night sweats, breast soreness, vaginal dryness, bloating, thinning hair, and more. : If a woman is having symptoms of menopause after a (surgery to remove the uterus) or a hysterectomy with bilateral salpingoophorectomy. However, there hasn’t been enough research to prove the effectiveness of cannabis in treating menopause. depression. 2. Menopause that happens before age 45 is called early menopause. Starring: Engin Günaydın, Tamer Karadağlı, Derya Karadaş. In the years around menopause, you may experience changes in your sex life. Introduction. Menopause is more than just hot flashes and night sweats. I like to say that before I became a mom I was the picture of perfect health. Improved mood and overall sense of mental well-being in some women. vaginal dryness. Luteinizing hormone and the aging nervous system. Those with IMS may. 1 – 3. . The time of a woman's life following menopause is called postmenopause. 5. Menopause is often stigmatized and framed as if it were a disease, as opposed to a natural part of a woman's life cycle. A number of terms have been used to describe the loss of hormone production and their secretory patterns as we age including menopause, andropause, adrenopause, and somatopause. During the menopausal. It can happen naturally, or as a side effect of some treatments. If it happens before you are 40 it's called premature menopause (or premature ovarian insufficiency). You have a lower risk of breast and ovarian cancer. Women with an intact uterus using systemic ET should receive adequate progestogen,Hormone replacement therapy (HRT) is a treatment that can help ease some of the symptoms associated with menopause—the point in time when a person’s menstrual cycle has stopped for 12 straight months and permanently ends. The symptoms and menopause-related complications are caused by. Some people call the time leading up to a woman's last period menopause. Weight-bearing exercises also promote bone strength and prevent osteoporosis, which is a risk after menopause. Most women experience menopause between the ages of 45 and 55 years as a natural part of biological ageing. Answer From Tatnai Burnett, M. A loss of muscle mass. Research also shows depression during the menopause transition is strongly linked to higher cardiovascular disease risk. Andropause is a common part of aging in older men that affects a multitude of health parameters. improved sexual desire. Women who have premature menopause will be at higher risk for osteoporosis due to the early decline of. Menopause, which is defined as one year after your last period. The male menopause, also known as the andropause, is a term often used to refer to a cluster of features seen in some men in their late 40s to early 50s, such as depression, loss of sex drive. 1. g. 26. The Age Risk Factor for Cancer, Explained. See moreOverview What is menopause? Menopause is a point in time when you’ve gone 12 consecutive months without a menstrual cycle. People experiencing menopause symptoms may benefit from a consultation with the following experts. HRT (also known as , menopausal hormone therapy, and. [is overweight ] and she can either lose 50 pounds or take estrogen, I say losing 50 pounds is better for overall health," Minkin said, adding that the estrogen seems to help glucose metabolism. Menopause is a natural physiological phenomenon resulting from primary ovarian failure secondary to apoptosis or programmed cell death. Summary Menopause officially begins when you’ve gone 12 consecutive months without menstruating. 0. This can cause symptoms such as hot flashes, night sweats, pain during sex, and vaginal dryness. Menopause Hormones Decrease Change Rapidly, Andropause Hormones Decrease Gradually But Are Persistent. Menopause is associated with a marked decrease in ovarian estrogen production. ANDROPAUSE In men and women many physiological and psychological symptoms and biochemical changes attributed to an aging-related decline in gonadal hormones. 0 percent topical formulation, applied twice daily to areas with soft tissue (e. Andropause symptoms include: Fatigue. Difficulty concentrating. Although the treatment lowers the risk of bone fractures, it increases the risk of cardiovascular disease (heart and blood vessel problems) and breast cancer. Kondisi ini membuat wanita tidak lagi mengalami masa subur (ovulasi) dan menstruasi sehingga tidak dapat hamil. A woman goes through menopause when she has not had a period for twelve months or more. 1 out of 45, respectively. Menopause, also known as the climacteric, is the time when menstrual periods permanently cease, marking the end of reproduction. Menopause Menopause is when you stop having periods, which usually happens between the ages of 45 and 55. vaginal dryness. Andropause results from the natural decrease in testosterone levels that occurs with age. Dalam webinar “Meningkatkan Kualitas Hidup melalui Kesehatan Seksual Pria dan Pasangan” yang digelar ICTEC RSCM FKUI pada Selasa (27/10/2020), dijelaskan lebih jauh apa itu. After age 40, men may experience a phenomenon similar to the female menopause called andropause, due to the gradual decline in testosterone level. The relationship of these symptoms to decreased testosterone levels is still controversial. But if you wait 10 years after menopause to start hormone replacement therapy, the risks of breast cancer, deep vein thrombosis, stroke and cardiovascular disease increase, outweighing the benefits. Age and menopause. Andropause. These neurological changes may be responsible for some menopausal symptoms, including hot flashes, mood disruption and a mild, usually temporary decline. Note that when research or. The average age for menopause in. Complications associated with andropause include an increased risk of cardiovascular problems and osteoporosis (brittle bones). Vitamin supplements for male menopause may help your body produce. Treatment of andropause with testosterone has been recently considered. ♦ Increased body fat. The level of the male sex hormone, testosterone decreases gradually. 38–2. Unlike menopause, which is a sudden cessation of reproductive function in women, andropause is a gradual decline in hormone production. Last modified on Sun 19 Nov 2023 08. These risks depend on the type of hormone therapy, the dose. Hot flashes: Hot flashes. Other terms used to describe age-related male hypogonadism include male menopause, male climacteric, and androgen decline in the aging male (ADAM) . Andropause is the gradual reduction of the male sex hormone (testosterone) with increasing age. Hot flashes 4. Hormone replacement therapy (HRT) is. However, people can enter menopause. A man gave himself poop transplants using his mom's feces to treat his debilitating Crohn's. There are certain subthreshold. The symptoms associated with this change often appear in a person’s late 40s or early 50s. These symptoms can include irregular periods, vaginal dryness, hot flashes, night sweats, irritability, depression, and more. After menopause, a woman cannot. Talk to your doctor or nurse about. lack of focus. low testosterone. There are other treatments if you cannot, or choose not to, have HRT. This condition can start to be apparent around the age of 45 to 55. Diagnosis of late-onset of hypogonadism is based on presence of symptoms suggestive of testosterone deficiency - prominent among them are sexual symptoms like loss of libido, morning penile erection and erectile dysfunction; and. You may have to apply the moisturizer every few days. For men, testosterone production gradually decreases across the. More than 1 million women in the United States experience menopause each year. Men experience a very real, if gradual, decrease in testosterone beginning around age 30, at which point testosterone levels drop, on average, 1% per year. The average age for menopause is 52 years. The goal is simply to restore the body’s testosterone to a more youthful level. Symptoms like night sweats are common right before, during, and after menopause. We attempt to discuss the most modern and relevant po. Hormone therapy can help ease symptoms of menopause. People in postmenopause are at increased risk for osteoporosis and heart disease. As a man ages, his body naturally makes less testosterone. For most women, experts agree that HT is okay to control moderate to severe menopause symptoms, such as hot flashes and vaginal dryness, within 10 years of menopause and up to age 59. This will help improve blood circulation to the whole body including sexual organs and brain. Even though it usually occurs after the age of 40, it can affect younger men too. Menopause and sexuality. But you could experience symptoms up to a decade before. [1, 2] Hormonal changes and clinical symptoms occur over a period leading up to and immediately following menopause; this period is frequently termed the climacteric or perimenopause but is increasingly referred to as the menopausal transition. Male andropause, male climacteric or viropause is a condition in which men suffer from complex symptomatology due to low androgen level with aging. 2. Andropause or “male menopause” is a group of symptoms seen in an aging male with low testosterone. 5 or 3. During this stage, menopausal symptoms, such as hot flashes, get milder or go away. Then he bungles it up completely. 23. Andropause refers to the natural decline of testosterone, typically affecting men as early as 40 or as late as 65. Hormone replacement therapy (HRT) HRT is a safe and effective treatment for most going through menopause and. difficulty sleeping, which may be a result of night sweats and make you feel tired and irritable during the day. Fluctuating and the deficiency of hormone levels during post-menopause can cause a change in women's sexual function 6. improved relief of vasomotor symptoms of menopause. You may find that your symptoms go away by themselves. Post-menopause officially begins 12 months after. Menopause brings a number of bothersome effects, including hot flashes. After menopause, your ovaries make very little estrogen. Changing emotional and physical feelings related to sex. Many women do not need treatment for their menopause symptoms. As men get older, the levels of testosterone in their blood often drop. Learn more about the causes, symptoms, stages, diagnosis, treatment, and complications of menopause. Examples of common health problems in the years after menopause. Menopause is sometimes called the change of life, or the change. Although the end of menstruation is accompanied by several uncomfortable symptoms like hot flashes, night sweats, depression, and weakening. Other causes include surgery that removes both. Menopause is the time when your menstrual periods stop permanently and you can no longer get pregnant. e. 46. Menopause. Diminished libido due to a lack of testosterone. Zinc is an essential mineral that serves the function of maintaining reproductive health and creating a balance of hormones including testosterone. Telephone: 440/442-7550 - Fax: 440/442-2660 - Email: [email protected] billion women worldwide will be menopausal or postmenopausal by the year 2030, with 47 million new entrants each year. In 2004, the study was stopped early because of an increased risk of stroke and blood clots in women receiving. Sleep problems 7. 5 million women each year and often involves troublesome symptoms, including vasomotor symptoms, vaginal dryness, decreased libido, insomnia, fatigue, and joint pain. Andropause, also known as late-onset hypogonadism, is characterized by a series of physical, psychological, and sexual changes in men. The cause of these symptoms may be sleep disruption associated with. Introduction. By The New York Times. This time actually is the transition to menopause, or perimenopause. Menopause is usually a natural change. But for some women. Menopause in women is based on the end of the reproductive cycle associated with ovarian failure, and is characterized by the relatively abrupt onset of well-recognized symptoms. Menopause is when a woman stops having her monthly periods. Menopause Figure 2. Hormone therapy has also been proved to prevent bone loss and reduce fracture in postmenopausal women. During the transition to menopause, changing hormone levels can affect your menstrual cycle and cause symptoms like hot flashes and problems sleeping. Night sweats. Other women take hormone. Various traditional folk medicines have been used to enhance metabolism to reduce fatigue [1] [2] [3]. It is a normal part of aging. Most women experience vasomotor symptoms, but menopause affects many other areas of the body, such as urogenital, psychogenic, and cardiovascular. If it happens before you are 40 it's called premature menopause (or premature ovarian insufficiency). What Is male menopause? Simply put, male menopause is a collection of symptoms caused by a dip in testosterone. 50. " Menopause symptoms and signs include hot flashes, night sweats, irregular vaginal bleeding, vaginal dryness, painful intercourse, urinary incontinence, weight gain, and emotional symptoms such as mood swings. The "male menopause" (sometimes called the andropause) is an unhelpful term sometimes used in the media. The North American Menopause Society has a tool to help you find a qualified menopause expert in your area. Signs include fatigue, insomnia, mood changes, and more. Premature menopause and early menopause are conditions where a woman or person assigned female at birth (AFAB) goes through menopause at an earlier age than is typically expected. Osteoporosis is a disease that weakens bones, increasing the risk of sudden and unexpected fractures. This is known as menopause. 1–4 The decline in testosterone seen in aging men has clinical implications. Because male menopause is less well-defined than female menopause, this is a complicated question to answer. In addition, some of the drugs used. 5 Health Risks Women Face After Menopause. Avoid hot flash triggers, such as hot beverages, caffeine, spicy foods, alcohol, stress, hot weather or a warm room. While. Irritable male syndrome can have a big impact on your relationships. The intensity, length and frequency vary. Founded in 1998 specializing in natural fertility, we offer quality natural products for fertility, endocrine, and total body health; adolescents through menopause, andropause & senior health. Low levels of estrogen and progesterone raise your risk for certain health problems after menopause. Without these hormones, periods become erratic for a time, and then eventually stop. Guidelines from both the North American Menopause Society and IMS recommend that estrogen therapy immediately after surgical menopause could help improve cognitive function [22,90]. To treat genitourinary syndrome of menopause, your doctor may first recommend over-the-counter treatment options, including: Vaginal moisturizers. In addition, midlife — when menopause occurs — is a time when women sometimes face multiple sources of stress, including caring for children, dealing with aging parents, and navigating life changes, all of which may contribute to the incidence of depression and anxiety at this age. Most women experience vasomotor symptoms, but menopause affects many other areas of the body, such as urogenital, psychogenic, and cardiovascular. Although testosterone levels fall as men age, the. 2022 | Maturity Rating: TV-MA | 1 Season | Comedies. During menopause, some women have problems like hot flashes, vaginal dryness and irritation, and thin. Shree mentioned above, this can last for years before they stop completely. The menopause transition is experienced by 1. A woman has officially entered menopause after she hasn't had her. The menopause transition represents a significant change in a woman’s lifetime, marking the end of her reproductive years with the decline of the ovarian follicles and consequently endogenous estrogen. The links below point to information resources, including the most current from the NIH, on both long-term and short-term hormone use, and other concerns related to. Some women will experience weight gain during or after menopause. These symptoms may continue after menopause. Menopause is a natural transition in a person’s life. There is robust research and information regarding its biological aspects specially its endocrine base, yet the psychosocial aspect is quite interesting and debatable due to its variability among different cultures and climates. Another good thing about this herbal ingredient is that it will stimulate the liver to produce more testosterone. Most osteoporosis medications work by reducing the rate at which your bones break down. In the years before and during menopause, the levels of female hormones can go up and down. Abstract. There is an array of menopausal symptoms; however, vasomotor and vaginal symptoms are the most closely related to hormonal changes during. In a 2007 review of several. Your Name: Your Friend's E-mail: Optional Message: 255 character limit. org. Its symptoms are sexual dysfunction, weakness, fatigue, insomnia, loss of motivation, mood disorders and reduction of bone density. LOH, or functional. For women, a waist measurement of more than 35 inches (89 centimeters) signals an unhealthy amount of belly fat and a greater risk of health problems. However, the rates of many cancers, including breast cancer, do increase with age. Menopausal women are also at a higher risk of developing osteoporosis. Menopause is the permanent cessation of menses for 12 months resulting from estrogen deficiency and is not associated with a pathology. During the menopause, the change in hormones can mean the body stores more fat and burns calories less efficiently. Sleep problems. The magnitude of the decline in testosterone with age and the prevalence of older men. Systemic estrogen therapy — which comes in pill, skin patch, spray, gel or cream form — remains the most effective treatment option for relieving perimenopausal and menopausal hot flashes and night sweats. Results: The mean score of knowledge and attitude about andropause was 29. Hot flashes and vaginal changes are due to the decrease in estrogen levels. vaginal dryness. A study from 2020 found that nearly 27% of people in menopause used marijuana to ease symptoms. Yes Andropause is a "male version" condition of 'menopause for female'. In the WHI, the hazard ratio for coronary heart disease in women who initiated MHT ≤10 years after menopause was 0. Menopause is a point in time 12 months after a woman's last period. campaign in the history of the universe, because it’s not just hot flashes and night sweats,” says Rachel Rubin, a sexual. A person enters menopause 12 months after their last period. This results in low serum estradiol concentrations and vasomotor symptoms (hot flashes) in. Check out these 7 things early menopause can mean for your health: More From Prevention. CVD and Menopause. The years leading up to that point, when women may have changes in their monthly cycles, hot flashes, or. Univariate Cox models were fitted to the age at menopause for all individual covariates before the multivariate analysis. It is also available in an. Common physical symptoms of menopause and perimenopause include: hot flushes, when you have sudden feelings of hot or cold in your face, neck and chest which can make you dizzy. Steven Lamm, medical director of. Still, little is known about the health effects of this natural biological occurrence. Its symptoms are sexual dysfunction, weakness, fatigue, insomnia, loss of motivation, mood disorders and reduction of bone density. It is nature's protective phenomenon against reproductive morbidity and mortality in the aging population. A blood test is the only method to confirm low testosterone. Although the biological role of testosterone in women remains unclear, the sharp and rapid decline in. Research explores the impact of menopause on women’s health and aging. In the U. That can affect vaginal lubrication, causing the vagina to be too dry for comfortable sex -- but there's help for that. 1038/sj. This is because the root and bark of Eurycoma longifolia are often used orally for dealing with. Natural menopause usually. Medications are often used to treat perimenopausal symptoms. During this third step of urine formation, urine filters into the ureters and ultimately to the urinary bladder for storage. Menopause is the permanent cessation of menses for 12 months resulting from estrogen deficiency and is not associated with a pathology. Perimenopause is the period before the menopause characterized by irregular. Menopause, also known as the climacteric, is the time when menstrual periods permanently cease, marking the end of reproduction.