WHAT IS MENOPAUSE?
The menopause marks the time in a woman’s life when her menstruation stops and she is no longer fertile (able to become pregnant).
In the UK the average age for the menopause is 52 (National Health Service), while in the USA it is 51 (National Institute of Aging). About one fifth of women in India experience menopause before the age of 41.
The menopause is a normal part of life – it is a milestone, just like puberty – it is not a disease or a condition. Even though it is the time of the woman’s last period, symptoms may begin many years earlier. Some women may experience symptoms for months or years afterwards.
The peri-menopause is the 3 to 5 year period before the menopause when a woman’s estrogen levels begin to drop.
A study found that some women are in denial when it comes to the menopause.
The menopause, sometimes referred to as the “change of life”, is the end of menstruation. This is when a woman’s ovaries stop producing an egg every four weeks.
She no longer has a monthly period and is unlikely to get pregnant.
In the UK, 51 is the average age for a woman to reach the menopause, although some women experience the menopause in their 30s or 40s.
If you experience the menopause before the age of 40, it’s known as a premature menopause.
Menstruation (monthly periods) can sometimes stop suddenly when you reach the menopause. However, it’s more likely that your periods will become less frequent, with longer intervals between each one, before they stop altogether.
WHAT ARE THE SYMPTOMS OF MENOPAUSE AND PERI-MENOPAUSE?
Experts say that technically, the menopause is confirmed when a woman has not had a menstrual period for one year. However, the symptoms and signs of menopause generally appear well before that one-year period is over. They may include:
- Irregular periods – this is usually the first symptom; menstrual pattern changes. Some women may experience a period every two to three weeks, while others will not have one for months at a time.
- Lower fertility – during the peri-menopausal stage of a woman’s life, her estrogen levels will drop significantly, lowering her chances of becoming pregnant.
- Vaginal dryness – this may be accompanied by itching and/or discomfort. It tends to happen during the peri-menopause. Some women may experience dyspareunia (pain during sex). The term vaginal atrophy refers to an inflammation of the vagina as a result of the thinning and shrinking of the tissues, as well as decreased lubrication, caused by a lack of estrogen. Approximately 30% of women experience vaginal atrophy symptoms during the early post-menopausal period, while 47% do so during the later post-menopausal period. There are cases of women who experience vaginal atrophy more than a decade after their final period. The majority of post-menopausal women are uncomfortable talking about vaginal dryness and pain and are reluctant to seek medical help.
- Hot flashes (UK term: hot flushes) – a sudden feeling of heat in the upper body. It may start in the face, neck or chest, and then spreads upwards or downwards (depending on where it started). The skin on the face, neck or chest may redden and become patchy, and the woman typically starts to sweat. The heart rate may suddenly increase (tachycardia), or it may become irregular or stronger than usual (palpitations). Hot flashes generally occur during the first year after a woman’s final period.
- Night sweats – if the hot flashes happen in bed they are called night sweats. Most women say their hot flashes do not last more than a few minutes.
- Disturbed sleep – sleeping problems are generally caused by night sweats, but not always. Sleep disturbance may be caused by insomnia or anxiety. Difficulty falling asleep and staying asleep increase as women go through menopause.
- Urinary problems – women tend to be more susceptible to urinary tract infections, such as cystitis. Having to urinate may also occur more frequently.
- Moodiness – this often goes hand-in-hand with sleep disturbance. Experts say that most mood disturbances are triggered by poor sleep.
- Problems focusing and learning – Some women may also have short-term memory problems, as well as finding it hard to concentrate on something for long. Some women may not be able to learn as well shortly before menopause compared to other stages in life.
- More fat building up in the abdomen.
- Hair loss (thinning hair).
- Loss of breast size
What causes the menopause?
The menopause is caused by a change in the balance of the body’s sex hormones.
In the lead-up to the menopause (perimenopause), oestrogen levels decrease, causing the ovaries to stop producing an egg each month (ovulation). Oestrogen is the female sex hormone that regulates a woman’s periods.
The reduction in oestrogen causes physical and emotional symptoms, including:
• hot flushes
• night sweats
• mood swings
• vaginal dryness
TREATING THE MENOPAUSE
Medication for the oestrogen deficiency symptoms that can occur around the time of the menopause isn’t always needed. Many women find that making simple diet and lifestyle changes relieve their symptoms.
If your menopausal symptoms are more severe and interfere with your day-to-day life, treatment may be recommended.
Hormone replacement therapy (HRT) is one of the main treatments used for the menopause. It helps relieve menopausal symptoms by replacing oestrogen. It’s available in many forms including tablets, cream or gel, a skin patch or an implant.
Vaginal lubricants can be used to treat vaginal dryness, and antidepressants are sometimes prescribed for treating hot flushes.
Making simple dietary and lifestyle changes can often improve your menopausal symptoms.
For example, eating a healthy, balanced diet and taking plenty of regular exercise can help you avoid putting on extra weight, which can often occur during the menopause.
A healthy diet that includes all the food groups will help keep your bones strong and healthy. Combining aerobic activities, such as walking, with strength and flexibility exercises will also help you maintain bone strength and muscle mass.