Menopause

What is Menopause?

Menopause is a natural decline in hormonal function. A woman is considered to be in menopause once she stops menstruating for 12 months.


Menopause doesn't occur overnight; it's gradual, and most women experience it between 45 and 55.


Stages of Menopause

Menopause is unavoidable in every woman's life, but not every woman experiences unpleasant symptoms.


Women who experience hot flashes, rapid changes in mood or sleep disturbances may be going through menopause.


The time leading into menopause is called perimenopause and can last 5-10 years. This is when the menstrual cycle may change, and women experience some menopausal symptoms. 


Menstruation fluctuates and may become longer, shorter, lighter, or heavier. Eventually, hormone levels fall to a point where menstruation ceases altogether.


Cause of Menopause

Menopause is a natural process in every woman as she reaches her early forties or fifties. 


The production of the hormones by ovaries that regulate the menstrual cycle, namely oestrogen and progesterone, decreases.


Eventually, the ovaries stop producing eggs and menstruation stops.


Symptoms of Menopause

Menopause may lead to physical and emotional changes, such as

  • Hot flushes, 
  • Emotional changes, including irritability or mood swings,
  • Decreased fertility
  • Vaginal changes, including dryness, itching, or burning
  • Sleep disturbances and night sweats
  • Weight gain
  • Headaches, general aches and pains
  • Forgetfulness, declined ability to focus and concentrate 
  • Reduced sex drive, Tiredness
  • Irregular menstrual periods
  • Dryness of the vagina, dry skin, sagging of the breasts
  • Thinning hair
  • Slow metabolism
  • Urinary frequency


Several chronic medical conditions tend to appear after menopause. Women need to become aware to minimise the risk.


Menopause Awareness

Things to be conscious of include the following:

  • Loss of calcium from menopause increases your risk of osteoporosis. Your bones may become brittle and weak, increasing the risk of fractures. Engage in regular, weight-bearing exercises to keep your bones strong.
  • As your oestrogen levels decline, your risk of cardiovascular disease increases. Make sure to get regular checkups with your doctor.
  • Some women may experience urinary incontinence. As the tissues of your vagina and urethra lose their elasticity, you may experience urine leakage when coughing, laughing or lifting.


Premature Menopause

Premature menopause is diagnosed once women have stopped menstruating for 12 months before age 40, with blood tests supporting this diagnosis.


Some factors that can induce early menopause include the following:

  • Cancer treatment: Chemotherapy (treatment with chemical agents) and radiotherapy (treatment by exposure to radiation) can cause menopause symptoms and a temporary or permanent stop to your menstruation.
  • Failure of ovaries: Autoimmune diseases or genetic factors can cause your ovaries to produce less than normal reproductive hormones. This is known as primary ovarian insufficiency and can lead to premature menopause.
  • Surgery: Surgery such as total hysterectomy and bilateral oophorectomy that involve the removal of your uterus and both ovaries will immediately stop menstruation.


Diagnosis

We can identify your transition to menopause with your signs and symptoms. Menopause is diagnosed once a woman has stopped menstruating for 12 months. 


To confirm the diagnosis, we may order blood tests to check your follicle-stimulating hormone (FSH) levels and oestrogen (oestradiol), as a decrease in the level of Oestrogen hormone can project menopause.


Treatments for Menopause

Menopause does not need treatment, but it may be required to control its signs and symptoms.


Menopause is usually natural, so it's best to let it run. Often, if you improve your lifestyle habits, unpleasant symptoms of menopause will be greatly reduced.


Recommended treatments include

  • A healthy diet. Choose various foods, including plenty of fresh vegetables, fruits, cereals, whole grains and small portions of lean meat, fish or chicken.
  • Increase your intake of fluids and low-fat dairy foods with high calcium content.
  • Limit caffeine and alcohol.
  • Exercise regularly - at least 45 minutes three times per week.
  • Avoid smoking due to the associated risk of osteoporosis, coronary heart disease and lung cancer.
  • Hormone replacement therapy can effectively reduce many unpleasant effects of menopause symptoms. Discuss the advantages and disadvantages of hormone replacement therapy with your doctor.


To minimise symptoms, get regular pap smears and breast checks. Your surgeon recommends a two-year check-up for optimum health.


Lifestyle Remedies for Menopause

Some of these lifestyle remedies can also help you reduce or prevent the symptoms of menopause.

  • Cool off hot flashes by drinking cold water or staying in a cool room. Identify factors that trigger your hot flashes, like hot beverages, alcohol, caffeine and spicy foods, and try to avoid them.
  • Use water-based vaginal lubricants to help you with vaginal dryness and discomfort.
  • Reduce stress, get adequate sleep, eat healthy, stay active and don't smoke
  • Exercise regularly. Kegel exercises can help you strengthen your pelvic floor muscles and improve urinary incontinence.
  • Some women find Yoga / Pilates/ Meditation useful exercise
  • Some women also find dietary changes helpful


Hormone replacement therapy (HRT)

We may recommend treatment with hormones, including oestrogen and progestin, for hot flashes and bone loss. It may also help prevent cardiovascular problems if started within five years of menopause.


Vaginal Oestrogen

Small doses of oestrogen in cream or pessaries can help you manage vaginal dryness, urinary symptoms and discomfort during intercourse.


Antidepressants

Low-dose antidepressants can help you manage hot flashes when hormone replacement therapy is not advisable and will also help improve your mood. Some other non-hormonal medications can be used as an alternative to HRT.


Other Medications

You may also be prescribed medications to reduce your bone loss and risk for fractures if you are high risk or already have developed osteoporosis.


Complications of Menopause

Some of the possible complications associated with menopause include the following:

  • The risk for heart and blood vessel (cardiovascular) diseases increases with decreased oestrogen production.
  • Bone density may decrease, making them brittle and leading to a condition known as osteoporosis. This can make you more prone to fractures.
  • Vaginal and urethral tissues will begin to lose their elasticity, and you may experience the sudden urge to urinate or develop  (urge incontinence or stress incontinence). You may also become more prone to urinary tract infections.
  • The loss of moisture and elasticity in your vagina can cause discomfort during intercourse and affect your sexual desire (libido).
  • As your metabolism rate slows down, you may start gaining weight.
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