Menopause

WHAT IS MENOPAUSE?

Menopause is the medical term used for the last menstrual period a woman will ever have. However, the term is also often used to describe the years leading up to this time, ‘the peri menopause’. This time is more accurately known as the ‘climacteric’.

Menopause is a natural process that women go through and every woman’s experience of the menopause is different.

WHEN DOES THE MENOPAUSE OCCUR?

The menopause usually happens between the ages of 45 and 55, although it can be earlier or later. The average age for the menopause to occur is 51 years old. There can be a family pattern so it may be worth asking your mother, sister or grandmother when it happened to them.

No matter what age you are, having the ovaries removed (most commonly at hysterectomy) causes the menopause to happen instantly. If the ovaries are destroyed with chemotherapy or radiotherapy in the treatment of cancer, this can also bring on an immediate menopause. The symptoms of the menopause can be more severe when the menopause takes place prematurely or abruptly.

Cigarette smokers often reach the menopause earlier than non-smokers.

WHAT HAPPENS DURING THE MENOPAUSE?

Every baby girl is born with all the eggs in her ovaries that she will ever have in her lifetime. There is a steady reduction of these egg numbers over time as some never mature and wither away and others are released each month at ovulation. By the time most women have reached their late 40′s the number of eggs remaining in the ovaries is low.

The brain (specifically the pituitary gland) responds to this fall in egg production by increasing Follicle Stimulating Hormone production dramatically in an attempt to encourage the ovaries to respond and cause the remaining eggs to mature. At this time your periods will probably become irregular and unpredictable (until they stop altogether).

Oestrogen has many functions; it is needed to keep your body ready for a possible pregnancy and controls development of female sexual characteristics such as development of the breasts, genitals and uterus. When the ovarian function declines, oestrogen levels fall causing many effects on the body.

WHAT ARE THE SYMPTOMS OF MENOPAUSE?

Around 80% of women will experience additional symptoms of the menopause apart from the cessation of the period. The symptoms of the menopause result from reduced levels of oestrogen and some women might have severe problems that affect their lifestyle.

Symptoms of the menopause may include any of the following:

  • Periods – most women’s periods will become unpredictable for several months and in some cases for a few years before they actually stop.
  • Hot flushes – the most common symptom of the menopause. Hot flushes are sudden intense waves of heat, sometimes accompanied by redness and sweating. They can occur at any time and some women find that these flushes disrupt their sleep. Hot flushes can last anything from a few seconds up to several minutes and at the start of the menopause can occur as frequently as several times an hour.
  • Vaginal dryness – your vagina may become dryer and much thinner, making sex painful and uncomfortable. The thinning of the vagina walls also puts you at an increased risk of vaginal infections like thrush.
  • Feeling emotional and depressed – the menopause can make many women experience headaches, forgetfulness and make them feel irritable and ‘moody’.
  • Tiredness – this can often be due to difficulties in sleeping.

The menopause does not happen overnight and symptoms of the menopause can continue for an average of 4 years. However, the majority of women continue to function well during the menopause. For some women the menopause brings a sense of freedom since the end of fertility means no more birth control and dealing with periods, which may have been heavy or painful.

HOW IS THE MENOPAUSE DIAGNOSED?

Doctors will usually diagnose the menopause from your symptoms and age alone.

ARE THERE HEALTH RISKS ASSOCIATED WITH THE MENOPAUSE?

As oestrogen levels fall the skin becomes thinner. You may find your skin is drier and your hair could thin. As mentioned previously, the lining of the vagina becomes thinner and the uterus will also become smaller and the lining thinner. Osteoporosis can develop – approximately 1 in 4 women are at risk. Osteoporosis or thinning of the bones tends to occur after the menopause when the bones have lost much of the calcium they need to remain strong.

After the menopause you are also more at risk of heart disease, as oestrogen appears to protect the blood vessels. As oestrogen levels fall so does this protection.

IS THERE ANY TREATMENT FOR MENOPAUSE?

Many symptoms of the menopause can be reduced with certain lifestyle changes like exercise and diet. Exercise, such as walking for 20-30 minutes, 3-4 times a week, will help maintain general fitness, reduce the risk of developing heart disease and will strengthen the bones. You should also ensure that you eat a well balanced diet containing foods that provide calcium, such as milk products, cheese, salmon and green leafy vegetables. A good intake of calcium will slow down bone thinning and help to prevent fractures. In moderation a small glass or 2 of red wine can reduce the risk of heart disease and cancer.

For vaginal dryness, try using a vaginal lubricant like KY Jelly, which is available from most chemists.

If you smoke you should now stop. Smoking can make menopause symptoms worse and increase the loss of bone density.

The menopause can be relieved with treatment. Speak to your pharmacist or doctor about taking supplements, (e.g. evening primrose oil and vitamin D) as these can help some women cope with symptoms of the menopause.

Medical treatment that is designed to make up for the loss of oestrogen is available for women who are troubled by symptoms of the menopause. This treatment is called Hormone Replacement Therapy (HRT) and can help ease or prevent some of the symptoms of the menopause.

Other treatments that are available for the menopause include antidepressants and sleeping pills. If you have any symptoms that are causing you concern or discomfort then you should seek your doctor’s advice.

HOW LONG SHOULD I CONTINUE TO USE CONTRACEPTION?

Many women stop using contraception before their periods have completely stopped and although fertility decreases with age, it is important to use adequate contraception until the risk of pregnancy no longer exists. An unplanned pregnancy at an older age may be devastating.

 


 

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