Are you going through the menopause?
Menopause, or better known as the change of life; is the absence of menstrual periods for 12 months. The diagnosis can only be made in retrospect. The menopausal transition starts with varying menstrual cycle length and ends with the final menstrual period. Perimenopause means “the time around menopause” and is often used to refer to the menopausal transitional period. It is not officially a medical term, but is sometimes used to explain certain aspects of the menopause transition in lay terms. Post menopause is the entire period of time that comes after the last menstrual period.
Menopause is the time in a woman’s life when the function of the ovaries ceases. The ovary, or female gonad, is one of a pair of reproductive glands in women. They are located in the pelvis, one on each side of the uterus. Each ovary is about the size and shape of an almond. They are responsible for providing eggs (ova) a process known as ovulation. During each monthly menstrual cycle, an egg is released from one ovary. The egg travels from the ovary through a Fallopian tube to the uterus. The ovaries are the main source of female hormones, which control the development of female body characteristics such as the breasts, body shape, and body hair. The hormones also regulate the menstrual cycle and pregnancy. Oestrogens also protect the bone by helping the entry of calcium into the bone structure. Therefore, a woman can develop osteoporosis (thinning of bone) later in life when her ovaries do not produce adequate oestrogen. Perimenopause is different for each woman. Scientists are still trying to identify all the factors that initiate and influence this transition period.
When do women reach menopause?
In general women go through the menopause at the age of 51. But there is no way to predict when an individual woman will enter menopause. This is not related to menarche which is the age of onset of periods. However, the age usually ranges between 45 and 55, but menopause may occur as earlier as the 30s or 40s or may not occur until a woman reaches her 60s. Usually women tend to undergo menopause at an age similar to that of their mothers, but this is not always the case.
Perimenopause, where the periods are usually irregular, there might be as well minor menopausal symptoms, can begin up to 10 years prior to the last menstrual period.
Symptoms of menopause :
Hot Flashes & Night Sweats
A hot flash is the sensation of “flushing” or a sudden feeling of heat, often accompanied by sweating. When they occur during sleep they are called night sweats. Hot flashes are the menopause symptoms most often mentioned by women. About 75% of women will experience hot flashes as they go through menopause.
With the decline in Estrogen and Progesterone levels, some women find themselves very emotional. They are easily triggered into strong emotional responses such as sadness, anger, irritability or delight. Because they see themselves as suddenly unpredictable, women find this unsettling, and are likely to seek help for this symptom.
Both migraine and tension headaches may increase during menopause. Since migraine headaches are vascular in nature, and since the vascular system is unstable during menopause, migraines can become more frequent and difficult to manage.
Many women report a greater tendency to be wakeful. Sometimes this is due to night sweats and sometimes due to neurological excitability. Once they are awake, it is difficult to go back to sleep and can suffer from sleep deprivation as a result.
Vaginal Dryness & Urinary Problems
Due to lack of Estrogen, the walls of the bladder, urethra and vagina become drier and less flexible. This makes the tissue more easily damaged and more prone to infections. They may suffer as well from urinary incontinence.
Your metabolism slows down with age, thus weight gain is more common in menopause. The combination of changing patterns of fat deposit, less muscle mass and a slower metabolism can give you flabby abdomen, arms and legs.
Memory & Cognitive Changes
This can be very distressing for women. While some loss of memory is normal with aging especially word retrieval and short term memory. Sometimes cognitive changes can interfere with your ability to do every day’s activities.
This is usually temporary and is due to the body’s adjustment to lower Estrogen level. If it prevents you from doing your daily activities, or if it lasts more than two months, you do need to seek medical advice.
Many women notice that their sexual desire lessens when they become menopausal. Sometimes this is a temporary response to hormone shifts; sometimes it is a reaction to other things like stressors or difficult life situations. If you notice that you desire sex less often, or don’t seem to enjoy it, and this creates problems in your life or relationships, talk to your gynaecologist.
Worrying symptoms of menopause
If you find that your periods are increasingly heavy and that you have to change your tampon more often than usual. Heavy bleeding can be a sign of fibroid tumours or uterine polyps, which are usually benign. But bleeding may be related to cancer of the womb. You should be evaluated by a medical professional especially if you are getting anaemic.
High Blood Pressure
Check your blood pressure every few months, and if it becomes higher than 140/80 make an appointment to have it evaluated. High blood pressure can put you at risk for heart disease or stroke, and may be a sign of more serious medical problems.
Some occasional heart palpitations or irregular beats can be normal during the time around menopause. But if they are happening frequently, or are accompanied with trouble breathing, fainting, chest pain, anxiety, or nausea they could be signs of heart disease or a heart attack.
Menopause is a time of changing moods and grief over life’s losses. If you are finding yourself sad most of the time, or if you feel hopeless, irritable, have lost pleasure in things you used to enjoy or think about dying or hurting yourself, make an appointment to see whether you are clinically depressed. Some treatments for depression are also effective for other menopausal symptoms.
Management of menopausal symptoms
Menopause occurs at the natural end of every woman’s reproductive life. So why not treat it in a natural way? Hormone replacement therapy (HRT) was long the standard treatment for menopause, however, since we now know that traditional HRT using synthetic oestrogen and progestin increases the risk of breast cancer and heart disease, many women and healthcare providers are no longer routinely asking for or prescribing traditional oestrogen replacement therapy. More women, every day, are turning to natural alternative treatments to treat their menopausal symptoms.
Diet is an important tool that you can use to help control your menopausal symptoms. Foods to avoid include high amounts of caffeine in any foods, and carbonated beverages, which contain phosphorous and can increase bone loss. Also, limit your consumption of commercially raised meats including beef and chicken because these meats contain a high amount of saturated fats and decrease the body’s ability to metabolise estrogen. Excessive sugar intake also limits your liver’s ability to metabolize oestrogen and impairs the immune system.
Increase your intake of foods that contain phytoestrogens including soya. Other foods that you should include in your diet include grains, oats, wheat, brown rice, tofu, almonds, cashews, and fresh fruits and vegetables.Research has shown that red clover supplements to food, have been shown to have a significant positive effect on the rate of bone loss, improve cardiovascular health, and may offer some protective effect against breast and endometrial cancer. There is also evidence, which suggests that red clover decrease the incidence of hot flashes, one of the most common vasomotor complaints experienced by peri-menopausal and menopausal women.
Lactobacillus acidophilus and Bifidus cultures known as “good” bacteria in our intestines are important for women during menopause to help with metabolism and utilization of oestrogen. These “good” bacteria may help reduce the occurrence of yeast infections. These can be found in various nutritional formulas on the market.
Certain vitamins and minerals can provide particular benefits to menopausal women. These include Vitamin E (400 to 800 IU daily) to help reduce hot flashes and night sweats; Calcium (1500 mg daily), the best type of calcium is not calcium carbonate which may not be fully absorbed, but microcrystalline calcium hydroxyapatite calcium (MCHC) or calcium citrate; Magnesium (500 mg to 750 mg daily) is essential to help with the absorption of calcium; Vitamin C (1,000 mg to 2,000 mg daily) helps absorption of Vitamin E and decreases capillary fragility.
Black Cohosh (20 mg to 60 mg, 3 times daily) which is a phytoestrogen that helps many women manage menopause symptoms. There are a number of Black Cohosh products on the market for menopause. Evening Primrose Oil (500 mg 3 or 4 times daily), Ginseng (100 mg to 500 mg, 3 times daily are very helpful in controlling menopausal symptoms.
It is important to remember than menopause is not the end of the women’s sexual life as the Arabic translation implies “the age of despair”. It is a different phase in women’s life where sex may be more fulfilling, as there is no worry about pregnancy and the hustle of using contraception and their related side-effects.
It is a time when all the period related symptoms cease such as pain, heavy or irregular bleeding etc….
In the next issue of the magazine I will be discussing the role of hormone replacement (HRT) in the management of the menopause. The article will address the risks & benefits, as there are a lot of myths surrounding their use. There are various forms and types of HRT available depending on the age of the patient and as well on whether the uterus has been removed or not.