What is Menopause?
Menopause is a natural phase in a woman’s life characterized by the cessation of menstruation, marking the end of her reproductive years. It’s not just a pause but a permanent stop in menstrual cycles. There shouldn’t be any stigma attached to this biological process.
Diagnosing menopause typically involves retrospectively observing the absence of periods for a year or more, without any obvious underlying medical conditions. Unlike other health issues, there’s no specific laboratory test to confirm menopause or distinguish between perimenopause and menopause.
It’s crucial to understand that menopause is not a static endpoint but a dynamic journey. Each woman’s experience with menopause is unique, requiring an individualized approach to manage symptoms and overall well-being.
When Does Menopause Occur?
Menopause typically occurs in women between the ages of 45 and 55, with an average age around 51 years old. However, it’s important to note that individual experiences can vary widely. Some women may experience menopause earlier, which is defined as before the age of 45 (early menopause), while menopause before the age of 40 is termed as premature menopause. If premature menopause occurs without a clear medical or surgical cause, it’s often referred to as primary ovarian insufficiency.
Note the lowest limit usually used in populations where studies have not been done to determine the average age of women at menopause is 40 years. Below this, one is considered to have premature menopause if this has occured
What Causes Menopause?
It is as a result of depletion of the ovarian oocytes leading to diminished ovarian function. This results in significant reduction of estrogen and other hormones usually produced by the ovary.
The changes in the ovarian hormone levels affect individuals in different ways. Some women may only experience mild menopausal symptoms while others may have severe menopausal symptoms.
In case the symptoms are worrying you, seek medical attention from your healthcare provider.
Menopause, Perimenopause and Postmenopause
Perimenopause is the transitional phase leading to menopause, characterized by various symptoms.
Is associated with intermittent/irregular ovarian function leading to irregular menstrual periods. You may also experience some of the menopausal symptoms as you go through this transition period before complete stop of menses and menopause.
Menopause marks the end of menstruation and brings about hormonal changes.
Postmenopause refers to life after menopause, with potential health risks like osteoporosis and heart disease.
Common Menopause Symptoms
Hot flashes, mood changes, sleep disturbances, and vaginal health issues are prevalent symptoms.
Each woman’s experience with menopause is unique, requiring individualized support.
What are the signs and symptoms of Menopause?
These symptoms can significantly impact quality of life, but lifestyle changes, hormonal therapies, and support from healthcare providers can help manage menopausal symptoms effectively. The signs and symptoms of menopause can vary widely among individuals but commonly include:
Changes in Periods
Irregular periods during perimenopause lead to complete cessation of menstruation in menopause. Any post-menopausal bleeding requires medical evaluation.
Hot Flashes
It is characterized by sudden sensations of heat over the upper body (disturbing feeling of heat or cold over the chest, neck and face), often accompanied by sweating, palpitations, and cold chills. These can cause discomfort and sleep disturbances. Hot flash may cause dizziness.
This is a vasomotor symptom which is common during menopause and perimenopause. Vasomotor symptoms affect 7 women out of 10 going into menopause. Hot flashes is quite common during the perimenopausal period resulting from the intermittent ovarian activity during this time period.
It is thought to be as a result of dysregulation of the temperature regulatory centre in the hypothalamus which is usually under estrogen control.
Hot flashes will last 5-7 years in 6 out of 10 women but may persist for close to 15 years in a small percentage of women (<15%)
Hot flashes may be accompanied by the other vasomotor symptoms such as sweating, palpitations, apprehension causing significan distress/discomfort and inconvenience. The discomfort is worse with frequent attacks. These symptoms contribute to sleep disturbance
Hormonal replacement therapy you will begin to get relief of the vasomotor symptoms within weeks
Night Sweats
Another vasomotor symptom associated with menopause. You experience Intense sweating during sleep, often associated with hot flashes, contributes to sleep disturbances.
Vaginal Changes:
Dryness, pain, or itchiness in the vagina due to decreased estrogen levels, leading to discomfort during sexual activity and reduced libido.
Estrogen keeps the vagina and the vulva moist and supple and maintains the collagen in the tissues to keep them firm too. With menopause the vagina and vulva may be dry which then leads to pain and itchiness during sexual activity. There is atrophy of the tissues like the vulva, prepuce, urethra which become flat, less elastic, more friable and thin with reduced glandular secretions. The vaginal and urethral flora is altered and becomes more basic rather than acidic and this is one of the causes of the increased infections.
These symptoms contributes to reduced interest in sex
Low Sex Drive and Libido:
Decreased sexual desire and sensitivity, are often related to hormonal changes, sleep problems, and vaginal dryness. Menopause is associated with low testosterone levels and this may contribute to the low sex drive and libido by some women
Urinary Symptoms:
Discomfort with urination, increased frequency, urinary tract infections, and bladder control issues due to weakened pelvic floor muscles.
The genitals and the urinary system arise from similar structures embryologically and both suffer when there is low amounts of estrogen
Genitourinary syndrome of menopause is a compilation of signs and symptoms affecting the genitourinary systems. The genital symptoms are vaginal dryness, painful sexual intercourse, discomfort, atrophic vagina; vulvar pain and discomfort or irritation. Urinary symptoms which you may experience during menopause include frequent urinary tract infections-with pain upon peeing, urgency and frequency of urination, bladder discomfort and some level of incontinence.
Brain Fog and Forgetfulness:
Cognitive changes such as fuzzy thinking, memory lapses, and difficulty concentrating, are attributed to hormonal fluctuations affecting the brain’s memory centre.
Mood Symptoms:
Mood swings, low self esteem, depression, anxiety, irritability, and aggressiveness are common emotional changes during menopause.
Skin Changes:
Dry, itchy skin, and other skin changes due to hormonal shifts affecting collagen and moisture levels.
Joint and Muscle Aches:
Pain and discomfort in joints and muscles are often attributed to hormonal changes and decreased estrogen levels.
Insomnia:
Difficulty falling and staying asleep is often associated with night sweats, leading to fatigue and irritability.
Migraine Headaches:
Increased frequency of headaches, including migraines, during menopause.
Lifestyle Remedies that will help you with Menopause
Here are some lifestyle remedies for dealing with menopause and promote well-being
Maintain a Heathy Diet
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Focus on a diet rich in fruits, vegetables, and fiber to support your overall health.
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Limit sodium and simple sugars, and avoid saturated fats while incorporating unsaturated or trans fats.
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Reduce meal portions, eat regularly, and ensure a balanced plate with vegetables, grains, and proteins.
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Consider taking calcium and vitamin D supplements if needed, and include dairy products like milk.
Maintain an Healthy Weight throughout life
- Aim to achieve and maintain a healthy weight to reduce risks associated with cardiovascular issues, metabolic disorders like diabetes, and certain types of cancers..
Physical Exercise
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Engage in regular physical activity, aiming for at least 150 minutes of moderate to vigorous exercise per week.
Include a variety of exercises such as dancing, walking, step aerobics, running, and strength training to improve bone and heart health.
Start slowly and gradually increase intensity, focusing on muscle and bone strengthening exercises for at least 2 days per week for 20-30 minutes per session - Exercise improves physical health by reducing lipid or cholesterol levels and decreases weight. Lower stress levels improves mental health and reduce menopausal symptoms
Join Menopause Support Groups
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Consider joining support groups specifically for menopause to connect with others going through similar experiences.
These groups can provide emotional support, a safe space to share feelings, and valuable information and resources to navigate menopause effectively.
By incorporating these lifestyle remedies, you can support your physical and mental well-being during the menopausal transition and beyond.
- These lifestyle adjustments can significantly contribute to managing menopausal symptoms and improving overall well-being.
Lifestyle Remedies that will help with specific menopausal Symptoms
Here are some lifestyle remedies for dealing with menopausal symptoms:
Hot Flashes
- Identify Triggers: Avoid spicy foods, warm temperatures, caffeine, stress, alcohol, and smoking as they can trigger hot flashes. Smoking is a no-no. Besides tobacco products are associated with 1 out of 3 cancer risks-breast, colon, rectal, endometrial and other cancers. If case where you are unable to avoid alcohol intake-reduce to maximum of one in a day
- Diet: Consider a Mediterranean diet rich in fruits, vegetables, seeds, nuts, fish oil, and olive oil. Incorporate foods containing plant estrogens like chickpeas, soybeans, lentils, flaxseed, and grains.
- Regulate Body Temperature: Use fans, wear light layers, take cool baths, and drink cold beverages.
- Maintain a Cool Bedroom Environment.
- Limit Alcohol Intake to no more than one drink per day.
- Quit Smoking to reduce associated cancer risks.
- Practice Stress Management through mindfulness, meditation, or regular breaks.
- Exercise regularly, even though it may be challenging during hot flashes, as it can help alleviate symptoms.
Vaginal Health and Sexual Function
- Use lubricants, available over the counter, to reduce pain during intercourse caused by vaginal dryness.
Mood
- Engage in calming exercises like yoga to improve mood and reduce anxiety.
Difficulty Sleeping
- Regular exercise can aid in improving sleep quality and is recommended for managing insomnia.
- These lifestyle adjustments can significantly contribute to managing menopausal symptoms and improving overall well-being.
Management
Hormonal Replacement Therapy is the mainstay of treatment.
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There are various forms of hormonal replacement medication -systemic-oral or transdermal and even vaginal creams or tablets, rings or implants. Vaginally administered ones have local effects mostly. The transdermal are in the form of gels/sprays or patches. Hormonal IUS is also used.
Non-Hormonal Treatment
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Non-hormonal treatment are mostly deployed when the HRT cannot be tolerated or when symptoms are not controllable due to severity.
The treatment prescribed by your doctor will depend on the symptoms at play, age, age since menopause and other risk factors.
There is no one treatment that fits all and you are likely to be reviewed three months after initiation of treatment and yearly afterwards if you are on the right path in terms of treatment. Dose adjutsments and even stoppage is likely once you discuss with your doctor depending on improvemnt note
Long-term Health Risks of Menopause
Long-term consequences of menopause can include osteoporosis and coronary artery disease.
Osteoporosis
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teoporosis is a condition where bone mass decreases significantly due to the decline in estrogen levels after menopause. This reduction in bone density can lead to brittle bones and an increased risk of fractures. Symptoms may include back pain, loss of height, kyphosis (a hunchback appearance), and fractures. Bone mineral density tests can help assess calcium levels in the bones, aiding in the early detection and management of osteoporosis.
Coronary Artery Disease
- Coronary artery disease involves the narrowing or blockage of arteries supplying the heart muscle. It is influenced in part by low estrogen levels post-menopause, contributing to the buildup of fatty plaques along artery walls. This condition underscores the importance of managing cardiovascular health during and after menopause to mitigate the risk of heart-related issues
Maintaining good bone health during menopause is crucial.
Here are some key strategies:
Exercise: Incorporate resistance, balance, and weight-bearing exercises into your routine. Choose safe movements that don’t increase the risk of falling. Regular exercise helps strengthen bones and improve overall physical health.
Diet: Consume a balanced diet rich in calcium. Include dairy products fortified with vitamin D, as well as fish if possible. Exposure to sunlight is also essential for adequate vitamin D levels. Preventing obesity through healthy eating habits contributes to keeping bones strong.
Avoid Smoking: Smoking can negatively impact bone health, so it’s best to avoid tobacco products during menopause and beyond.
Limit Alcohol Consumption: Excessive alcohol consumption can interfere with calcium absorption and contribute to bone loss. Limiting alcohol intake supports bone health.
Supplements: Consider taking calcium and vitamin D supplements as part of preventive care during menopause and postmenopause. Consult with a healthcare professional to determine the right dosage for your needs.
By incorporating these lifestyle measures, you can promote and maintain optimal bone health as you navigate through menopause and beyond.
Regular visits to your doctor during and after menopause are crucial for maintaining your overall health and well-being. Preventive health care measures, including health screening tests like mammography, colonoscopy, and triglyceride screening, are essential to detect any potential health issues early.
If you’re experiencing menopausal symptoms that are significantly affecting your quality of life, it’s important to talk to your gynecologist. They can guide managing these symptoms and recommend appropriate treatments or lifestyle changes.
Additionally, any bleeding from the vagina after menopause should always be evaluated by a medical professional. It could indicate underlying issues that need to be addressed promptly. Don’t hesitate to seek medical advice and follow up on any concerns related to your health during this phase of life.
Talk to your gynecologist if you are experiencing menopausal symptoms affecting the quality of your life in any area or aspect.
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