Understanding Menopause

Menopause marks a major biological milestone in a woman’s life. It symbolises the beginning of a new phase in life. Understanding this transition can help you navigate it with ease and confidence.

This article will cover everything you need to know, including the symptoms, different stages, potential causes, risks, diagnosis, and the available treatment options can help women dive into this transition smoothly.

Stages of Menopause

Menopause is a natural biological process that marks the end of a woman’s reproductive years. Menopause is when she has not had a menstrual period for 12 consecutive months.

The onset of menopause can vary among individuals. Generally, it starts between the ages of 45 and 55.

There are three key stages, each characterised by certain physiological changes, driven by hormonal shifts, predominantly the decline of oestrogen and progesterone production

Perimenopause is the transitional stage between a woman’s reproductive years and menopause. The possibility of pregnancy exists if a woman has not yet completed menopause and continues to ovulate. So, to prevent unplanned pregnancies, it is recommended to keep using contraception until one has experienced an entire year without any periods.
Menopause is the stage when a woman has not had a menstrual period for 12 consecutive months.
The post menopause stage spans the remaining years of a woman's life. Most symptoms of menopause might reduce in intensity during this time. Still, it is essential to be aware of potential medical risks like cardiovascular diseases and osteoporosis, which may worsen due to diminished oestrogen levels.

There are also cases whereby menopause occurs prematurely, before reaching 40 years. This can be triggered by various factors including surgical procedures such as hysterectomy with bilateral oophorectomy, antioestrogen treatment, or chemotherapy drugs used to treat cancer.

Signs and Symptoms of Menopause

Symptoms of menopause can vary for different women. However, here are the common ones.

Menopause signs and symptoms	Details
Changes to menstrual cycle	During the transition to menopause, women often experience changes in their menstrual cycle whereby their periods may become shorter, longer, heavier, or lighter before stopping altogether. While not common, spotting, or sporadic periods can occur in women in their 50s. Consult your doctor if you are experiencing unexpected spotting.
Hot flashes	Experiencing sudden flashes of heat accompanied by flushing and sweating, is a hallmark symptom of menopause. The hypothalamus, which is the brain's control centre becomes sensitive as oestrogen levels decrease. The spillover effects of the body attempting to stabilise its temperature include hot flashes, typically accompanied by flushed skin and sweating. For many, these hot flashes are negligible, not requiring any alterations to their daily routine or seeking treatment. Yet, for others, they can significantly interrupt daily activities, prompting a need for management methods. Some management methods include staying cool, dressing in layers, avoiding hot-flash triggers, practicing relaxation techniques, and staying hydrated.
Sleep disturbances	During menopause, women may find their rest disrupted by a range of sleep disturbances such as insomnia or nocturnal awakenings (waking up frequently at night). These interruptions in sleep patterns are often due to hormonal shifts and night sweats due to hot flashes.
Mood changes	During menopause, the changes in oestrogen levels can trigger mood swings, irritability, and feelings of anxiety or depression.
Urinary incontinence	Many women struggle with increased frequency of urination or urinary incontinence as they transition into menopause due to decreasing oestrogen and weak pelvic floor muscles. In fact, urinary incontinence is a condition that affects more than 50% of women post-menopause.
Vaginal health issues	The decrease in oestrogen levels during menopause and perimenopause can lead to various discomforts, including itching, vaginal dryness, and pain during sexual intercourse. However, this does not signal the end of your sex life. Honest communication with your partner and exploring options like lubricants can help maintain a fulfilling sexual relationship.
Changes in the body	During menopause, the fluctuations in hormone levels can lead to changes in body composition that leads to weight gain, particularly around the abdomen, increased waist circumference, and an accumulation of fat deposits. Other changes include joint discomfort, decrease in muscle mass, cognitive difficulties that could influence memory and focus, and weakening of skin texture.

Find out more about the signs of menopause.

Health Risks Associated with Menopause

Individuals with pre-existing health issues before menopause might face a higher likelihood of encountering risk post-menopause.

Coronary artery disease is a common heart disease characterised by plaque build-up inside the arteries that transport blood to the heart and various body parts. The transition into menopause, marked by major hormonal shifts, elevates the risk of women developing coronary artery disease.

Adopting healthy lifestyle habits is vital to protect your health during and post-menopause, which includes incorporating a healthy diet, monitoring blood and cholesterol levels, quitting smoking, and having regular physical activities.

Osteoporosis often results from the hormonal shifts that occur during menopause. During menopause, the reduced levels of oestrogen disrupt the balance between osteoclasts (cells responsible for bone reabsorption) and osteoblasts (cells responsible for bone formation). This decline in oestrogen results in a surge in osteoclast activity, creating an environment where bone loss occurs more rapidly than bone formation. This scarcity of oestrogen also triggers the release of certain cytokines like RANKL, which is essential for the formation of osteoclasts.

Consequently, the increased bone loss brought about by reduced oestrogen levels amplifies the chances of developing osteoporosis (a condition characterised by fragile bones with an increased vulnerability to fractures).

Diagnosis of Menopause

Diagnosing menopause is often a complex process combining clinical evaluation and individual medical history. If the lack of a period for more than 12 consecutive months is due to no underlying medical reason or intervention, then it is generally considered as menopause.

Treatments That May Be Required During Menopause

Several hormonal and non-hormonal treatment options are available to manage the symptoms during menopause.

Hormone therapy is often prescribed to manage the more severe symptoms of menopause. This could involve oestrogen therapy or a combination of oestrogen and progesterone therapy.

Oestrogen therapy is suitable for women who have had a hysterectomy and do not have a uterus, this therapy aims to replenish the declining oestrogen levels, easing symptoms such as hot flashes and vaginal dryness. Oestrogen progesterone or progestin hormone therapy is appropriate for women who still have their uterus.

Apart from hormonal options, non-hormonal approaches include lifestyle changes such as eating a balanced nutrition, avoiding hot-flash triggers, doing regular exercise, having plenty of rest, and relaxation techniques.

Supporting a loved one during menopause involves understanding and patience as they navigate various physical and emotional changes.

Engage in open communication about their experiences and symptoms.
Encouraging them to maintain a healthy lifestyle.
Be empathic and willing to adjust to changes in their mood or libido brought about by the hormonal shifts.

Make an Appointment at Gleneagles Hospitals

If you have questions about menopause, get in touch with us to book an appointment today for a consultation, or visit our Obstetrics and Gynaecology Department at your nearest Gleneagles Hospital

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