Menopause

Understanding Menopause: The End of Monthly Cycles

Menopause is the time when menstrual periods permanently stop, marking the end of the reproductive stage for females. It typically occurs between ages 45 and 55 but can vary widely. Have you ever wondered what happens to your body as it transitions into this new phase? Let’s dive deep into understanding menopause and its impact on women’s lives.

The Natural Change

Menopause is usually a natural change related to decreased estrogen levels, but it can occur earlier due to smoking or other factors. The ovaries produce less estrogen and progesterone, leading to symptoms such as hot flashes, vaginal dryness, and mood changes.

Symptoms of Menopause

Do you know what to expect during this transition? Irregular periods, hot flashes lasting 30 seconds to ten minutes, vaginal dryness, trouble sleeping, and mood changes are common. These symptoms can vary in intensity and duration for each woman.

The Menopause Transition

Menopause is defined as one year after the last menstruation. During this time, women can experience a range of physical and emotional effects. Vaginal dryness, atrophic vaginitis, painful intercourse, urinary urgency, and urinary incontinence are some of the physical consequences.

Emotional Changes

Mood and memory symptoms may be reported but are not specific to menopause. Women can experience anxiety, poor memory, inability to concentrate, depressive mood, irritability, and mood swings. These changes can significantly impact daily life and relationships.

Long-term Effects

The long-term effects of menopause include an increased risk of cardiovascular disease due to declining estrogen levels, which can lead to fat gain, insulin resistance, dyslipidemia, and endothelial dysfunction. Bone health is also affected with a higher risk of osteopenia, osteoporosis, and fractures starting one year before the final menstrual period.

Induced Menopause

Menopause can be induced early by medical treatment or complications such as chemotherapy, radiotherapy, oophorectomy (removal of ovaries), hysterectomy, tubal ligation, and leuprorelin usage. The average age of the last period varies by country: 51 US years, 50 Russian years, 49 Greek years, 47 Turkish and Egyptian years, 46 Indian years.

The Menopausal Transition

During perimenopause, menstrual cycles become irregular with longer intervals between cycles. Hormone levels fluctuate, and ovulation may not occur. The menopausal transition is characterized by marked variations in FSH and estradiol levels.

The Main Cause of Menopause

Menopause occurs because of the sharp decrease of estradiol and progesterone production by the ovaries. After menopause, estrogen continues to be produced mostly by aromatase in fat tissues and is produced in small amounts in many other tissues such as ovaries, bone, blood vessels, and the brain where it acts locally.

Diagnosis and Management

The diagnosis of menopause effects includes the Greene climacteric scale questionnaire, Cervantes scale, and Menopause rating scale. Perimenopause is a transition years before menopause, lasting 4-10 years, characterized by increased estrogen levels, fluctuations, and symptoms such as hot flashes, mood swings, and vaginal dryness.

Management Options

Postmenopause occurs when menstrual flow has ceased for at least 12 months. Management of perimenopause involves acknowledging it as a natural stage of life. Melatonin supplementation may improve thyroid function, fertility, and depression in perimenopausal women.

Menopausal Hormone Therapy (MHT)

Menopausal hormone therapy (MHT) is the use of estrogen in women without a uterus and estrogen plus progestogen in women who have an intact uterus. MHT may be reasonable for the treatment of menopausal symptoms, such as hot flashes. It is the most effective treatment option, especially when delivered as a skin patch.

Psychological and Social Factors

The menopause transition is influenced by psychological and social factors, including past experience, lifestyle, social and cultural meanings of menopause, and a woman’s social and material circumstances. Negative attitudes and expectations predict symptom experience during menopause.

Celebrity Insights

Celebrities have spoken out about menopause, increasing awareness and leading to TV shows and campaigns promoting treatment options like hormone replacement therapy (HRT). In 2021, Carolyn Harris sponsored the Menopause (Support and Services) Bill in the UK, which aimed to exempt HRT from NHS prescription charges and provide support services for perimenopausal and post-menopausal women.

Conclusion

Menopause is a natural part of aging, but it can bring about significant changes. Understanding its symptoms, management options, and the psychological impact can help women navigate this transition with more ease. Remember, every woman’s experience is unique, and seeking support from healthcare professionals can make all the difference.