All about the Menopause

Menopause is commonly referred to as the years in a woman’s life, when her ovaries gradually start releasing fewer eggs, and production of the female sex hormones oestrogen and progesterone decreases. Because of the reduction in hormone production, the menstrual cycle becomes steadily irregular and stops altogether after a period of time. This also produces various physical and psychological symptoms in women. On the basis of severity of the symptoms and risk factors that contribute to health conditions, doctors may recommend various treatment and lifestyle changes.

Menopause which means “last period” is a normal part of ageing in a woman’s life. Typically, when a woman has not had a period for one year, the stage is commonly termed as menopause. It usually occurs between the age of 45-55 years for most women and 52 years is the average age of menopause however this is rapidly increasing in Western Society. When the periods stop at age 40, or younger, it is referred to as premature menopause.

What causes Menopause?

At birth, the ovaries usually contain a large number of eggs stored in small follicles. When a female reach at the age of puberty, the ovaries get stimulated by the hormones produced by the pituitary glands in the brain and they begin ovulating every month. The ovaries then begin releasing oestrogen and progesterone, which cause the uterus lining to thicken and get prepared for the implantation of fertilised eggs. If the egg does not get fertilized, the uterus wall shed and it leads to menstrual cycle. This whole process of breaking and shedding of uterus wall is commonly known as menstruation. (See our video on the normal menstrual cycle).

However, when a woman starts ageing the number of follicles in her ovaries start decreasing gradually and the production of hormones also decreases. When the ovaries stop releasing hormones, which prompts endometrium to grow monthly, the menstrual cycle stops permanently. The time frame that occurs before the final cessation of the menstrual cycle is medically termed as perimenopause or climacteric.

As women enter the age of menopause, they become more prone to the risk of coronary heart diseases like heart attack, stroke and high blood pressure. Not only this, the risk of bone thinning or osteoporosis also increases.

Types of menopause –

Natural menopause – when a natural decline occurs at the levels of oestrogen and progesterone, it is referred to as natural menopause.

Premature or early menopause – The cessation of periods before the age of 40 year is termed as early or premature menopause. There can be many causes of early menopause, including medical problems such as hypothyroidism or surgery that have affected the supply of blood to the ovaries. Additionally, women who smoke often are also prone to experience premature menopause.

Surgical menopause – when ovaries are removed surgically or get destroyed by some cancer treatments, the consequence is known as artificial or surgical menopause. The symptoms experienced by women in surgical menopause are more severe than the ones in natural or early menopause because rather than a natural decrease in hormones there is an abrupt cut off.

Signs and Symptoms

Menstrual pattern changes or irregular periods are often the first symptom of impending menopause. Some women experience shorter, longer, lighter or heavier periods while some of them occasionally miss their menstrual cycle.

Additionally, there are a variety of physical and psychological symptoms and signs of menopause. Some women experience mild symptoms while others may face severe effects. The menopausal symptoms usually last for about five years. The following includes physical signs and symptoms –

• Nearly 60% of women experience hot flashes/flushes
• Headaches
• Tiredness
• Dryness in vagina
• Urinary tract infections
• Vaginal infections (caused due to the thinning of vaginal linings or bladder walls)
• Urinary incontinence
• Palpitations
• Pain in bones and joints
• Hot flashes in the night
• Abnormal skin sensations

The psychological signs and symptoms of menopause includes –

• Lack of interest in sexual activity
• Higher stress levels or anxiety
• Depression
• Sleeping disorders
• Concentration problems and forgetfulness
• Mood swings and irritability
• Loss of confidence

Diagnosis for Menopause

Generally, there are no tests needed to diagnose menopause, it can be confirmed only after considering the number of years periods have been absent for. There are certain symptoms that may indicate an imminent menopause. But your doctor can conduct a  blood test to check the level of hormones, including Follicle stimulating hormone (FSH) and Luteinizing hormone (LH) produced by the pituitary glands. 

If you experience heavier or no periods, it can indicate several medical conditions including cancer, so make sure to seek a consultation with your doctor to confirm that these are changes associated with the menopause. If your periods have been absent for one year, you must consult your doctor rather than assuming it to be the menopause. 

Menopause Treatment

Many women experience intense and frequent menopausal symptoms while others don’t, so different woman may experience different menopausal symptoms. However, if symptoms are significantly affecting a woman’s health, then she must see a doctor. These women are more likely to develop heart diseases or osteoporosis later.

Of course, the type of treatment will ultimately depend on the personal preferences and symptoms. However, following are the available treatments for menopause –

Hormone Replacement Therapy (HRT)

In this therapy, hormones that have been already released by the ovaries are replaced. HRT is available as skin patches, tablets and vaginal creams. Vaginal preparations gradually decrease vaginal dryness, urinary incontinence and other vaginal infections. HRT can also provide great relief from various menopause symptoms, including sweating at night, hot flushes and vaginal dryness. It also helps in minimizing the risk of osteoporosis or heart diseases that may occur when menopause starts. HRT is also helpful in slowing down the excess hair growth that develops due to hormonal changes. Find more information about Hormone Replacement Therapy.

However, if some forms of HRT have been used for more than 5 years. It may increase the risk of breast cancer, while some forms may maximize the risk of endometrial cancer. But according to a recent survey, some types of HRT can also help in minimizing the risk of bowel cancer, Alzheimer’s disease and in preventing skin ageing.

MonaLisa Touch (MLT)

MonaLisa Touch (MLT) is a non-hormonal treatment for several of the physical menopause symptoms mentioned above. As estrogen levels drop many women experience a dryness of the vagina with a lack of natural lubrication. They can also suffer repeated urinary tract and vaginal infections as the vaginal wall thins and the pH environment changes. MLT provides a non-surgical, non-invasive laser treatment to combat these symptoms. The laser, as it treats the facial skin, also rejuvenates the vaginal skin. The vaginal wall thickens and starts behaving as it did prior to menopause minimising, if not eliminating the above mentioned symptoms.

Alternative treatments

Some of the herbal preparations, natural hormones, minerals, vitamins and homeopathic therapies also help in dealing with menopausal problems. These include ginkgo biloba, ginseng garlic, black cohosh, evening primrose oil, chamomile and vitamins B, C and E. However, if not used according to the doctors prescriptions they can have adverse effects on health.  

Diet

In order to reduce the risk of osteoporosis, women must take higher amounts of calcium and vitamin D. Some really excellent sources of calcium are dark green vegetables like broccoli and spinach, low fat dairy products like cheese, milk or yoghurt, nuts, fish with bones like salmon, sardines. Doctors generally recommend that women must take 1000mg of calcium regularly.

Also, eating low fat and healthy diet is highly recommended by doctors to maintain a healthy weight and prevent menopause issues. 

Lifestyle Changes

Healthy changes in lifestyle are also helpful to minimize the severe side effects of menopause and reduce the risk of heart diseases and osteoporosis.

Exercise

Exercise is indeed helpful to strengthen the bones and reduce the risk of osteoporosis as well as other menopausal symptoms like hot flushes. Other than this, exercises like walking, tennis, dancing, aerobics, etc. are very helpful in maintaining an ideal weight, which is crucial for general well being. There are also some particular pelvic exercises that are helpful in reducing urinary tract infections, incontinence and burning with urination.

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