Menopause is something natural that occurs to every woman later in life, therefore it is important to be informed and prepared for what the future holds. Perimenopause, menopause, postmenopause... read about all these things belowđšâđ»đ©âđ».
What is menopause?
As women age, hormone levels drop, causing menopause. It is a natural, gradual process and consists of three different stages: perimenopause, menopause and postmenopause.
Perimenopause can occur up to 10 years before menopause when the ovaries start to produce fewer hormones (estrogen). In the final years of perimenopause, menopause symptoms start to appear, as the level of hormones drops faster. Menstruation is still happening, so there is a possibility of getting pregnant.
Menopause appears in women when their menstruation stops permanently. The average age of a woman starting menopause is 51 years. When menopause happens, the ovaries stop producing eggs, therefore natural pregnancy is not possible anymore*. It can be diagnosed only after 12 months of amenorrhea (lack of menstruation).
* Pregnancy during menopause can happen with IVF treatment (in vitro fertilization).
Premature menopause (premature ovarian insufficiency) can arise when the reduction in hormones happens before the age of 40. It is characterized by oligomenorrhea (infrequent menstrual period) or amenorrhea (lack of menstruation). The cause of premature menopause is not fully discovered yet. Research shows that genetics plays an important factor and that it can also appear due to medication (chemo- and radiotherapy) for the treatment of cancer.
Postmenopause is the stage after menopause and it is present for the rest of a womanâs life. Usually, menopausal symptoms are alleviated in this period, but for some women, they can be present up to 10 years.
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Symptoms and treatment
Hot flashes
Hot flashes are a sensation of warmth, usually accompanied by skin flushing (the skin gets red around your neck, upper chest and face as a result of increased blood flow) and sweating. Sometimes, these hot flashes are preceded by a chill, as the body temperature drops. These symptoms vary from one person to another and can be occasional or frequent, it may last from seconds to minutes and can be perceived as very uncomfortable or a minor inconvenience. Hot flashes usually start during perimenopause.
Treatment options: Treatment with estrogen diminishes hot flashes symptoms.
Urinary incontinence
Studies have shown that sexual hormones (estrogen and testosterone) have important functions in the lower urinary tract. Therefore, when the level of hormones drops during menopause, the urge to urinate more frequently is common.
Treatment options: Pelvic floor muscle training (Kegel exercises) is a start in reducing urinary incontinence.
Urinary tract infection
As physiological changes occur during menopause, the body is more susceptible to infections. Alteration of the vaginal flora or an increased vaginal pH can lead to urinary tract infections.
Treatment options: Estrogen therapy has shown to decrease vaginal pH and changes in the vaginal flora, making this treatment suitable for urinary tract infection prevention.
Vaginal atrophy
Due to the hormone level being lower during menopause, the natural functions of the vagina are weakened. Symptoms such as dyspareunia (difficult or painful intercourse), genital itching or irritation can occur.
Treatment options: Vaginal atrophy can be treated by using an oral estrogen therapy or local treatment of vaginal moisturizers (hormonal or non-hormonal therapy).
Reduced sexual function
As a probable reduced sexual life can also be connected to an older age, research suggests that symptoms appearing during menopause can interfere with sexuality. Vaginal dryness and irritation can lead to dyspareunia (difficult or painful intercourse) and therefore, reduced arousal during intercourse.
Treatment options: Since hormonal therapy with estrogen improves the integrity of vaginal tissue, consequently increasing the sensations and the vaginal secretions, enhanced arousal is possible.
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As hormones have essential functions in the human body, the reduction of them has multiple implications in various organs and metabolic processes.
Heart diseases
Women going through menopause have twice the risk of developing a heart condition than those that are in the premenopausal period.
Treatment options: Observational studies of estrogen therapy on menopausal women show positive effects on reducing the risk of cardiac diseases.
Osteoporosis (bone weakening)
After menopause the density of bones lowers, increasing the chances of bone fractures.
Treatment options: The goal of osteoporosis treatment is the prevention of fractures. Therefore, menopausal women need a dietary intake of Calcium and vitamin D. Pharmacological therapy should be based on a risk-benefit decision, and when necessary, medication such as Bisphosphonates and hormone therapy can be used.
Postmenopausal bleeding
Health-care providers consider this postmenopausal bleeding as âendometrial cancerâ until proven otherwise.
Treatment options: This symptom needs to be investigated and diagnosed correctly. For endometrial protection, a combined therapy of estradiol and progesterone can be used.
Women that are going through menopause should be counseled by their doctor regarding the suitable therapy for them. Medical therapy should be given only based on risk-benefit decisions.
Always consult your doctor before taking any medication to relieve your menopausal symptomsđ©ââïžđšââïž!
Techniques such as paced respiration, cognitive behavioral therapy, mindfulness training and acupuncture may be useful to alleviate menopausal symptoms.
Furthermore, changing the lifestyle by practicing regular sports and a balanced healthy diet, represent an important factor when going through menopauseđ .
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