A Look at Menopause


Menopause is a normal part of life that women experience as they get older. On average, the age for menopause is 52 years old, and perimenopause usually starts when a woman is in her mid- to late forties. An estimated 1.3 million women go through menopause each year in the United States. Menopause is a natural process that the body goes through, but educating yourself about what to expect can help make the process as easy/seamless as possible.
Definition of Menopause
What is menopause? It is when your menstrual periods stop permanently, meaning you can no longer get pregnant. Another term you will hear is “perimenopause,” which is when you will start to notice your periods becoming more and more infrequent. You don’t officially reach menopause until you have been without your period for a full year and have not experienced any bleeding or spotting during that time. When your periods stop, your ovaries begin to produce deficient levels of estrogen and progesterone. Once you have these lower hormone levels, you are more likely to experience a variety of health issues.
Causes of Menopause
Sometime in your late thirties, the ovaries begin to produce less progesterone and estrogen. These are the hormones that are responsible for your menstruation, and when this happens, your fertility is decreased. As you get into your forties, you may begin to experience signs of perimenopause. Eventually, your periods become increasingly irregular. In addition, there are other causes of menopause, which you will learn in this section.
Primary Ovarian Insufficiency
About 1 percent of women experience menopause before their forties due to primary ovarian insufficiency, which is referred to as premature menopause. This can be caused by either autoimmune disease or genetic factors, but sometimes there is no apparent cause. When this happens, women are often prescribed hormone therapy until the average age of menopause to protect their bones, heart, and brain.
Hysterectomy
This procedure removes the uterus, but not the ovaries. You won’t immediately go through menopause, despite not having your period, because your body still produces reproductive hormones, and eggs are still released. If you undergo a total hysterectomy with bilateral oophorectomy, where the ovaries and uterus are removed, this causes immediate menopause.
Radiation Therapy/Chemotherapy
A side effect of these cancer treatments is that they can cause menopause. However, you should know that while you may still suffer from symptoms like hot flashes, the loss of fertility and stopped periods may be temporary. Therefore, during the course of these therapies, you may still need to use contraceptives to prevent pregnancy.
Signs & Symptoms
The symptoms of menopause can vary in terms of their severity, and some women may not even experience them. Everyone is different. Some of the symptoms include:
  • Hot flashes: This is a feeling of warmth that spreads suddenly over the upper body, accompanied by sweating and blushing.
  • Insomnia: Lower levels of progesterone can cause difficulty falling asleep and staying asleep. Hot flashes can also cause sleeplessness.
  • Vaginal dryness: Lower levels of estrogen can cause the vaginal tissue to become thinner and drier. This can lead to pain, discomfort, itchiness, and burning in the vagina.
  • Mood swings: You will have an increased chance of suffering from this symptom if you were prone to mood changes during your periods or after giving birth.
  • Change in sex drive: For some women, this may mean that they are not as easily aroused and less sensitive to touching and fondling, which can result in decreased interest in sex.
If you are worried about your symptoms or want to know if you are going through menopause, you can visit your doctor. Make sure that you track your symptoms, including their frequency and severity. You should also write down when you last had your period, as well as any medicines or supplements you are taking.
Diagnosis
There are several tests that a doctor can perform to determine whether you are going through menopause. One test that the doctor can do is to swab your vagina to test the pH levels. When going through menopause, your vagina has a pH level of 6, whereas the level is around 4.5 while you are still fertile. Your doctor will also perform blood tests to see if your symptoms are caused by other conditions, such as thyroid issues or ovarian conditions. Some of these tests include a thyroid function test, lipid profile, checks on levels of estrogen and follicle-stimulating hormones, and tests of liver and kidney function. A more recent test measures the anti-Mullerian hormone in the blood to determine when you are going to experience menopause if you haven’t started it already.
Treatment
Some treatments can help you ease the symptoms of menopause if they are interfering with your quality of life. There is no cure for menopause, as it is a natural part of the aging process, but these treatments can help minimize the symptoms so that you can continue to live your life as normally as possible.

A typical treatment that is used is hormone therapy. The goals of these therapies are to reduce the symptoms, such as vaginal dryness and hot flashes. A common type of hormone therapy is taking a pill, usually estrogen, but sometimes an estrogen and progesterone combination is used, depending on your symptoms. Your physician may want to prescribe you the lowest dosage possible in order to reduce the potential side effects. Another type of hormonal therapy is vaginal estrogen, which doesn’t help with hot flashes but does work to relieve vaginal dryness. In addition, Selective Serotonin Reuptake Inhibitors (SSRI) and Clonidine may reduce the symptoms of hot flashes.

There are also simple lifestyle changes you can take, especially if your symptoms aren’t severe. For instance, if you are suffering from hot flashes, you can stay cool and comfortable by wearing looser, layered clothing at night or when the weather is warm. If you have night sweats from the hot flashes, keep your bedroom cool, use waterproof sheets under your bedding, and remove thick blankets.

Taking better care of yourself can also help. You should exercise for at least twenty minutes every day and eat a healthy diet to help manage your weight, improve your mood, and prevent insomnia. You can also talk to your doctor about taking medication or supplements to improve your symptoms.
Complications
You may be at a higher risk for certain medical conditions due to reduced hormone levels after menopause. However, not all women will experience these conditions, but it’s important to be aware that they are more likely to occur after menopause.
Osteoporosis
Osteoporosis is a condition that can cause your bones to become weak and brittle, increasing your risk of fractures or broken bones. During those first few postmenopausal years, the body loses its bone density at a rapid rate. This condition can make you more susceptible to fractures in your hips, wrists, and spine.
Weight Gain
While you are perimenopausal or postmenopausal, your metabolism begins to slow down. A slower metabolism can lead to weight gain if you are not leading a healthy lifestyle.
Urinary Incontinence
Your urethra and vagina lose elasticity throughout menopause, which can cause frequent and sudden urges to urinate. Eventually you could notice a loss of urine as you sneeze, which is known as involuntary incontinence. You may also suffer from UTIs (urinary tract infections) more often.
Lack of Sex Drive/Sexual Function Issues
This lack of elasticity and vaginal dryness can cause women to suffer discomfort during sex or a decreased sensation, which can reduce sexual desire.
Cardiovascular Disease
As your estrogen levels drop, you are at increased risk for cardiovascular disease. This risk can be reduced by adopting a healthy lifestyle of eating better and exercising regularly.
Breast Cancer
It is important to know that menopause does not cause cancer. The risk of cancer increases as women get older. However, there is an increased risk of breast, ovarian, and uterine cancers if a woman starts menopause after age 55. It is probably due to the exposure of more estrogen which can stimulate the growth of breast tissues during menstrual periods. In other words, more menstrual periods cause more exposure of estrogen to uterine and breast tissues.
Conclusion
Menopause is a natural process that all women go through, whether due to the natural process of aging or through surgery. Getting the right information can help you understand what your body is going through, as well as what you can do to make this process as easy as possible. This process is your body’s way of inviting the next chapter of your life, and it should be a positive experience.

Posted on 12/08/2019


Disclaimer: No content on this site should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician.
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