Menopause
What is menopause?
Menopause is a natural part of the aging process in every woman’s life. For most women, this process begins around the age of 40, when menstrual cycles become irregular. The decrease in hormone levels – estrogen and progesterone – is responsible for changes in menstruation. These hormones protect the health of the vagina and uterus, regulate menstrual cycles, and enable pregnancy. Estrogen is also essential for protecting bone health and maintaining normal cholesterol levels in the blood. Certain surgeries, such as the removal of the uterus (hysterectomy) or both ovaries (oophorectomy), can lead to menopause. When both ovaries are removed, menopause symptoms begin immediately, regardless of age.
Hormonal Changes and Menopause
A woman’s body changes throughout her life, and menopause-related changes are almost always triggered by hormone imbalances. The transition period before menopause and the first year after menopause is commonly called perimenopause. This is when the most intense menopause symptoms occur, including irregular periods, hot flashes, and night sweats. Perimenopause usually begins about 2-4 years before the last menstrual cycle and lasts for about 1 year after that. Menopause is defined as the time when a woman has no period for 12 months. Menopause then lasts for the rest of a woman’s life, and achieving pregnancy naturally is no longer possible. Some symptoms, such as vaginal dryness, may continue during menopause.
Signs and Symptoms of Menopause
Changes in hormone levels (mainly the lack of estrogen and progesterone) can cause several symptoms that may last from a few months to a few years. Some women go through menopause without any complications or unpleasant symptoms, while others find menopausal symptoms quite debilitating. If any of these symptoms significantly impact your daily life, please contact your Health Care Provider. The most common symptoms are:
Menstrual changes: This is usually one of the first signs. Your period may become less regular, with changes in blood flow or duration. You may also notice spotting between periods. Women with heavy menstrual bleeding and cramps are usually relieved from these symptoms when menopause begins.
Hot flashes: These involve a sudden hot, burning sensation, mainly in the face, neck, and chest, or throughout the body. Red spots can appear on the chest, back, and hands, followed by intense sweating and shivering. Hot flashes can last from 30 seconds to 5 minutes.
Vaginal and bladder problems: The lack of estrogen results in atrophic changes in the genital and lower urinary tract, leading to vaginal dryness, pain during intercourse, and increased risk of infections. Urinary incontinence may also occur.
Sexual intercourse: Libido may change, and vaginal dryness can make intercourse painful. Contraception is no longer needed after menopause, but the risk of sexually transmitted diseases remains.
Sleep problems: Difficulty falling asleep, waking up too early, or frequently waking up due to hot flashes are common.
Mood changes: Mood swings can be linked to hormonal changes, stress, or family changes. Depression is not a direct symptom of menopause but can occur during this time.
Body changes: Muscle mass decreases, adipose tissue increases, and skin loses elasticity. Memory problems, joint pain, and muscle stiffness may also occur.
How Can I Stay Healthy During Menopause?
To stay healthy, consider making some lifestyle changes:
– Quit smoking.
– Follow a healthy diet** that is low in fat and cholesterol. Include fibers, fruits, vegetables, whole grains, vitamins, minerals, and calcium.
– Lose weight if you are overweight.
– Exercise regularly (walking, running, dancing) at least 3 days per week.
– Visit your Health Care Provider and follow the recommended treatment to lower blood pressure.
– Treat vaginal dryness using a water-based lubricant (not petroleum jelly) or an estrogen cream.
– Consult your Health Care Provider about techniques to treat frequent urination, such as pelvic muscle exercises, biofeedback, and bladder training.
– Have regular examinations including gynecological exams, smear tests, breast exams, mammography, bone density measurements, and ultrasounds. Contact your Health Care Provider if you notice any lumps in your chest.
– Keep a record of hot flashes to identify triggers and manage symptoms. Techniques include staying in cool places, sleeping in the coolest room, wearing breathable clothing, and drinking cold drinks.
Bone Loss During Menopause: The decrease in estrogen during menopause accelerates bone loss, leading to osteoporosis.
Detection: A Bone Density Measurement test can help determine the risk of osteoporosis.
Prevention: Regular weight-bearing exercises (e.g., walking, running, dancing) and daily intake of calcium and vitamin D can help reduce the risk. Medications are also available, so consulting a Health Care Provider is essential.
Increased Risk Post-Menopause: After menopause, women’s risk of cardiovascular disease increases to levels similar to men.
Leading Cause of Death: Heart disease is the leading cause of death in women.
Prevention: Regular monitoring of blood pressure, cholesterol, triglycerides, and blood glucose levels is crucial. A healthy diet, quitting smoking, weight loss, and regular exercise can reduce the risk. Medications may also be necessary, so discussing options with a Health Care Provider is important.
Staying Healthy During Menopause
Lifestyle Changes:
Quit smoking.
Follow a healthy, low-fat diet rich in fibers, fruits, vegetables, whole grains, vitamins, minerals, and calcium.
Lose weight if overweight.
Exercise regularly (at least 3 days per week).
Medical Care:
Regular check-ups and follow recommended treatments for blood pressure.
Treat vaginal dryness with water-based lubricants or estrogen creams.
Consult a Health Care Provider for techniques to manage frequent urination.
Regular examinations (gynecological exams, smear tests, breast exams, mammography, bone density measurements, ultrasounds).
Managing Symptoms:
Keep a record of hot flashes to identify triggers.
Use techniques like staying in cool places, wearing breathable clothing, and drinking cold drinks.
What is Hormone Treatment Method?
During perimenopause, your Health Care Provider may prescribe hormone treatment, especially if you experience heavy and unpredictable menstruation. Medication can also help reduce other perimenopause symptoms such as hot flashes. During menopause, your Health Care Provider may prescribe estrogen and progesterone, known as hormone treatment. This treatment replaces hormones no longer produced by the ovaries and can relieve menopausal symptoms such as hot flashes and sweats, while helping to prevent or delay osteoporosis. However, hormone treatment has risks, including an increased risk of blood clots and breast cancer, though it may reduce the risk of colon cancer. Always consult your Health Care Provider before taking estrogen, progesterone, or both.
What are Phytoestrogens?
Phytoestrogens are plant-derived estrogens found in cereals, vegetables, legumes, and herbs. They have similar effects to estrogen produced by the body but are less effective. Some phytoestrogens help lower cholesterol. Soybeans, wild yams, and herbs like black cohosh and dong quai contain enough phytoestrogens to relieve certain menopause symptoms. Scientists are studying these herbal estrogens to determine their benefits and safety. Consult your Health Care Provider before including phytoestrogen-rich foods in your diet and be alert to potential side effects.
How Do I Decide What to Choose?
Discuss with your physician the best way to manage climacteric and menopause symptoms. Consider which symptoms affect your daily life and your individual medical and family history. Remember, your decision is not final and should be reviewed regularly with your Health Care Provider. Today, women live longer, and with a healthy lifestyle and good management, you can enjoy many years ahead!