Source: www.sundayobserver.lk
Menopause is a word that can bring different reactions to many. Call a woman as menopausal (incorrectly, that is) and the next thing you know you will probably have earned yourself a black eye. Employees of female bosses may have the word menopause at the top of their list to describe their superiors. While the word may be harmless to others, it is suffice to say that the word is thrown about much, but very few will actually have an understanding of the condition.
Menopause is a natural state of ovarian shutdown, accompanied with depleting and eventually lack of estrogen (ladies’ hormones). So basically, the ovaries, that wondrous place where the eggs are kept, will cease its services. This will be accompanied by a deficiency in estrogen. While all these occur naturally, there may be certain instances where the menopause is induced, or come about as a result of certain conditions that cause ovarian failure. For example, someone who had both ovaries removed for whatever medical reason that requires the removal, will experience menopause, even if she was still very young.
Premature menopause is someone who experiences menopause at the tender age of 40 and below. Those between 50-59 years old are categorized as early menopause, while late menopause is reserved for those who experience menopause after the age of 60.
The doctor will make a diagnosis of menopause (after all others have been excluded) based on clinical grounds as below:
- Age: around conventional menopausal age (around 50 years old)
- No periods or menses for 12 months
- Presence of menopausal symptoms
Laboratory or blood tests are usually not required but if there was any doubt, the doctor will probably test for the Follicle Stimulating Hormone (FSH) level, which is responsible for the growth of eggs in the ovaries.
Menopausal Symptoms
There are many symptoms of menopause or those surrounding the menopausal era, which range from physical to psychological symptoms. Some common ones are explained below:
1. Hot flashes
Hot flashes are also known as hot flushes, which are bouts of sudden but transient sensations of warmth or heat, usually felt at the cheeks and neck. This results from decreased supply of the estrogen hormone.
2. Night sweats
Nights sweats occur as a result of severe hot flashes, which persist into the night, causing the sufferer to sweat profusely. It is not a sleep disorder but rather a condition affecting the perspiration or sweating.
3. Headaches
This is one of the commonest complaints of women in Malaysia. It is associated with hormone imbalance and this is why during the reproductive period, women may experience headaches around the time of the fluctuation of their hormones. During menopause or the period before the actual menopause, women may experience more and worse headaches.
4. Irritability/anxiety/depression/mood swings
These bouts of low or bad mood are pretty common, and are also brought on by low levels of circulating estrogen, which is a major player in mood regulation. The mental stability of women during menopause is affected by the changes in hormones that women experience during this period. ‘Feeling blue’ is natural and some women report feelings of irritability, depression and mood swings. These often go from extreme highs to severe lows in a short period of time.
5. Sleep disorders
Despite feeling tired, some women may experience sleep difficulties that involves poor sleep quality, difficulty in staying asleep or have trouble in falling asleep.
6. Vaginal dryness
Reduced estrogen production may cause some women to experience vaginal dryness, which in turn may make sexual intercourse difficult and sometimes painful.
7. Decreased libido
Some women may feel less interested in sex or find it difficult to become aroused during menopause. This is caused by physiological changes brought upon by reduced estrogen production: delayed clitoral reaction time, slow or absent orgasmic response, and diminished vaginal lubrication, all contribute to the decreased libido.
8. Frequent urination
During menopause, the tissues in your vagina and urethra lose their elasticity and the lining thins. The surrounding pelvic muscles may also weaken. Thus, it is common for menopausal women to lose control of their bladder. They may also feel a constant need to urinate even without a full bladder, or experience painful urination.
So what will happen to me once I reach menopause?
Nothing. Nothing out of the ordinary, that is. It is important to understand that the experiences that you have with menopause are not exclusive and affects almost every other women. Thus, it is a pretty common condition that can be managed, with help from your doctor. Sometimes, lifestyle change is the only step necessary, such as weight control, exercising, meditation, and others as such. However, some women may need medical help, by taking hormone replacement therapy (HRT).
HRT is essentially a regimen or program of medications containing female hormones to replace those that the body no longer produces after menopause. Usually it includes estrogen and progestin. Due to the fact that fluctuating hormone levels causes the symptoms of menopause, HRT is very effective at easing nearly every menopausal symptom. Thus, if your symptoms get unbearable, you may want to speak to your doctor about HRT.
Life after menopause
Life after menopause goes on as usual. There is nothing stopping you from doing the things you’ve enjoyed previously. However, there are certain conditions that may become more prevalent with menopause. Osteoporosis, a condition where the bones become weak and brittle, is more common in menopausal women. So is heart disease, which includes heart attack. Another common complication of menopause is Alzheimer’s disease, which involves problems with our memory.
Thus, despite the no holds barred take on life, proper precautions must be taken to reduce or prevent complications of menopause, such as taking a balanced diet, quit smoking, exercising and taking proper safety measures during carrying out physical activities.
Dr. Ayu Akida is a Public Health specialist. Her area of interest is family health, especially women’s health and infectious diseases. Find out more about her at The Team page.
[This article belongs to The Malaysian Medical Gazette. Any republication (online or offline) without written permission from The Malaysian Medical Gazette is prohibited.]
References:
- CPG: Hormone Therapy During Menopause In Malaysian Women, 2011