Every woman goes through changes in her body functions throughout her life, which marks different stages in her reproductive life cycle. Puberty marks the start of the menstruation, where the hormones that control the release of the egg, occur in a monthly pattern. The end of menstruation and fertility of women is known as menopause and occurs 12 months after the last menstrual period. The average age in Australia of menopause is 51; some women can experience menopause before their forties, and this is known as premature menopause.
Menopause can be characterized by physical and emotional changes. Approaching the time of your menopause (perimenopause), you may experience irregular menses, dryness of the vagina, dry skin, hot flushes, night sweats, problems with sleeping, thinning hair, slow metabolism, weight gain, sagging of the breasts and mood changes.
Menopause is a natural process that takes place in every woman as she reaches her forties or fifties. The production of the hormones by your ovaries to regulate your menstrual cycle, namely estrogen and progesterone, start to decrease. Eventually, your ovaries will stop producing eggs. This will make you experience changes in your menstrual pattern and bring an end to your periods.
There are some factors that can induce an earlier menopause. These include the following:
- Cancer treatment: Chemotherapy (treatment with chemical agents) and radiotherapy (treatment by exposure to radiation) can cause menopause symptoms and a temporary or permanent stop to your menstruation.
- Failure of ovaries: Autoimmune diseases or genetic factors can cause your ovaries to produce less than normal amounts of reproductive hormones. This is known as primary ovarian insufficiency and can lead to premature menopause.
- Surgeries: Surgeries such as total hysterectomy and bilateral oophorectomy that involve the removal of your uterus and both ovaries will immediately stop menstruation.
Some of the possible complications associated with menopause include the following:
- Your risk for heart and blood vessel (cardiovascular) diseases increases with the decrease in oestrogen production.
- Your bone density may decrease, making them brittle and leading to a condition known as osteoporosis. This can make you more prone to fractures.
- Your vaginal and urethral tissues will begin to lose their elasticity, and you may experience the sudden urge to urinate or may lose control over your bladder (urge incontinence or stress incontinence). You may also become more prone to urinary tract infections.
- The loss of moisture and elasticity of your vagina can cause discomfort during intercourse and can affect your sexual desire (libido).
- As the rate of your metabolism slows down, you may start gaining weight.
Your doctor can identify your transition to menopause with your signs and symptoms. To confirm the diagnosis, your doctor may order blood tests to check your levels of follicle-stimulating hormone (FSH) and oestrogen (oestradiol), as a decrease in the level of these hormones can project menopause.
Some of these lifestyle remedies can also help you reduce or prevent the symptoms of menopause.
- Cool off hot flushes by drinking cold water or staying in a cool room. Identify factors that trigger your hot flushes, like hot beverages, alcohol, caffeine, and spicy foods, and try to avoid them.
- Use vaginal lubricants to help you with vaginal dryness and discomfort. Coconut Oil and “Olive & Bee” are natural, low irritant lubricants.
- Reduce stress, get adequate sleep, eat healthy, stay active and don't smoke.
- Exercise regularly. Pelvic floor exercises can help you strengthen your pelvic floor muscles, improve vaginal blood flow and reduce vaginal symptoms of the menopause.
Menopause itself needs no treatment, but treatment may be required to control its signs and symptoms. Your doctor will discuss the risks and benefits and may recommend any of the following depending on your condition.
Menopausal Hormone Therapy: Your doctor may recommend treatment with hormones including estrogen and/or progestin or progesterone for your hot flushes and bone loss. It may also help prevent cardiovascular problems if started within five years of menopause.
Vaginal Oestrogen: Small doses of vaginal oestrogen cream can help you manage vaginal dryness, urinary symptoms, discomfort during intercourse and reduce the severity of mild prolapse symptoms.
Antidepressants/ Pain medications: Low-dose antidepressants and gabapentin can help you manage hot flushes when menopausal hormone therapy is not advisable for you, and will also help improve your mood.
Vaginal Laser: Some doctors and patients report an improvement in vaginal menopausal symtoms with vaginal laser treatment. At this stage, there is not enough good quality evidence for RANZCOG (the Royal Australian and New Zealand College of Obstetricians and Gynaecologists) to recommend this treatment or verify its safety.
Menopause is an unavoidable phase in every woman's life. Its signs and symptoms can be often disturbing, but it is important to understand your body and learn ways to cope with your difficulties. There are various options available to successfully manage your distress, and your doctor will be the right person to guide you.