Common condition
Menopause is part of the natural ageing progress for women. In most cases, menopause occurs between the age of 44 and 55 years. Menopause occurs when there is a reduction in naturally occurring oestrogen levels. The decline in oestrogen levels results in unpleasant symptoms experienced during menopause. Hormone Replacement Therapy (HRT) is used to relieve the symptoms and prevent osteoporosis. Various HRT options are available, including gels, patches, and tablets.
What is Menopause?
Menopause is characterized by the period of time when your menstrual cycle stops due to low hormone levels. Menopause is a natural biological process that normally occurs between the ages of 45 and 55 but can happen earlier due to genetics, oophorectomy, hysterectomy, cancer treatments, or unknown reasons.
Premenopause occurs when you experience the symptoms of menopause but you still have monthly menstrual periods. You have reached menopause when you have not had a period for 12 months.
The symptoms of menopause, such as hot flashes and mood swings, can cause insomnia, affect your emotional health, and lower your energy. Many affect treatments are available for menopause, from lifestyle to Hormone Replacement Therapy.
Symptoms
The female sex hormone, oestrogen, plays an essential role in the functioning of the woman's body. Oestrogen is produced by the ovaries and is responsible for regulating menstrual cycles and releasing eggs from the ovaries. Oestrogen also plays a role in bone density, controlling skin temperature, and maintaining a healthy environment for the vagina. When oestrogen levels start to decrease, the symptoms of menopause start to present.
Signs and symptoms of menopause or perimenopause may include:
- Hot flashes
- Irregular periods
- Mood changes
- Insomnia (sleep problems)
- Vaginal dryness
- Chills
- Night sweats
- Thinning hair and dry skin
- Osteoporosis
- Loss or reduction of libido
- Weight gain and slowed metabolism
- Loss of breast fullness
- Stress incontinence
These signs and symptoms may vary or change among women. It is very likely that you will experience irregular periods just before the end.
It is common during perimenopause that periods are skipped. In most cases, menstrual periods will skip a month before returning, or they will skip for several months and start again after a few months. Menstrual cycles may also occur on short cycles (they are closer together).
For most women, symptoms associated with menopause will typically pass within two to five years. Stress incontinence and vaginal dryness may continue or worsen if left untreated.
Although periods are irregular, it is still possible to fall pregnant. If you experience uncharacteristic irregular periods, a pregnancy test may be considered if you aren't sure menopausal transition has become.
When to see a doctor
Schedule regular visits to see your doctor for any medical concerns or preventative health care. Preventive health care as you age includes health screening tests such as mammography, colonoscopy, pap smear, or triglyceride screening. Depending on your medical history, your doctor may order other tests and exams, such as breast and pelvic exams or thyroid testing.
It is crucial to seek immediate medical advice if you experience bleeding from the vagina after menopause.
Diagnosis
The signs and symptoms that are experienced are usually enough to diagnose the start of the menopausal transition. If you have any concerns about the symptoms you are experiencing, talk with your doctor, as in some cases, further investigation may be needed.
Under certain circumstances, blood tests may be ordered by your doctor to check the following:
- Thyroid-stimulating hormone (TSH). An underactive thyroid (hypothyroidism) can cause similar symptoms to those experienced during menopause.
- Follicle-stimulating hormone (FSH) and estrogen. When menopause occurs, the levels of FSH and estradiol decrease.
Over-the-counter home tests can also be used to check FSH levels present in your urine. These at-home tests may tell you whether you have increased (elevated) levels and might be starting perimenopause or menopause. However, during the course of your menstrual cycle, your FSH levels naturally rise and fall. These at-home tests cannot definitively tell you if you are in a stage of menopause.
Treatment
Treatment for menopause focuses on relieving symptoms or managing chronic conditions such as osteoporosis that occur during ageing. Treatment options may include:
- Hormone Replacement Therapy (HRT). HRT is designed to replace the hormones progesterone and oestrogen that are lost (decrease) during the stages of menopause. There are more than fifty different HRT treatment options. Normally, a low dose and short-length treatment are preferred to minimize side effects. HRT is available as tablets, gels, or patches. The different types of HRT include:
- Oestrogen-only HRT
- Cyclical HRT
- Continuous combined HRT treatment
- Low-dose antidepressants. Certain classes of antidepressants can be used to decrease hot flashes or mood disorders. Low-dose antidepressants can be an option for women that can not take oestrogen for health reasons.
- Medications to treat or prevent osteoporosis. Depending on individual cases, medications may need to be prescribed to reduce bone loss and the risk of getting bone fractures. Vitamin D supplements may be recommended to help strengthen your bones.
- Gabapentin. This seizure medication has been shown to help reduce hot flushes and nighttime flashes. Gabapentin can be prescribed for women that can't take oestrogen.
- Vaginal oestrogen. This medicine is used to relieve vaginal dryness. The oestrogen can be applied directly to the vagina using a tablet, cream, or ring. The vaginal tissue absorbs a small amount of oestrogen to help relieve dryness, some urinary symptoms, and discomfort experienced during intercourse.
- Clonidine. Clonidine is available in the form of patches or a tablet that is normally used to treat high blood pressure. This medicine may provide relief from hot flushes.
Talk to your doctor about the possible risks and benefits involved with each treatment. Your treatment plan may need to change annually depending on the severity of symptoms, underlying medical conditions, or other medications you are taking.
Prevention
While menopause can not be prevented as it is a natural biological process, there are some measures that you can implement that may help reduce symptoms. Talk to your doctor before implementing any of the lifestyle measures, especially if you are taking other menopause treatment options.
Lifestyle changes that can be implemented alongside treatment include:
- Herbal remedies.
- Regular exercise.
- Quit smoking if you are a smoker.
- Avoid alcohol, spicy food, and caffeine.
- Stay cool at night.
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