Menopause is a time of change for a woman. It signals the end of monthly periods and ovulation, and therefore fertility. Also called the “change of life”, menopause is a natural event. Every woman experiences menopause in her own way. Many women may have little discomfort, but others may have a number of distressing symptoms.
“Going through menopause” is a common expression for the months or years that a woman may experience menopausal signs and symptoms. However, strictly speaking, menopause occurs only when monthly periods stop. Menopause is confirmed when a woman has not had a period for twelve consecutive months.
Most women reach menopause between the ages of 45 and 60, with the average age for Australian and New Zealand women being about 52.
If menopause occurs before the age of 40, it is considered to be early or premature. The cause in many cases is unknown, but some causes may have a genetic origin or be part of a multiple hormonal gland failure.
Removal of the ovaries by surgery, radiotherapy to the lower abdomen, or chemotherapy may also bring on early menopause.
Hormone therapy is virtually always recommended for women with early menopause to replace the hormones that their bodies are no longer producing.
One of the first signs of the onset of menopause is a change in the menstrual cycle. As the production of hormones begins to slow and levels in the blood fluctuate, cycles may become irregular, shorter or longer. Bleeding may be heavier or lighter.
This is the most commonly reported symptom of menopause. A hot flush is a sudden feeling of warmth or intense heat that spreads over the face, neck and chest and may last for several minutes. It may be accompanied by a red complexion, sweating, nausea, heart palpitations, increased heart rate and sudden tiredness.
Oestrogen plays a major role in keeping the vagina and surrounding tissues healthy. Low oestrogen levels cause the lining of the vagina to become thinner, drier and lose elasticity. The dryness may cause discomfort during intercourse, and the woman may be more susceptible to vaginal irritation and some types of infection.
Similar changes occurring in the urinary tract can cause a need to pass urine more frequently and a vulnerability to infection.
Some women find it harder to get to sleep and do not feel rested when they awaken.
Some women have wide mood swings and may have difficulties with memory and concentration.
Around the time of menopause, a woman’s sexual feelings and desires may change. Some women may become less interested in sex.
Some women may experience such physical changes such as weight gain, aching joints and muscle pain. Skin may become dry and itchy, hair may become coarser.
A woman may become pregnant until menopause has been confirmed; that is, she has not had a period for at least 12 months. Until this time, she should continue to use a proven method of birth control or discuss other options with her doctor.
Recent clinical trials have not shown a reduction in heart disease for menopausal women taking hormone therapy as compared to women not taking hormone therapy. This was a surprise finding that contradicted the previous thinking. Such conflicts among clinical studies are still a matter of ongoing debate and research.
Osteoporosis is a condition where the bones become weak and brittle due to loss of calcium and other minerals or connective tissue that are a part of the bone structure. Calcium loss is a normal part of ageing.
To help relieve menopausal symptoms, hormone therapy (HT) may be useful. Combined HT involves oestrogen and a form of progesterone called progestin. These hormones reverse the effects of decreasing levels of oestrogen in the body.
If oestrogen is taken alone, then the treatment is referred to as oestrogen therapy (OT).
Most women report that menopausal symptoms, particularly hot flushes, ease when they take HT or OT. Long-term HT or OT may also protect against bowel cancer and the progression of osteoporosis.