DID YOU KNOW THAT MOST WOMEN DO NOT EVEN KNOW WHEN THEY HAVE REACHED MENOPAUSE? The write up below will enlighten you about menopausal stages its accompanying symptoms and how to prepare yourself for it.
Menopause can be defined simply as a physiological phenomenon in which a woman's menstrual periods ceases permanently .Medically, when this takes place, it becomes impossible for a woman to conceive. Menopause usually begins between the ages of 45 and 55, but can develop before or after this age range.
There are 3 stages involved in menopause:
PRE-MENOPAUSE: This is the period of time before a woman experiences menopause. This stage involves irregular ovulation and reduction of eggs in the ovaries also there is a decrease in hormonal levels (estrogen and progesterone) causing irregular menstrual flow.
MENOPAUSE: It is the period where the production of hormones responsible for menstrual flow have stopped. In this phase a woman should have lasted 12 months in a row or more without seeing her monthly flow. Though, some women tend to experience menopausal symptoms for a decade or even more after menopause.
POST-MENOPAUSE: This is the stage after menopause has occurred. There is increased risk of certain health conditions like osteoporosis and heart disease. Also in this stage, hormonal levels remain low and monthly flow ceases permanently.
EPIDEMIOLOGY
The prevalence of menopause is estimated to be about 50 million cases yearly though it differs in women according to areas and countries where they live. Studies have shown that African American women had experienced the largest number of menopausal symptoms but the Asian women experienced the smallest number of menopausal symptoms. On the average, menopause occurs naturally in women between 49 and 52 years.
PATHOPHYSIOLOGY
Menopause occurs as a result of reduced ovarian sensitivity to circulating gonadotropin (follicule stimulation hormone and lutenizing hormone) as a result of a marked decrease in available binding sites to the reduction in follicle numbers.
Symptoms
Reduction in breast size
Change in texture, volume and hair colour
Weight gain
Estrogen level drops
Dryness in the vagina
Hot flashes
Mood swings
Irregular periods
Night sweats
Painful/stiff joints
Headaches
Frequent urination
RISK FACTORS
Age : It is mostly associated with women above the age of 50, but can still occur in women between 30 - 50 years.
Smoking and drinking
Underweight : Having a body mass index below 18.5 (normal body maximum index 18.5 to 24.9)
High physical activity
Irregular menstruation
High intake of fat
High serum lead levels
The use of high dose of oral contraceptive could accelerate the onset of menopause
DIAGNOSIS
Though no test can indicate that menopause has started, menopause is often diagnosed using blood tests to measure hormone levels . Typically FSH is measured ,and a level above 40iu/L is indicative of the menopause. Though some women choose to allow menopause progress naturally and find the symptoms tolerable, those who cannot withstand the symptoms opt for hormone replacement therapy(HRT).
COMPLICATIONS
Urinary incontinency
Slower metabolic function
Mood swings/ emotional changes
Pain during sex(dyspareunia)
Heart diseases
Osteoporosis
TREATMENT
Pharmacological Action
1) Hormonal replacement therapy : This is a medication that contains female hormones. It is used to treat some common menopausal symptoms such as hot flashes and vaginal discomfort. This therapy also helps to prevent osteoporosis and other post-menopausal medical conditions. This therapy still has its own risk attached to it such as: heart diseases, stroke, blood clots, breast cancer.
Studies have suggested that certain factors also aid in the development of these risk such as:
Age : Women above the age of 60 or more than 10 years of experiencing menopause are at a greater risk of experiencing one of the hormonal replacement therapy risk.
Type of hormone therapy : The risk differs depending on; if the estrogen is given alone or in combination with a drug such as progestin, and the dose ,the type of estrogen also.
Health history : The medical history of the patient will also determine where the therapy is suitable for the patient.
Patients who mostly need this form of treatment include those experiencing moderate to severe hot flashes, have other symptoms of menopause , experiencing early menopause or have estrogen deficiency.
2) Sleep medications for insomnia
3) Raloxifene or calcitonin for postmenopausal osteoporosis
4) Antidepressants such as paroxetine to help with hot flashes ,anxiety & depression.
5) Supplements such as vitamin E, melatonin etc.. and also those that have been specially prepared for women experiencing menopausal symptoms can be taken.
It is important to note that these medications are prescribed by the physician based on one's symptoms.
Non-Pharmacological Action :
Getting regular exercise, sleep, meditation and other relating activities can help with depression and other side effects of menopause.
Limiting the intake of alcohol and coffee.
Doing kegel exercise
Seeking counselling for anxiety, mood changes and relationship concerns
Having a healthful diet which includes vegetables, fresh fruits and whole grains
Exploring new ways of enjoying intimacy with partner, to keep sex life active.
Use of a water-based vaginal lubricant during sex to aid in vaginal dryness
Eating healthy meals with vegetables and fruits and maintaining a healthy weight will help reduce hot flashes.
ReferenceS
"Menopause : Symptoms , Causes and Treatments ".Medically reviewed by Carolyn Kay,M.D. -Written by Yvette Brazier on January 28,2020
Postmenopause :Signs , Symptoms & What to Expect. Cleveland clinic(
"Menopause : Definition , Symptoms , Causes". Medically reviewed by Gabriela Picardo, MD on May 25,2020
Speller,Jess. (2021,September 4).Menopause. Teach me Physiology. Retrieved from https://teachmephysiology.com/reproductive-system/development-maturation/menopause/
Hormone Therapy : Is it right for you? By Mayo Clinic Staff
"Everything You Should Know About Menopause" Medically reviewed by Holly Ernst, PA-C — Written by Jennifer Huizen — Updated on January 13, 2020
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