Menopause, a hormonal decline and its clinical effects
At a Glance:
What is menopause? An overview
Menopause is a phase in a woman’s life when she stops getting her periods and consequently any chances to conceive. It is a natural biological phenomenon occurring between 40 to 50 years of age. However, about 1% of women experience premature menopause, where periods stop before the age of 40 years.
Why does menopause happen? An Insight
Following are some causes of menopause:
- Natural cessation of the release of female sex hormones: In women, ovaries produce sex hormones called estrogen and progesterone that regulate menstruation. As the age advances, usually after 35 years, there is a gradual decrease in the production of these hormones by ovaries. Once there is a complete stoppage of production of these hormones in the body, menopause happens.
- Primary ovarian insufficiency: Some underlying genetic, autoimmune, and undefined causes may render the ovaries incapable of producing appropriate levels of the female hormones, thus causing premature menopause.
- Induced reasons: Menopause may happen as a side effect of certain conditions like Down’s syndrome or Addison’s syndrome or medical procedures like surgeries involving removal of ovaries (oophorectomy) or uterus (hysterectomy), chemotherapy, and radiotherapy, etc.
What are the symptoms of menopause?
Early symptoms of menopause appear in the perimenopause (peri-“around”) phase which is the time of progression towards the last period. The duration and severity of symptoms related to these hormonal imbalances vary from woman to woman and may even last up to 4- 12 years after the last period. Some of these include:
Irregular periods: Periods may be heavier or lighter, or of shorter or longer duration.
Hot flushes and night sweats: Most common symptom involves a short, sudden feeling of heat with red and sweaty skin especially in the area of the face, neck, and chest.
Vaginal dryness: Experienced by many, vaginal dryness may lead to vaginal and urinary tract infection and discomfort during sexual intercourse.
Decreased sexual drive
Disruption of sleep that can result in long-term lack of sleep and energy, fatigue, and loss of memory
Mood changes, such as irritability or anxiety
Reduced metabolism and weight gain
Painful and stiff joints
Dry skin and thin hair
What are the complications of menopause?
Post-menopausal state may increase a woman’s risk of certain medical conditions, like:
- Heart and blood vessel disorders
- Osteoporosis or loss of bone density making the bones weaker, brittle, and susceptible to fractures
- Urinary incontinence: Loss of volunteer control over urination resulting from a gradual loss of elasticity of vaginal and urethral tissues
How is menopause diagnosed?
Your gynecologist may be able to diagnose menopause by:
- Medical history
- Signs and symptoms: Once a female has missed her periods for a year, a diagnosis of menopause is confirmed.
- Tests: Though typically no tests are needed for its diagnosis; under some circumstances, like in the case of younger women, the gynecologist may advise blood tests to check the level of Follicle Stimulating Hormone (FSH), estrogen, and Thyroid Stimulating Hormone (TSH).
Does menopause need any treatment?
Treatment of menopause is required only to manage its symptoms. The main modality undertaken to deal with menopausal symptoms is Hormone Replacement Therapy (HRT), which involves supplementation of estrogen to normalize its depleted level. HRT is available as tablets, skin patches, topical gel, or implants.
What are the lifestyle modifications that can alleviate symptoms of menopause?
Maintaining a healthy lifestyle is necessary for women in postmenopause to ease hot flushes, reduce the risk of heart disease and osteoporosis, and maintain a healthy weight. Certain lifestyle modifications may help alleviate symptoms.
Hot flushes can be dealt by wearing light clothes, taking a cool shower, keeping the bedroom cool at nights, and avoiding potential triggers. Relaxation techniques like practicing yoga, taking sufficient sleep and rest, exercising regularly, and having a balanced diet certainly helps to combat mood swings.
Here are a few more lifestyle changes you can make to bring the control back in your hands:
- Exercise regularly
- Avoid smoking, caffeine and alcohol
- Enjoy a balanced diet rich in whole grains, leafy vegetables and nuts.
- Ensure the right amounts of calcium and vitamin D.
- Choose food with low saturated fat and cholesterol.
- Control your blood sugars, if you are a diabetic.
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- Mayo Clinic. Menopause. Available at: https://www.mayoclinic.org/diseases- conditions/menopause/symptoms-causes/syc-20353397. Accessed on March 24, 2018.
- US Department of health and Human Services. Menopause. Available athttps://www.womenshealth.gov/menopause.Accessed on March 24, 2018
- US National Library of Medicine. Menopause. Available at: https://medlineplus.gov/menopause.html. Accessed on March 24, 2018