The Menopause
The menopause means the stoppage of periods at the end of women's reproductive years. A woman can not be sure that she is established into the menopause until she stopped having periods for twelve consecutive months.
When does the menopause happen?
The average age of menopause is 51 years and this is not influenced by race. However, the menopause may set in any time between the ages of 40 and 56 (rarely later). When this happens before 40 years of age it is called premature menopause.
Why does the menopause happen?
This is a natural phase in women's life when ovulating stops because the ovaries run out of eggs. Each ovary has a limited number of eggs that will be used each month to produce an egg from the age periods start till the menopause. The developing eggs will manufacture the estrogen hormone which is released by the ovaries. As women approach the menopause ovulation may not happen regularly. As a result women may experience irregular periods during the years leading to the menopause.
What are the consequences of the menopause?
The most significant consequence of the menopause is the lack of estrogen which has a wide spread effects on different parts of the body including:
Immediate effects:
Hot flushes
Night sweats
Irritability and lack of concentration
Lack of energy
Reduced desire for sex causing relational problems
Intermediate effects (appearing 3-5 years into the menopause)
Thinning of the vaginal skin and vaginal dryness leading to difficulties in intercourse and vaginal bleeding
Thinning of the bladder lining leading to difficulties inn controlling the waterworks
Skin rinkles
Long term effects (after 5 years into the menopause)
Osteoporosis (thinning of the bone) leading to increased risk of fracture
Raised blood pressure and increased risk of heart attack and stroke
All these changes are progressive with the exception of hot flushes and night sweets which generally ease off with the passage of years.
How long will it take for the hot flushes to resolve?
Hot flushes will naturally resolve within two years in 50% of women. However 25% of women will continue to experience hot flushes in 5 years after the onset of the menopause.
How can I coup with menopause?
There are several strategies
Understanding the menopause will empower you to make the right decision about how best address the issues associated with it.
Life style changes to keep your heart healthy and protect your bones
Hormone replacement therapy (HRT): the most up to date information indicate that the best time to start HRT is with the onset of the menopause.
Herbal treatment: may help with some of the symptoms but does offer natural estrogen.
How long will it take before HRT works?
You will notice improvements in you symptoms after six weeks of treatment but the full effect of HRT will be achieved after three months
How can HRT help me?
- Ease off the troublesome hot flushes
- Reverse other symptoms that interfere with your professional life such as lack of energy and forgetfulness.
- Maintains youthful skin
- Enhances libido
- Reduce the risk of osteoporosis related fractures.
Is HRT risky?
In the last 10 years the results one large American study (Women Health Initiative study, WHI) and another British study (the Million Women Study) revealed increased risk of breast cancer, blood clotting and heart attack which caused great alarm. Further analysis of the WHI results concluded that the risks of using HRT was more in relation to overweight women and those naturally at increased risk of developing blood clotting or breast cancer. Women who start HRT very late after the menopause and those who continued the treatment at very old age are also at greater risk of developing these complications.
The WHI also revealed that taking HRT reduced risks of developing cancer of the colon and bone fracture by one third.
How can HRT be made safer?
Carful initial patient assessment to identify factors that are associated with increased risk of treatment's unwanted effects.
Start treatment as early as possible after the menopause
Using the right preparation for each menopausal problem
Use the smallest possible dose for the shortest possible time
Periodic review of the treatment
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