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Menopausal Symptoms1

What is Menopause?

Menopause is the time in a woman's life at which the menstrual cycle ceases. Women who experience the absence of menstrual bleeding for a minimum of 12 consecutive months without any related medical conditions or pregnancy are considered to be in menopause.

What are the Causes of Menopause Symptoms?

Occurring as a natural biological process in a woman's reproductive life, menopause is usually seen between age 40 and 50.

Common risk factors for early menopause include:

  • Hysterectomy (surgical removal of uterus)
  • Oophorectomy (surgical removal of ovaries)
  • Endocrinal disturbances (hormonal imbalance)
  • Cancer (especially of ovary, uterus)
  • Radiation and chemotherapy treatments
  • Polycystic ovary syndrome (PCOS)
  • Infertility and related treatments
  • Premature ovarian failure
  • Excess alcohol intake
  • Smoking and tobacco use
  • Sedentary lifestyle
  • Stress and anxiety

How does Menopause occur?

Oestrogen and progesterone are hormones that cause the release of an egg and the shedding of the uterine line every 21-35 days (during the menstrual cycle). However, due to the ageing process, there is a reduction in the level of these hormones, which impairs the menstrual cycle and finally leads to menopause.

Natural menopause occurs in the following 3 stages:

  • Perimenopause: This is a period of 4-5 years before menopause, when oestrogen levels drop, causing decreased ovum (egg) production in the ovaries.
  • Menopause/Amenorrhoea: absence of menstruation for a minimum of 12-15 consecutive months, due to ceased formation and release of eggs from the ovary.
  • Post menopause: This is the phase after menopause when women are at risk of developing disorders such as osteoporosis from reduced hormone levels.

What are the Symptoms of Menopause?

Every woman experiences menopause differently. Menopausal symptoms can include:

  • Irregular periods
  • Scanty or heavy bleeding
  • Hot flashes
  • Palpitations
  • Dryness of the vagina
  • Night sweats
  • Fatigue
  • Feeling of heaviness or weakness
  • Mood swings like depression, anxiety or agitation
  • Loss of appetite
  • Weight gain
  • Sleep disturbances
  • Dry skin
  • Joint pain
  • Back pain
  • Dull hair and hair loss
  • Shrinking and sore breasts
  • Muscle cramps
  • Decreased interest in sex

Diagnosis of Menopause

Your doctor may order the following blood tests to assess hormonal changes:

  • Follicle-Stimulating Hormone (FSH): Levels will be elevated during menopause
  • Oestradiol: Levels will be low during menopause
  • Thyroid hormones such as Thyroid-Stimulating Hormone (TSH) can be adversely affected

Treatment of Menopausal Symptoms

Treatment is required only if symptoms interrupt daily life or cause significant complications.
The treatment options for menopausal symptoms include:

  • Hormone replacement therapy (HRT): The necessary hormones are supplemented to maintain the menstrual cycle in women with premature ovarian insufficiency, PCOS or infertility
  • Topical hormone therapy: Creams and gels are used to treat vaginal dryness
  • Selective oestrogen receptor modulators (SERM): These are medicines to enhance oestrogen efficiency in the body to treat hot flashes and dryness
  • NSAIDS and corticosteroids: These medications are used to treat arthritis and joint pain
  • Vitamin D and calcium supplements are used for the treatment of osteoporosis

Complications from Menopausal Symptoms

Menopause at the usual age with underlying normal physiology is rarely harmful; however, early or late menopause may produce the following complications:

  • High cholesterol
  • Cardiac issues
  • Cancer
  • Endometriosis
  • Osteoporosis and fractures
  • Arthritis
  • Mental health imbalance

Post-menopausal women are also more susceptible to develop conditions long term, such as the following:

  • Metabolic disorders
  • Urinary incontinence (loss of bladder control)
  • Alzheimer’s disease
  • Sexually Transmitted Disease (STD)
  • Deep Vein Thrombosis (DVT)

Preventive Measures for Menopausal Symptoms

The following lifestyle changes can help you manage menopausal symptoms:

  • Healthy dietary habits
  • Quitting smoking, tobacco and alcohol
  • Being active and exercising regularly
  • Using yoga and meditation to avoid stress
  • Maintaining intake of fluids to avoid dehydration
  • Seeking social and emotional support