MENOPAUSE
Menopause is an important natural phase of life triggered by declining estrogen levels. It is time to change dietary habits and modify lifestyle to adapt to these physical, chemical, hormonal, and neurological changes.
This blog would educate about this common problem and guide you to deal with it effectively.
What is menopause?
It is natural cessation of periods for 1 year between 45 to 55 years, the mean age is 51 years.
What are common symptoms of menopause?
Women have hot flushes, sweating, rash, irritability, mood swings, and depression.
How long it takes?
These changes start near 40 years and can take 5 to 8 years for menopause to occurs.
Why menopause occurs?
The ovaries stop working and there is decrease in production of estrogens and progesterone.
Are there any reasons for cessation of periods?
Breast feeding (lactation), hormone intake, and drugs.
What is perimenopause?
The symptoms of hot flushes, mood swings, night sweats, decreased libido start years before menopause, it’s called perimenopause.
What is early menopause?
The menopause before 45 years of age is categorized as early menopause.
What is premature menopause ?
It occurs before 40 years due to ovarian insufficiency.
What is artificial (induced) menopause?
It occurs as a result of chemotherapy, surgical removal of uterus or ovaries, and radiation .
What causes early menopause ?
There are various causes like:
- Hereditary predisposition
- Genetic factors (chromosomal abnormalities), Turners syndrome, fragile X syndrome
- Low BMI, thin lean women with low fat stores
- Smoking
- Autoimmune disorders
- Thyroid disease
- Rheumatoid arthritis
- Epilepsy
What are complications of early menopause?
- Heart disease
- Bone fractures
- Osteoporosis
- Depression
- Dementia
- Early death
What are hot flashes? why they occur during menopause?
Hot flashes occur in 2 out of 10 women which may last from few months to years. There are sudden feeling of increased heat rate, anxiety, red flushed skin followed by sweating; it’s all because of dilatation of blood vessels.
How can you reduce it?
Avoid triggers like heat, spicy food, tight clothing stress, caffeine, smoking, and alcohol.
Take plenty of fluids, wear cotton, loose cloths, and practice relaxation techniques like exercise, yoga, meditation are also useful.
How is heart affected by menopause?
Estrogens are cardioprotective; after menopause the risk of heart disease increases as there is increase in cholesterol levels, leading to high blood pressure, heart attack and stroke.
How are bones and muscles affected?
Women have peak bone mass at 25 to 30 years of age. But in first five years of menopause muscles weaken, bone loss starts and women lose 10 percent of bone mass due to which bones become thin, osteoporotic and risk of fractures increases.
How can prevent bone damage?
- Adequate intake of calcium 1300 mg per day and vitamin D
- 3 to 4 serving of dairy products, milk, cheese, and yogurt
- Almonds
- Green leafy vegetables
- Fish sardine
- Butter
- Stop smoking, excessive caffeine, alcohol
- Exercise
How nervous system is affected?
Hormone imbalance results in irritability, mood swings, sleep disturbances, memory loss and depression.
Why women gain weight with age?
Perimenopausal women body conserves energy by storing fat resulting in weight gain.
Can menopause change voice or excessive facial hair?
There is decline in estrogen hormones from ovaries however male like hormones continue to get secreted from adrenal glands on kidneys. There could be some changes in skin but marked voice change or excessive facial hair need proper investigations of blood tests and ultrasound.
How menopause affects genitourinary system?
Low levels of estrogen cause urinary bladder weakness with increased frequency, poor urine control and leakage (incontinence) of urine, whereas thinning of vaginal resulting in dryness, dyspareunia, increased risk of infections.
Can a women have periods after menopause?
There is decline of estrogens and progesterone’s during menopause making lining of uterus very thin (less than 4 mm). If hormone levels increase then lining of uterus gets thick and can cause bleeding. Therefore it’s important to get ultrasound pelvis yearly for ruling out any disease.
Can a women conceive after menopause?
During menopause ovaries stop responding to brain hormones for growing and maturing eggs, lining of uterus is also not prepared for a new life to start, so chances of conceiving is rare.
But it’s possible through hormonal manipulation.
Do women need contraception after menopause?
Fertility declines with age and becomes almost nil after menopause. Oral contraceptives are never given after 40 years, IUCD should be removed 1 year after menopause.
What is replacement therapy for menopause?
There are of two types:
- Non hormonal
- Diet and lifestyle modification
- Vitamins, Calcium, Iron, BCom plex, bisphosphonates
- Exercise
- Hormonal
- Low dose estrogen and progesterone’s
- SERMs selective estrogen receptor modulators
What are benefits of replacement therapy?
Improved mood, reduce hot flushes or night sweats, reversal of skin changes
What are side effects of replacement therapy?
- Irregular bleeding
- High blood pressure
- Heart, Liver, Gall bladder disease
- Blood clot formation
- Stroke
- Heart attack
- Increase risk of cancer uterus, breast, and ovary
Remember menopause is a natural process. It is associated with certain problems and disease predisposition BUT if it is dealt TIMELY and APPROPRIATELY; then it can be managed without any complications.
Dr. Ayesha Azam Khan