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A natural phenomenon, the menopause is a phase all women go through, but it's not an illness. It can bring unpleasant physiological effects, mood swings, bloating and cognitive problems, however. What happens to your body during the menopause? What are the different symptoms and treatments on offer? Here’s a summary.
Why does the menopause happen?
The origin of the word means ‘end of menstruation.’ A woman enters menopause when her ovaries stop producing reproductive hormones. It generally occurs around a woman’s 50s and more precisely when menstruation has stopped for a year. The menstruation cycle can also be ended when and if the ovaries are removed. This is known as surgical menopause. Menopause can happen between 40 and 55 years of age. Heavy smoking can accelerate the process by one or two years. Also the age of menopause is usually the same for mother and daughter.
In theory, the menopause doesn't just happen all of a sudden. What is termed the premenopause is a period of around 4 years during which the production of sexual hormones gradually reduces. This phase causes various physiological problems: periods may become irregular, and other equally undesirable symptoms can also show, such as painful, swollen breasts, bloating, insomnia etc. This phase continues for the 12 months following a woman's final period, and this shorter phase is called the perimenopause (the menopause transition years in between the final period and the onset of the menopause).
Problems with the menopause
1 in 2 women is affected by the symptoms of menopause. They vary from one woman to the next and also may change over time. Among the symptoms are hot flushes, vaginal dryness, mood swings, sleeping problems, fragile and thin skin, attention and memory problems, and often a reduction in libido. Here’s a focus on the main problems:
- Hot flushes signal the beginning of menopause: sudden sensations of heat on the face and neck accompanied by a skin rash, followed by cold sweats. These happen day and night, 15 to 20 times a day. In around 30% of cases, the flushes may be unbearable and treatment may be required.
- Vaginal problems. The inner wall becomes thinner, less elastic and the natural lubricant diminishes. Sex can become unpleasant.
- Urinary problems. The perineum also loses elasticity, causing little ‘leaks’ when you sneeze or giggle, for example.
- Slight weight gain may occur. Fat builds up more around the stomach than the thighs and bum.
As oestrogen levels drop, the bones become more fragile and the risk of fracture increases. This is known as osteoporosis and it affects more or less all women. Other factors that can contribute to osteoporosis include being underweight, drinking excessive alcohol, smoking, a sedentary lifestyle and premature menopause.
Women become more vulnerable to cardiovascular illness when they reach the menopause; however, the menopause itself does not pose any particular risk. Factors like smoking, diabetes, obesity, high blood pressure, a sedentary lifestyle and some hereditary illnesses need to be taken into account.
HRT: the debate
HRT (hormone replacement therapy) acts as a substitute for the hormones oestrogen and progesterone that are no longer produced by the ovaries. It is prescribed to treat hot flushes and osteoporosis. HRT comes in various forms such as sprays, patches, pills and creams. Around 1 in 3 women between the ages of 50 and 65 years old resort to HRT.
- If hot flushes become unbearable, HRT can be prescribed (but for the shortest possible length of time). The prescription will be reviewed regularly. HRT is not automatically prescribed for the prevention of osteoporosis in every case. A healthy lifestyle and diet with plenty of calcium and Vitamin D are effective and will reduce the risks. Recent studies have linked HRT to breast cancer and cardiovascular problems, so before making any decisions it’s important to check your medical history and evaluate the risks with your doctor.
- Another question mark surrounds the effectiveness of HRT on memory and concentration problems, as this has not been proven. Some doctors even question the necessity of HRT altogether because the menopause is not an illness. Whatever it is, only take HRT if the benefits outweigh the risks.
Alternative therapies and the menopause
Alternative therapies such as homeopathy, acupuncture, phytotherapy and a host of other natural remedies can help relieve the symptoms of the menopause. To date, only derivatives of soy (phytho-oestrogen) have proven effects on hot flushes, but the long-term risks associated with the use of these products are not yet known.
Living with menopause
In addition to mid-life crises that strike in the 50s and the shake-up they cause, the arrival of the menopause is a reminder that the body is ageing. You need to accept this and age gracefully, so take control. Keep an eye on your diet, eat healthily, watch your portion control and make sure your intake of calcium, vitamins and protein is sufficient. Take regular exercise such as walking (at least 30 minutes a day, if possible), to help reduce hot flushes. You might find sleeping in a well-aired room, reducing sources of stress and doing relaxation techniques also help you get through the menopause more easily.