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Health talk: Menopause can cause misery in women

Many people do not understand much about menopause, the time that marks the end of your menstrual cycle.

It is diagnosed when a woman has gone for 12 months without a menstrual period. Women differ hence menopause can occur even in the 40s or the 50s age groups.

Many women present to clinicians with menopausal symptoms, but do not know that it might be simple pre-menopausal syndrome or menopause which will have appeared.

Menopause is not a disease, but just a normal biological process. What may be disturbing is that some physical symptoms such as hot flashes and emotional symptoms may disrupt a woman’s sleep, lower her energy and affect emotional health.

In the months or years leading to menopause, a woman may experience some of the following signs and symptoms:

  • Irregular periods
  • Vaginal dryness
  • Hot flashes
  • Night sweats
  • Sleep problems
  • Mood changes
  • Weight gain and slowed metabolism
  • Thinning hair and dry skin
  • Loss of breast fullness

Causes

Menopause can result from a number of issues that mainly circle around the female reproductive system. The following are some of the causes:

Naturally declining reproductive hormones

As a woman approaches her late 30s, the ovaries start making less oestrogen and progesterone, the hormones that regulate menstruation, therefore fertility declines. In the 40s, the menstrual periods may become longer or shorter, heavier or lighter, more or less frequent until eventually by age 50 when ovaries stop releasing eggs and the periods stop forever.

Surgery that removes the ovaries (oophorectomy)

Ovaries produce hormones which include oestrogen and progesterone that regulate the menstrual cycle. Surgery to remove ovaries will cause immediate menopause with resultant cessation of periods. Hot flushes will follow and many women may confuse the hot flushes with pathological fever. Other signs and symptoms can be quite severe as hormonal changes occur quite rapidly rather than gradually over years.

Chemotherapy and radiotherapy

These cancer therapies can induce menopause, causing symptoms such as hot flashes during or shortly after treatment. The halt to menstruation is not always permanent following chemotherapy so birth control medication is still desired. Radiation therapy only affects ovarian function if radiation is directed at the ovaries.

Primary ovarian insufficiency

About 1% of women experience menopause before the age of 40. Premature menopause may result from the failure of ovaries to produce normal levels of reproductive hormones (primary ovarian insufficiency). Which can stem from genetic factors or autoimmune disease. In many instances, the cause of premature menopause is not found.

Complications from Menopause

Heart and blood vessel disease: When the oestrogen levels decline, your risk of cardiovascular disease becomes high. Heart disease is the leading cause of death in both men and women. Close to 18,5 million people die of heart disease globally every year.

Osteoporosis: Menopause can cause bones to become brittle and weak, leading to increased risk of fractures. During the first few years of menopause, you may lose bone density at a rapid rate, increasing the risk of osteoporosis. Postmenopausal women with osteoporosis are especially susceptible to fractures of the spine, hips and wrists.

Reduced sexual function: Vaginal dryness from decreased mucus production and loss of elasticity can cause discomfort and even a bit of bleeding during sexual intercourse. Decreased sensation can reduce your desire for sexual activity. Water-based vaginal moisturizers and lubricants can help.

Urinary incontinence: As the tissues of the vagina and urethra lose elasticity, one may experience frequent, sudden and strong urges to urinate followed by involuntary loss of urine (urge incontinence) or loss of urine with coughing, laughing or lifting (stress incontinence).

Treatment

Menopause does not require medical treatments but available treatments focus on relieving of symptoms and signs or preventing or managing chronic conditions. The treatments include:

Hormone therapy: Oestrogen therapy is the most effective treatment option for relieving menopausal hot flashes. However, long-term use of oestrogen can have some risks on the heart and breast cancer.

Vaginal oestrogen: To relieve vaginal dryness, oestrogen can be administered directly to the vagina using a vagina cream, tablet or ring. This treatment releases just a small amount of oestrogen which is absorbed by the vaginal issues.

Low-dose anti-depressants: These may be of importance to manage hot flashes especially for women who cannot take oestrogen for other health reasons.

Anti-osteoporosis drugs: Such drugs include Vitamin D supplements to help strengthen bones.

Garbapentin: Though commonly used to treat neuropathy, seizures, has been shown to reduce hot flashes.

Menopause is part of reproductive nature so you wont escape from it as long as we continue singing for you at your birthday parties.

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