Menopause stages
CONDITION: TIME THAT MARKS THE END OF MENSTRUAL CYCLES
It occurs when a woman hasn’t menstruated in 12 consecutive months.
Menopause is defined as the absence of menstrual periods for 12 months. It is the time in a woman’s life when the function of the ovaries stops. It does not occur overnight, but rather is a gradual process.
The average age of menopause is 50 years old, but menopause may occur as early as the 30s or as late as the 60s.
Although it also ends fertility, you can stay healthy, vital and sexual. Some women feel relieved because they no longer need to worry about pregnancy. Even so, the physical symptoms, such as hot flashes, and emotional symptoms of menopause may disrupt your sleep, lower your energy or for some women trigger anxiety or feelings of sadness and loss.
Many effective treatments are available, from lifestyle adjustments to hormone therapy.
In the months or years leading up to menopause (perimenopause), you might experience: Irregular periods; Vaginal dryness;
Hot flashes;
Night sweats and sleep problems; Mood changes;
Weight gain and slowed metabolism;
Thinning hair and dry skin; Loss of breast fullness.
Natural decline of reproductive hormones. As you approach your late 30s, your ovaries start making less oestrogen and progesterone, the hormones that regulate menstruation, and your fertility declines. In your 40s, your menstrual periods may become longer or shorter, heavier or lighter, and more or less frequent; until eventually on average by age 51 you have no more periods.
Hysterectomy. Although you no longer have periods, your ovaries still release eggs and produce oestrogen and progesterone. But surgery that removes your uterus and ovaries does cause menopause, without any transitional phase.
Chemotherapy and radiation therapy. These cancer therapies can induce menopause, causing symptoms such as hot flashes during or shortly after the course of treatment. The stopping of menstruation after chemotherapy is not always permanent so birth control measures may be needed.
Primary ovarian insufficiency. About 1% of women experience menopause before age 40. Menopause may result from primary ovarian insufficiency stemming from genetic factors or autoimmune disease. For these women, hormone therapy is typically recommended at least until the natural age of menopause to protect the brain, heart and bones.
After menopause, your risk of certain medical conditions increases. Examples include:
Heart and blood vessel (cardiovascular) disease. When your oestrogen levels decline, your risk of cardiovascular disease increases.
Osteoporosis. This condition causes bones to become weak, leading to a risk of fractures.
Urinary incontinence. As the tissues of your vagina and urethra lose elasticity, you may experience frequent, sudden, strong urges to urinate, followed by an involuntary loss of urine, or the loss of urine with coughing, laughing or lifting. You may also have urinary tract infections more often. Strengthening pelvic floor muscles with Kegel exercises and using a topical vaginal oestrogen may help relieve symptoms of incontinence.
Sexual function. Vaginal dryness from decreased moisture production and loss of elasticity can cause discomfort and slight bleeding during sexual intercourse. Also, decreased sensation may reduce your desire for sexual activity (libido). Water-based vaginal moisturisers and lubricants may help.
Weight gain. Many women gain weight during the menopausal transition and after menopause because metabolism slows. You may need to eat less and exercise more.
Menopause requires no medical treatment. Instead, treatments focus on relieving your signs and symptoms and preventing or managing chronic conditions that may occur with aging.
Treatments may include:
Hormone therapy. Oestrogen therapy remains the most effective treatment option for relieving menopausal hot flashes.
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need progesterone in addition to oestrogen. Oestrogen also helps prevent bone loss.
Vaginal oestrogen. To relieve vaginal dryness, oestrogen can be administered directly to the vagina using a vaginal cream, tablet or ring. This treatment releases just a small amount of oestrogen, which is absorbed by the vaginal tissues. It can help relieve vaginal dryness, discomfort with intercourse and some urinary symptoms.
Low-dose antidepressants. A low-dose antidepressant for management of hot flashes may be useful for women who can’t take oestrogen for health reasons or for women who need an antidepressant for a mood disorder.
Gabapentin (Neurontin). Gabapentin is approved to treat seizures, but it has also been shown to help reduce hot flashes. This drug is useful in women who can’t use oestrogen therapy and in those who also have migraines.
Medications to prevent or treat osteoporosis. Depending on individual needs, doctors may recommend medication to prevent or treat osteoporosis.
Fortunately, many of the signs and symptoms associated with menopause are temporary. Take these steps to help reduce or prevent their effects:
Cool hot flashes. Dress in layers, have a cold glass of water or go somewhere cooler. Try to pinpoint what triggers your hot flashes. For many women, triggers may include hot beverages, caffeine, spicy foods, alcohol, stress, hot weather and even a warm room.
Decrease vaginal discomfort. Use over-the-counter, water-based vaginal lubricants or moisturisers. Staying sexually active also helps by increasing blood flow to the vagina.
Get enough sleep. Avoid caffeine and drinking too much alcohol, which can interrupt sleep.
Practice relaxation techniques. Techniques such as deep breathing, paced breathing, guided imagery, massage and progressive muscle relaxation can help relieve menopausal symptoms.
Strengthen your pelvic floor. Pelvic floor muscle exercises, called Kegel exercises, can improve urinary incontinence.
Eat a balanced diet. Include vegetables and whole grains.
Do not smoke. Smoking increases risk of health problems.
Exercise regularly. Get regular physical activity or exercise.