Menopause is a natural state of the female body determined by a 12-month period of amenorrhea (a lack of menstrual periods determining the end of menstrual cycles). Menopause is a natural biological state, marking the end of a woman’s fertile period (impossibility of remaining pregnant).

Causes

Natural decline of reproductive hormones:

When approaching the end of their late 30s, women’s reproductive organs (the ovaries) start producing lower quantities of estrogen and progesterone, which are the main hormones regulating menstrual cycles, resulting in a gradual decline of fertility

When entering their 40s, most women’s menstrual cycles may become longer or shorter, heavier or lighter, and more or less frequent up until around the median age of 51 when the menstrual cycles cease to occur altogether

 

Hysterectomy:

Hysterectomy is the surgical procedure in which a woman’s uterus is removed (partial hysterectomy) due to fertility related health issues, and depending on whether the physician removes the ovaries as well (total hysterectomy), the surgery determines an immediate or transitional phase into menopause

Partial hysterectomy does not usually determine immediate menopause just the end of monthly periods, due to the fact that ovaries are still releasing eggs and producing estrogen and progesterone

Total hysterectomy, however, usually results in an immediate menopausal state, without any transitional phase, while other signs and symptoms may be more severe due to the abrupt changes in hormonal activity, instead of the body’s gradual adjusting to the changes taking place over a span of several years

 

Chemotherapy and radiation therapy:

These types of therapies may induce menopausal-like symptoms such as hot flashes and may also halt menstruation and fertility for the duration of the treatment

The changes in menstruation and fertility may not be permanent once the therapies are concluded

 

Primary ovarian insufficiency:

It is a rare condition in which the ovaries fail to produce normal levels of reproductive hormones, determining a premature onset of menopause (before the age of 40)

An exact cause of this condition has not yet been found, although researchers believe that genetic factors and autoimmune diseases may be directly responsible for these changes

Symptoms and signs

In the months or years leading up to menopause (perimenopause) women may experience the following symptoms:

Fatigue

Irregular periods

Vaginal dryness

Hot flashes

Night sweats

Sleep disturbances

Weight gain and slowed metabolism

Thinning hair and dry skin

Loss of breast fullness

Breast tenderness or pain

Mood changes

Depression

The signs may begin up to 6 years before the final menstrual period and may also continue for a variable number of years after the onset of menopause

It is possible but very unusual to menstruate every month up until the very last period

During perimenopause skipping periods is common and expected

Often during perimenopause periods will occur every two to four months, especially one to two years before menopause

Despite menstruation irregularity, the risk of remaining pregnant is still present

Advice

Menopause does not necessitate medical treatment

Instead, therapy focuses on relieving symptoms and prevention and management of chronic conditions that occur with aging (i.e. osteoporosis, cardiovascular issues)

Treatments may include:

Hormone therapy, estrogen therapy being the most effective for relieving hot flashes

Vaginal estrogen for relieving vaginal dryness, discomfort with intercourse and some urinary symptoms, the estrogen being administered under the form of vaginal creams, tablets or rings

Low-dose antidepressants, selective serotonin reuptake (SSRIs) decreasing menopausal hot flashes

Medications to prevent or treat osteoporosis in order to help reduce bone loss and risk of fractures

Gabapentin (Neurontin) is a drug usually used for treating seizures, but it also helps alleviate menopausal hot flashes without resorting to hormonal replacement therapies

Strengthening pelvic floor muscles via Kegel exercises improves some forms of urinary incontinence

A balanced diet and regular exercise helps maintain an overall sense of health

Quitting smoking may reduce the severity of hot flashes

MISCONCEPTIONS
  • Menopause always starts at 50 years of age

    Weight gain is inevitable

    There is no difference between natural menopause and surgically induced menopause

    Sex drive decreases with menopause

    Sexual activity and desirability diminish significantly

    The first and foremost sign of menopause is having hot flashes

    After menopause the body stops producing estrogen and progesterone altogether

    The older a woman is when she first starts menstruating the older she will experience menopause

Statistics

For most women, menopause begins around 45 to 55 years of age

 

Bone loss in just the few years after onset of menopause may be as high as 20% of lifetime bone loss

 

It is estimated that in 1998, there were over 477 million postmenopausal women in the world. That numberis projected to rise to 1.1 billion by the year 2025

 

One study revealed that 80% of menopausal women experienced no change in quality of life

 

Asian women reported fewer physical and psychological symptoms than other ethnic groups

 

Did you know?

Men experience a similar phase to women’s menopause, which is called “the aging male syndrome” or “andropause”

 

According to Harvard Health Publications by the time a man reaches the age of 40 testosterone production begins to fall by about 1% each year

 

Lower levels of testosterone may affect sexual drive, may also cause erectile dysfunction, loss of energy and decreased muscle mass and bone density

 

Unlike women, men do not lose their ability to have children as they get older