Menopause

            Menopause

When a women’s periods end it is commonly called  ‘the change of life’ or the menopause.

This marks the end of menstruation.

However, it doesn’t happen suddenly, there is a transition period when periods may occasionally not happen.

A woman can be said to be ‘post menopausal’ when there are no more periods after one year. The average age for this to happen in the world is 50 years.

There may often be individual variation.

A very small percentage of women encounter the menopause before they reach 45 years, and a very few experience it before the age of 30 years.

You can expect most symptoms of the menopause to stop completely over time. This is quite natural and usually gradual.

The menopause occurs when the ovaries no longer respond to the controlling hormones released by the pituitary gland of the brain. As a result, the ovaries fail to release an egg each month and to produce the female sex hormones oestrogen and progesterone.

It is the fall in the levels of these hormones in the bloodstream that gives rise to the symptoms of menopause.

Many women experience symptoms of the menopause and irregular periods for several years up to the menopause itself.

This is called the climacteric, or 'perimenopause', and represents the gradual decline in the normal function of the ovaries.

Symptoms

1.  Hot flashes, flushes, night sweats and/or cold flashes, clammy feeling

2.  Bouts of rapid heart beat

3.   Irritability, Mood swings

4.   Sudden tears

5. Trouble sleeping through the night (with or without night sweats) 

6.  Irregular periods; shorter, lighter periods; heavier periods, flooding; phantom periods, shorter cycles, longer cycles

7.  Loss of libido

8.  Dry vagina 

9.  Crashing fatigue

10. Anxiety, feeling ill at ease

11. Feelings of dread, apprehension, doom

12.Difficulty concentrating, disorientation, mental confusion

13. Disturbing memory lapses

14.Incontinence, especially upon sneezing, laughing; urge incontinence

15. Itchy, crawly skin

16. Aching, sore joints, muscles and tendons

17. Increased tension in muscles

18. Breast tenderness

19. Headache change: increase or decrease 

20. Gastrointestinal distress, belching, indigestion, flatulence, gas pain, nausea

21. Sudden bouts of bloat

22. Depression

23. Exacerbation of existing conditions 

24. Increase in allergies

25. Weight gain

26. Hair loss or thinning, head, pubic, or whole body; increase in facial hair

27. Dizziness, light-headedness, episodes of loss of balance

28. Changes in body odor

29. Electric shock sensation under the skin and in the head

30. Tingling in the extremities

31. Gum problems, increased bleeding

32. Burning tongue, burning roof of mouth, bad taste in mouth, change in breath    odor

33. Osteoporosis

34. Changes in fingernails: softer, crack or break easier

35. Tinnitus: ringing in ears, bells, 'whooshing' buzzing etc. 

 Treatment

Not every woman requires treatment.  Sometimes menopause symptoms can be distressing so a number of options are available.

What type of treatment you need will be based on what your doctor suggests and what you prefer, your symptoms and medical past.

Common treatments are: HRT (hormone replacement therapy), Tibolune, Clonidine, vaginal lubricants and antidepressants.

HRT replaces the hormone oestrogen which decreases naturally as the menopause approaches.

Women who are still having periods but are experiencing symptoms of the menopause may be given a combination of oestrogen and progensterone (another hormone) in combination – called cyclical HRT.

Oestrogen alone is effective for women who have had their womb and ovaries removed, while women who are post menopausal are given continuous HRT.

Tiblone may also be used by post-menopausal  women who are still experiencing occasional periods and wish to end them effectively.  It is a man made alternative to HRT.

Clonidine can also be effective in reducing night sweats and hot flushes.

Vaginal lubricants or moisturisers are effective if you encounter vaginal dryness.

Antidepressents can be effective for the treatment of hot flushes and there are several brands which your doctor can suggest. Some people experience side effects however, such as anxiety, sleeplessness, nausea and dizziness.

The use of antidepresssents will need to be closely monitored by your doctor, who can advise you on the frequency of monitoring.