The symptoms associated with the time around the menopause are due to diminishing oestrogen levels as a result of decreasing ovarian function. What makes the whole thing even less appealing is the timing of it all.
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As if the symptoms aren’t bad enough, it has to choose a time when a woman has more than enough things bothering her already.
Natural menopause occurs at an average age of 50 – 51 years. This is of course also the time when the children leave home, when one is confronted with a sense of loss of one’s youth, career-wise the “glass ceiling” is often reached at this age and it’s also the age where divorce is a serious risk. And just when you thought you had more than enough problems, your body turns on you!
Some women go through the whole menopausal period without suffering any of the classic symptoms, but they’re a small minority. Not experiencing any of the symptoms doesn’t mean they will not be affected by the negative results of not having oestrogen later on in life.
Oestrogen is the hormone that protects you against osteoporosis, cardiovascular disease and the external signs of aging (skin, nails, hair, teeth, etc.). Without oestrogen, it’s just a matter of time before everyone will start experiencing these negative effects.
The word menopause is derived from the Greek words “men” meaning month, and the word “pausis” meaning cessation. It literally means the last menstruation and it is something every woman will eventually have. The cycles generally become more irregular in length and the flow diminishes as the menopause approaches.
Finally, the cycles become longer, with missed periods or episodes of spotting only. When no bleeding has occurred for one year, the menopausal transition can be said to have occurred. Bleeding after this time can be a sign of a serious underlying problem and should be seen to as soon as possible.
Hot flushes
Hot flushes are the things that have made the menopause famous. 75 – 80% of women will suffer these feelings of intense heat over the trunk and face with an accompanying flushing of the skin. They usually last less than 5 minutes and the sweating that accompanies these “attacks” usually starts a minute after the feeling of heat has started.
Hot flushes are believed to be caused by the effect a hormone (Gn-RH) released by the hypothalamus has on the temperature-regulating area in the midbrain. Hot flushes can begin before the cessation of menses and most women have hot flushes for more than 1 year whilst 25 to 50% will suffer them for up to 5 years without treatment.
The frequency of the flushing may range from 1 or 2 a day, to one every 15-30 minutes. Flushing is more pronounced late in the day, during hot weather, after ingestion of hot foods or drinks, or during periods of tension. If the general troubles of life don’t keep you awake at night, these babies will and may lead to fatigue and depression.
Sex and the menopause
The other major area that is affected is the genitourinary tract. Decreased oestrogen can lead to thinning of the vaginal lining and decreased lubrication, and this may lead to substantial pain during intercourse. As painful intercourse is seldom a turn-on, it might lead to a decline in the desire for making love.
The menopause shouldn’t affect the libido itself. 60 percent of women experience no change in libido, 20 percent experience a decrease and in 20 percent of cases, the libido improves.
The pelvic floor muscles relax progressively and this may lead to urinary incontinence. Other problems that may arise are frequent bladder and vaginal infections.
Mood and menopause
Psychological symptoms are often the focus of jokes about the menopause, but there is no objective evidence that cessation of ovarian function is associated with severe emotional disturbance or personality changes.
One can appreciate that the symptoms of menopause can affect one’s mood negatively and that added to the “normal” stresses associated with this age group, it can lead to anxiety, irritability, insomnia, forgetfulness and depression.
It can of course also precipitate an underlying psychological problem.
Menopause and your gut
The gastrointestinal system is another area that is affected. Appetite may decrease, but the stress associated with this period often leads to an increase in appetite. The associated weight gain doesn’t do the mood any good either.
Oestrogen is responsible for the female “pear-type” fat distribution and a lack of oestrogen will cause the fat distribution to change to the male “apple-type” fat distribution. This type of fat distribution is associated with an increase in the risk of developing cardiovascular disease.
Other symptoms associated with menopause include nausea, flatulence, constipation or diarrhoea.
Menopause and ageing
More general symptoms that are associated with oestrogen deficiency include skin wrinkling, loosening of the teeth, a decrease in mental abilities and alertness, atherosclerosis and of course the one everyone is concerned about, osteoporosis.
It has been proven that oestrogen replacement can decrease one’s chances of developing Alzheimer’s dementia, and retard the development of atherosclerosis and osteoporosis.
Atherosclerosis and osteoporosis are both potentially lethal and dementia isn’t something anyone looks forward to.
From this it is clear that menopause is the warning one gets before your quality of life starts going for a dive. It would therefore be very foolish to ignore these changes and wait until serious problems arise before you do something about it.
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