Description
The climacteric is the transition period in a woman's life when the ovaries stop producing eggs regularly. Production of the female hormones oestrogen and progesterone declines, and menstruation decreases and eventually stops. The term “menopause” means cessation of menstruation during the time of the climacteric. It is also sometimes called "change of life", or "climacteric". Menopause is the beginning of a distinct life phase, with its own particular health issues.
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Induced climacteric and menopause
Some women experience "induced" climacteric and menopause due to a medical intervention, such as surgically removing both ovaries prior to natural menopause. Induced menopause can also occur if the ovaries are damaged by radiation, chemotherapy, or certain other drugs. In such cases, there is an abrupt hormonal decrease, usually causing sudden onset of climacteric related disturbances.
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Diagnosis of menopause
Your doctor will review your medical history and perform a physical examination. |
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Treatment of menopause
With your doctor, you should determine your individual health status and risk factors for developing diseases in later years. If therapy is needed, there are options available.
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The role of hormones
The main function of any hormone is to carry chemical messages from one tissue or organ to another tissue or organ in the body.
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Oestrogen
The main female sex hormone is oestrogen. It is synthesised in the ovarian tissue from a number of precursor hormones and plays many roles.
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Progesterone
Progesterone works together with oestrogen to help regulate the menstrual cycle, as well as preparing a woman’s body for conception and the resulting pregnancy. Oestrogen and progesterone have a team work function when preparing the uterus for the coming embryo: oestrogen causes proliferation of the endometrium (“building the house”), and progesterone changes the proliferated endometrium into a secretory phase (“putting the furniture in”). |
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Androgen
Androgens are not only hormones generated in the male, but they are also produced in precursor form in the ovaries and adrenal glands. These hormones are partially responsible for the spurt of growth girls experience in early puberty. |
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Bones and menopause
Osteoporosis can be a serious, long-term health consequence of the climacteric. This condition is sometimes not detected until a fracture occurs. |
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Brain and hormones
Oestrogen has definite effects on the functioning of the brain. It affects the bloodflow to the brain, growth and survival of nerve cells and the way in which impulses are transmitted along nerve cells. |
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Heart and menopause
After menopause, the risk of a heart attack goes up steadily. Generally, the incidence in heart attack rises in both sexes with advancing age. However, the rate of increase is greater in women after age of 50 than in men. As a result, the ratio of heart attacks in women to men after 50 decreases to 2:1 by age 65 and 1:1 by age 80.
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Gastrointestinal system
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.
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Vaginal dryness
The epithelial lining and the underlying tissues of the vaginal wall may become thinner and less elastic – a condition known as atrophy. This is due to decreased oestrogen.
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Urinary tract
Decreasing oestrogen levels can weaken muscles controlling the bladder and urethra (tube through which urine is passed from the bladder). Urinary tract tissue also becomes less elastic.
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Skin
As oestrogen levels decline, skin collagen gradually becomes thinner and less elastic. |
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Hair and menopause
Oestrogen stimulates hair growth. When oestrogen levels fall, hair growth slows down and the hair becomes thinner and less manageable. |
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Teeth
Decreased levels of oestrogen can lead to dental problems such as tooth loss, and gingival bleeding and inflammation. Tooth loss could also be due to an underlining bone disease such as osteoporosis. |
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Prevent weight gain
Many women dread the menopause because they are afraid that they will gain weight once their bodies stop producing female hormones. |
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Preventing diseases of lifestyle
New research indicates that making certain dietary and lifestyle changes can radically reduce the risk of heart disease and cancer in postmenopausal women.
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Preventing osteoporosis
Dietician Dr Ingrid van Heerden discusses how calcium, vitamin D and exercise can help to delay the onset and severity of osteoporosis.
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Menopause and your diet
Click here for all you need to know about menopause and diet. |
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Natural oestrogen supplements
Natural oestrogen supplements are increasingly popular. These so-called phyto-oestrogens are derived from plants. |
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Natural progesterone cream
Progest – a natural progesterone cream – is popular among some women. In 1990 a doctor claimed that progesterone absorbed through the skin was better than oestrogen in preventing and reversing osteoporosis.
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Bisphosphonates to prevent and treat osteoporosis
The bisphosphonates form a class of drug which prevents and treats osteoporosis with no hormonal effects. While oestrogen as HRT is the most suitable method to prevent osteoporosis, the bisphosphonates are useful if there are contraindications for oestrogen therapy.
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Selective oestrogen receptor modulators – SERMs
SERMs form an oestrogen-like class of drug which is able to bind to oestrogen receptors of one organ system while remaining neutral to others. The SERM used in South Africa to prevent osteoporosis is raloxifene. |
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Why you have symptoms
Symptoms associated with the time around the menopause are due to diminishing oestrogen levels as a result of decreasing ovarian function.
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Hot flushes
Experiencing hot flushes (also called flashes) is the feature that has made the menopause famous by being the most common symptom of menopause. |
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Erratic periods
Very few women simply suddenly stop menstruating. The cycles generally become more irregular in length as the menopause approaches.
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Urinary tract problems
Decreasing oestrogen levels can weaken muscles controlling the bladder and urethra (tube carrying urine from the bladder). Urinary tract tissue also becomes less elastic. |
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Psychological changes
Anxiety, irritability, difficulty in concentrating, moodiness or depression may occur. |
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Fluctuations in sexual desire
Beginning in perimenopause, some women may experience a gradual decline in sexual desire (libido). |
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Fluctuations in sexual desire
Beginning in perimenopause, some women may experience a gradual decline in sexual desire (libido). However, 60 percent of women experience no change in libido. |
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Insomnia
Insomnia (sleeplessness) can be caused by hot flushes occurring at night which may be accompanied by night sweats (night-time hot flushes) as a result of fluctuating hormone levels. Insomnia may already be experienced some years before menopause, and it is a problem mainly because it can cause daytime tiredness. |
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Decreasing fertility
As the number of ova (eggs) in the ovaries is reduced and ovulation becomes irregular, the ability of perimenopausal women to conceive decreases. Pregnancy is still possible, however, and to avoid it, one should use contraceptive methods until after a period-free time of 12 months.
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Body and skin changes
As age advances together with declining oestrogen levels, muscle mass decreases, body fat increases and skin collagen gradually becomes thinner and less elastic.
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Increased premenstrual syndrome (PMS)
During the perimenopausal time span, some women notice worsening PMS or experience it for the first time. Menopause ends PMS. |
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Sex
If vaginal dryness makes sex uncomfortable, read further for tips on how to alleviate this condition. |
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Cooling down from hot flushes
Hot flushes are one of the most common and most bothersome symptoms of menopause. Here are some tips to help you cope. |
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Develop a personal stress management programme
In order to cope optimally with the stresses of the change of life, it is important to change the source of stress and/or your reaction to it. |
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Beating incontinence
Incontinence problems can often be improved by doing regular Kegel exercises (pelvic muscle-strengthening exercises).
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Managing the menopause
All women who have reached the menopause have less oestrogen available to their bodies than before menopause. But not all women who are menopausal need to have that oestrogen replaced.
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Menopause – symptoms and signs
As if the symptoms of menopause aren’t bad enough, it has to choose a time when a woman has more than enough things bothering her already. |
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Terminology
What do the different terms mean? |
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Natural climacteric and menopause
Natural climacteric and menopause is a normal life event that designates the end of fertility, and it may bring with it various physical and emotional changes. "Perimenopause", “premenopause” or "menopause transition" are more exact terms for the time leading up to menopause.
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Male menopause: more fact than myth
Research indicates that men also go through a difficult, stressful time in middle age; which again raises the question - does male menopause exist? Our experts claim it does. |
