Menopause is the time in a woman’s life when her menstrual period starts occurring at longer or irregular intervals, often with less menstrual flow. This is due to a gradual decrease in the levels of the female sex hormones estrogen and progesterone. Eventually, the menstrual period stops altogether. A woman is said to be in menopause when her period has stopped for more than a year. The time leading up to menopause is known as perimenopause, and the time after menopause is complete is known as postmenopause. Many physiological and psychological changes occur in the body, and this is a time of both physical and emotional adjustment in a woman’s life.

Normally, women go through menopause between the ages of 45 and 55. Certain circumstances may bring about early menopause or premature menopause, such as after surgical removal of both the ovaries, which is often done during a hysterectomy (uterus removal) operation. This is known as surgical menopause. Early menopause may also occur due to chemotherapy or anti-estrogen therapy for breast cancer, or due to premature ovarian failure. In such cases the symptoms come on suddenly and may be more severe than in normal menopause due to aging. Once menopause occurs, a woman can no longer fall pregnant.

Signs and Symptoms of Menopause

The symptoms of menopause occur due to fluctuating hormone levels in a woman’s body around that time. This is mainly due to the fact that with age, the ovaries gradually produces less estrogen and progesterone. Menopause symptoms may continue over several years before finally disappearing. However, some women may experience few or no symptoms at all.

The common signs and symptoms are :

• Irregular vaginal bleeding – the periods may come less frequently, with longer intervals in between periods, which may even stretch to a few months. Sometimes, the periods may come at shorter intervals.
• Menstrual flow usually becomes less, but heavy periods may occur. The menstrual flow eventually stops altogether.
• Fertility may decrease around this time but the possibility falling pregnant remains until true menopause occurs, which is the absence of periods for more than a year.
• Hot flashes are one of the most common symptoms of menopause. It is a sudden feeling of warmth over the upper body and face, and may be accompanied by flushing of the skin. Hot flashes may last from 30 seconds to a few minutes and may be followed by sweating. Hot flashes can come any time of the day or night. Although not harmful, they can be distressing, especially when they come several times during the day or night.
• Night sweats may be troublesome in some women.
• Hot flashes and night sweats often lead to sleep disturbances during menopause.
• Headache.
• Palpitation.
• Mood swings, irritability.
• Depression.
• Forgetfulness.
• Tiredness.
• Decreased interest in sex.
• Vaginal dryness, itching, or irritation.
• Dyspareunia or painful sexual intercourse, mainly due to vaginal dryness.

Certain health risks and other features may also develop :

• Increased risk of vaginal infections.
• Urinary problems, such as frequency and incontinence, especially stress incontinence.
• Increased risk of urinary tract infections.
• Joint pain.
• Changes in consistency and shape of the breast.
• Weight gain, with distribution of body fat around the waist and abdomen.
• Thinning of the skin and development of wrinkles.
• Thinning of hair.
• Some women may have hair growth on the chin, upper lip, chest, or abdomen.
• Decreased estrogen levels can cause bone loss which leads to osteoporosis.
• Postmenopausal women are more at risk of heart disease and stroke.

This is a condition of the bones where the bones become thin and weak, it mainly occurs in the wrist, hips and spine and it is a disease which mainly affects women who have gone through the menopause. However it isn’t just limited to women and men and younger people can also be affected too, though in younger people there are generally other factors contributing to the cause as well.

Who is affected by the disease?

The disease affects millions of people throughout the world, with more of these being women, a huge percentage of fractures that occur do so as a result of osteoporosis. Women are more at risk due to the loss of bone speeding up after they have gone through the menopause, the risk is increased even more in women who have gone through menopause early or who have had their ovaries removed before reaching menopause.

How do you know if you have osteoporosis?

You should ask yourself the following questions in order to determine if you might be at a higher risk of developing the disease.

• Did you reach menopause before the age of 45?
• Did you miss your periods for more than 6 months due to an eating disorder?
• Have you suffered from fracture due to low trauma in the past?
• Has the doctor mentioned thinning of the bones in previous x-rays?
• During the last 10 years have you shrunk in height?
• Have you taken steroid medication for longer than 6 months?
• Does anyone in your family suffer from the disease?
• Do you have arthritis, bone disease or hormonal problems?
• Do you smoke or drink excessively?

What should I do if I think I might be at risk?

If two or more of the questions above apply to you then you should talk this over with your doctor, your doctor might suggest that you have blood tests and an examination in order to determine if you have the disease.

There are a variety of ways which the disease can be determined; tests include a DEXA scan which involves a very low dosage of x-rays. The x-ray will usually be performed on the hip or wrist and this is to check for the density of your bones, the specialist can then determine if you have the disease or if you might be at risk in the future of developing it.

Ways you can prevent the disease?

You can help to prevent the disease from occurring in several ways:

• Increasing the amount of calcium in your diet.
• Maintain bone density by increasing the amount of weight bearing exercise you do.
• Stop or at least reduce the amount of cigarettes you smoke or the amount of alcohol you drink.

The menopause signifies the end of a woman’s reproductive period and as such is often called the change of life. On average the menopause will begin around the age of 50 but this can vary from person to person with some women starting as early as in their late 30`s and some as late as their 60`s.

The start of the menopause comes around when the ovaries stop responding to hormones released by the pituitary gland in the brain. When this happens the ovaries will not release an egg every month and the periods stop, the oestrogen and progesterone hormones which are the female sex hormones fail and when the level of these fall in the bloodstream the symptoms of menopause arise.

How the menopause begins

Generally most women will suffer from the symptoms and see a sign of the menopause and irregular periods well before the true onset of menopause itself, this period is called the perimenopause. One of the main symptoms at this time will be periods that are both erratic in between and amount, many women have problems with very heavy bleeding during this time. There are several treatments which can help with heavy bleeding and if this is a problem then you should always consult your doctor for advice.

Treatments for heavy bleeding due to menopause

Progestogen tablets

When these tablets are taken for long enough they can help to stop the menstrual flow, certain brands of these tablets are the most effective way of treating the problem and have now been developed to produce the least side effects.

Hysterectomy

Heavy menstrual bleeding is the single most common reason for having a hysterectomy, while the hysterectomy is a relatively major operation is thought to be a relatively safe and successful procedure to use in problems such as intense bleeding.

What are the symptoms of the menopause?

Some women are lucky and notice very few side effects to the menopause while others suffer a great deal from symptoms to the point where it begins to affect their life, common symptoms of the menopause are:

• Hot flushes and sweating.Problems sleeping.
• Depression and anxiety.
• Mood swings.Tiredness.
• Severe headaches.
• Forgetfulness and irritability.
• Lack of sex drive.
• Less intense orgasms.

Hormone replacement therapy

HRT can help to greatly relive the symptoms of the menopause by making adjustments to the hormone levels, there are some symptoms to taking this medication, however they don’t affect all women but the symptoms are:

• Nausea.
• Weight gain.
• Breast tenderness.
• Fluid retention.