Menopause

menopauseMenopause (climacteric) – is a normal physiological process of aging of the female body that arises from ovarian failure and the end of the reproductive period in a woman’s life when menstrual periods stop permanently (the date set retrospectively, i.e. after 12 months of absence of the menstruation).

It is not a disease, but may be accompanied by a number of negative symptoms, affecting the proper functioning of the female body. There are many definitions of menopause, but women needs to understand that it is impossible to avoid menopause. It often referred to climacteric or the climacteric period and symptoms that arise in the period are called climacteric syndrome.

Normally it occurs between 45 and 55 years of age, and doesn’t occur rapidly, it is more gradual process. Before menopause woman’s periods may become irregular, last for longer or shorter time, or be lighter or heavier in terms of the amount of flow.

The period of menopausal transition includes the actual menopause and post-menopause. The early stage of menopause transition characterized by an increase of variability in menstrual cycle length, that determined by stable differences at 7 days or more in comparison with successive cycles. Stable character of menopause has a similar picture in the range of 10 cycles after the first cycle increased in duration. Late stage of transition is different by the appearance of menopause amenorrhea with a duration of 60 days or more and characterized by increased blood levels of FSH more than 25 IU / L and lasts for about 1-3 years. Early postmenopause lasts 5-8 years, followed by a period of a late menopause.

According to the WHO classification, there are the following kinds of this illness:

  • Natural (physiological) menopause
  • Artificially induced menopause (after removal of the uterus, chemotherapy, radiation exposure)
  • Premature menopause (before age 40)
  • Premature ovarian failure (premature aging of the ovaries)

Causes:

  • Age (natural decline of reproductive hormones) – in 35 years woman’s ovaries begin to change the amount of estrogen produced, the hormone necessary for menstruation and pregnancy. With age, it is becoming less estrogen up until menstruation stops and a woman will lose its fertility.
  • Premature ovarian failure – it is diagnosed by identifying high blood levels of follicle stimulating hormones (FSH) and luteinizing hormone (LH) on at least 3 oc casions at least 4 weeks apart.
  • Surgical intervention – menopause occurs after bilateral oophorectomy (removal of ovaries).

Signs and symptoms:

The symptoms may occur months or year before it (perimenopause) and include:

  • Irregular or skipped periods
  • Abnormal vaginal bleeding
  • Hot flashes
  • Vaginal dryness and pain with intercourse
  • Frequent urination or urinary incontinence
  • Mood changes
  • Urinary tract infections
  • Insomnia
  • Fatigue
  • Depression
  • Weight gain and slowed metabolism
  • Vaginal atrophy
  • Decreased libido
  • Dry hair and skin

Tests and diagnosis

Regularly, it is enough to identify signs and symptoms of menopausal transition to diagnose disease. Anyway, every woman should have an appointment with a doctor to discuss all details. In certain cases your doctor may recommend to perform blood tests such as:

  • Follicle-stimulating hormone (FSH) and estrogen (estradiol), because your FSH levels increase and estradiol levels decrease when illness occurs
  • Thyroid-stimulating hormone (TSH), because an underactive thyroid (hypothyroidism) can cause symptoms similar to those of menopause.

The other examination methods that can be used are coagulation, measurement of blood pressure and heart rate, mammography every 2 years, pelvic ultrasound, osteodensitometry.

Treatment:

Menopause on its own doesn’t require medical treatment. Usually menopause treatment means relieving of symptoms. It is believed that to alleviate hot flashes woman should focus on diet with plenty of fluids, excluding alcohol and spicy food, and enriched with soy products, exercises, maintaining a cool temperature in the room.

However, since the flashes and all the other symptoms caused by a lack of estrogen, there is an effective treatment as hormone replacement therapy with drugs, containing estrogen, in the form of gels, tablets, and patches. The other option to decrease menopausal hot flashes is taking low-dose antidepressants linked to the drugs called selective serotonin reuptake inhibitors (SSRIs).

In order to avoid vaginal dryness, doctor may advise estrogen therapy when estrogen is inputted directly to the vagina using a vaginal cream, tablet or ring.

If women experience osteoporosis, doctor may prescribe specific treatment that help to reduce bone loss and risk of fractures.