Menopause is an end of the menstrual cycle in a woman’s life. Menopause occurs during 40 or 50s of a female, with the average age of Australian women around 51. During menopause hormonal changes occur and in the first few years, ovaries will reduce their production of the essential female hormones namely estrogen and progesterone, eventually cease release of eggs and menstrual period.
Menopause symptoms mostly associated with the drop in female hormones and many women find it hard to deal with them. Disruption in the function of estrogen and progesterone can be severe due to significantly lower levels. Menopause symptoms due to changes during menopause can affect mental as well as physical health of many women and it can last for few years. Menopause symptoms are subjective, and every woman may not suffer from similar symptoms.
The perceptions of hot flushes (hot flashes) for menopausal women may vary and the reason behind hot flushes are complex. It is a sudden intense warming sensation starts from the upper part of the chest and radiates to the face. It causes excessive perspiration, reddening of the skin, racing heartbeat and difficulty in breathing. Researchers assume that the effect of lower estrogen levels (oestrogen levels) on the brain thermostat can possibly one of the causes of hot flushes. Some of the symptoms are thought to be arising from stress and anxiety. Hot flushes with excessive perspiration are night sweats. They usually cause sleep disturbances, increases stress, anxiety and affect the general well being.
While there is no direct connection between Menopause and depression, those who had a history of depression are more prone to experience mood disturbances during menopause. It may include anxiety episodes, stress, feeling depressed, drained of energy, tearfulness, helpless and much more. Mood disturbances may be related to the hot flushes, sleeping disturbances due to night sweats, emotional disturbances and financial as well as career changes.
Personal factors can contribute to mood disorders during menopause such as family history or previous episode of depression, personal tendency to worry a lot, lack of self-esteem, long-term or serious medical illness, relationship problems, drug and alcohol problems and poor lifestyle.
Reduced level of estrogen and testosterone can cause decreased libido and vaginal dryness. Vaginal dryness, anxiety, stress, mood swings and vulvovaginal discomfort may be associated with the decreased sexual drive and sexual function. In addition vaginal dryness makes women more prone to candidiasis.
Other reported symptoms include aches and pains, crawling or itching sensation under the skin, urinary frequency and incontinence, weight gain, forgetfulness, irritability, lack of self-esteem, mood swings, and lack of concentration.
Osteoporosis, high risk of fractures, aches and pain such as joint pain, increased the risk of cardiovascular disease, high blood pressure, and stroke may be the long term implications of under managed menopause.
According to studies changes in hormone levels during menopause is associated with a decline in pelvic floor function as well as the weakening of connective tissues surrounding the pelvic organs (bladder and vagina).
It allows organs to move about from its original place. Hence it forms the pressure on the vaginal wall which pushes a part of the vagina to protrude from the vaginal mouth.
Prolapses are associated with pain, discomfort and tenderness in the pelvic region, difficulty in urinating and painful intercourse.
Skin and Hair Changes
In menopause as the estrogen level decreases, skin loses its moisture and gets more dry. It becomes more vulnerable to temperature changes and sensitive to redness and irritation.
Hair loss in menopause is one of the common symptoms seen during this phase just like hot flushes, mood swings and sleep disturbances. Most women experience a typical hair loss pattern called Female pattern hair loss (FPHL) with thinning of hair at the crown of the head, sides, top of the head and general thinning all over the head.
Menopausal symptoms can be managed in various ways from a holistic approach to hormone replacement therapy.
Researches have indicated a positive effect of mindfulness and relaxation techniques. Deep breather (a form of meditation), Yoga and Tai Chi have shown positive effects on the autonomic nervous system which controls sweating and heart rate.
Natural therapies such as soy isoflavones (phytoestrogens), black cohosh, red clover isoflavones are clinically proven to reduce symptoms such as hot flushes and night sweats. Herbs such as Chaste berries, Shatavari, Ashwagandha, Ginseng, Lemon balm was traditionally used years before and helps to manage the overall condition. Traditionally used herbs are now being practised in western herbal medicine and used in sophisticated supplements.
Severe symptoms may be addressed with Bioidentical hormones (conjugated estrogens and progesterone combinations) or other prescription medications (such as tibolone) by healthcare practitioners.
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3. Foran T. Managing menopausal symptoms. Australian Prescriber 2010;33:171-5.