Menopause refers to the last or final menstrual period a woman experiences. It is sometimes called ‘the change of life’ as it marks the end of a woman’s reproductive life. At menopause, the production of the female hormones estrogen and progesterone drastically reduces.
When a woman has had no periods for 12 consecutive months, she is considered to be postmenopausal. Most women become menopausal naturally between the ages of 45 and 55 years, with the average age of onset at around 50 years.
If you are going through menopause, you might have periods more or less often than your usual cycle, have bleeding that lasts for fewer days than before, skip 1 or more periods or have symptoms of menopause (described below).
You can still get pregnant as long as you are menstruating, even if the cycles are less frequent. If you have sex and do not wish to become pregnant, some form of birth control is advised. However, if you have not had a period for 12 months, it is safe to say you have undergone menopause and are unlikely to get pregnant.
Symptoms commonly reported around the time of menopause include:
If you are above 45 and having symptoms of menopause which do not affect your daily life, you do not have to consult a doctor. However, if the symptoms are affecting your quality of life, for example the hot flashes prevents you from getting good sleep or you are feeling sad and are losing interest in things or find difficulty coping with family life or work you should see a doctor.
However, you should see a doctor if your period bleed is more often than once in 3 weeks, you have heavy period flow or you have spotting between your periods. If you have undergone menopause with no bleeding for 12 months and then start bleeding again (even if very little) you should see a doctor.
Being informed about what may happen during the menopause transition is a very good starting point.
Pay attention to your health, including quitting smoking, eating well, exercising regularly, maintaining a healthy weight and incorporating some relaxation techniques.
Self management strategies for management of hot flashes include carrying a fan, dressing in layers, and having a cool drink. Facial water sprays can also be helpful. Avoiding spicy foods, red meats, caffeine and alcohol will also reduce flushing.
Some women may find relief from menopausal symptoms with herbal or alternative remedies. However most have not been studied or shown to be of benefit scientifically and some, like black cohosh, have been occasionally linked to liver damage. It is not recommended that these treatments are taken for longer than 6 months.
Menopause hormone therapy (MHT) has been demonstrated scientifically to reduce menopausal symptoms. Experts think these hormones are effective and safe for many women in their 40s and 50s with symptoms of menopause. However, for each individual woman its benefits must be weighed against the increased risk of side effects such as thromboembolism (blood clots) and breast cancer. You should not take hormones if you have had breast cancer, a heart attack, a stroke, or a blood clot. Any woman taking MHT should be reviewed regularly by her doctor.
Doctors may prescribe other drugs to relieve symptoms. Anti-depressants can reduce hot flashes and depression. Even women who are not depressed can take them to relieve hot flashes.
After menopause you have an increased risk of osteoporosis. You should increase dietary intake of Calcium and Vitamin D ( Calcium and Vitamin D supplements may be necessary for some women). Stay active and exercise to keep your bones strong and improve balance.
Being over 40 increases your risk of chronic diseases like diabetes and hypertension as well as cancers. Going for regular health screenings is important as these diseases may not have symptoms in their early stages. Screening for diabetes, hypertension and high cholesterol levels is important for women over 40.
Additionally, breast cancer screening should start for all women over 40 and colon cancer screening for women over 50. Sexually active women should also have regular Pap smears.
Women may experience physical and emotional changes during menopause but that doesn’t mean life has taken a turn for the worse! Many women are prompted at this time to ‘take stock’ of their lives and set new goals. The menopause occurs at a time when women may be juggling roles as mothers of teenagers, as care-givers of elderly parents, and as members of the workforce. Experts suggest that creating some ‘me time’ is important to maintain a balance in your life. Menopause can be seen as a new beginning: it’s a good time to assess your lifestyle and your health and to make a commitment to strive for continuing ‘wellness’ in the mature years.
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