Menopause. Causes, Symptoms, Hormone Therapy

Disclaimer: Not medical or professional advice. Always seek the advice of your physician.

Menopause refers to the transformative period of time that marks the end of a woman’s reproductive competence. It is associated with the reduced production of sex hormones (estrogen and gestagen) in the ovaries. The first symptoms of menopause usually appear between the ages of 45 and 50, and periods stop completely by the age of 55. Menopause is diagnosed after the full year of absent periods.

What does Menopause do to a Woman's Body?

Every woman is born with a certain supply of eggs. One girl may have 100,000 eggs, while another has more than 400,000. By the time of menopause, the woman runs out of her supply of eggs, and the ovaries cease to make the female hormone estrogen.
However, the human body is a unique system. As soon as the brain receives a signal about a low level of estrogen (which is an important participant in metabolic processes in the female body), it immediately begins to release hormones that stimulate ovarian function. Changes in hormonal levels affect all organs, presenting the first symptoms of menopause. Estrogen deficiency strongly affects the mucous membranes of the urogenital system: the urethra, bladder, vagina. Gradually, the brain realizes the uselessness of further egg stimulation and accepts the situation. The hormonal storm does subside and the unpleasant symptoms cease to be so intense.

Other Causes of Menopause

Primary ovarian failure. In this case, menopause starts early. Most often, ovarian insufficiency occurs in women with genetic or autoimmune diseases (Down syndrome, Addison's disease).
Surgical removal of an ovary or ovaries (oophorectomy).
Chemotherapy and radiation therapy. There is a chance of recovery of periods and fertility after chemotherapy. Radiation therapy affects ovarian function only if it is aimed at the ovaries. Radiation therapy to other parts of the body, such as the breast, head, or neck, will not affect menopause.

Menopause Symptoms

Woman at doctor's consultation on menopause

It is important to understand that menopause is not a disease. You can recognize the onset of menopause by its characteristic features. Symptoms can start months or even years before the end of the period and continue for about 4 years after the last period.

Irregular periods. They may be absent for months or happen every 2-3 weeks.
Hot flashes. The most common symptom of menopause. It is characterized by sudden feelings of heat, especially on the face and neck. Besides, it may also cause skin redness. Hot flashes occur frequently, up to several times a day.
Sweating. It typically accompanies hot flashes.
Bone fragility. During menopause, the body loses calcium and up to 2% of bone mass annually. There is a risk of bone fractures even with minor external impact.
Skin changes. The body produces less collagen, the skin loses its firmness, giving the appearance of wrinkles and dryness.
Chronic fatigue. Hormonal changes lead to unreasonable loss of energy, fatigue, and poor performance.
Emotional instability. Menopause affects all women differently. Other people notice their unusual behavior, mood swings, irritability, and crying spells. Some women develop depression during menopause.
Altered perception of the world. This is manifested in an inexplicable sense of anxiety, threat, fear, sensitivity to smell and noise.
Insomnia. More than a third of women experience sleep problems during menopause. Trouble falling asleep, frequent night wakings, difficulty getting up in the mornings worsen the quality of life and ruin the mood. Women who do not get enough quality sleep suffer from fatigue.
Physical distress. During menopause, women often have headaches similar to migraines, dizziness, and nausea. They also experience increased heart rate, difficult breathing, and a feeling of a lump in the throat. Other symptoms include chills and shortness of breath.
Sexual side effects. Sexual intercourse becomes painful due to vaginal dryness. The lining of the vagina tends to become thin and sensitive.
Atherosclerosis and coronary heart disease due to decreased estrogen levels.
Brittle bone disease (osteoporosis). Estrogen slows down the process of bone resorption and stimulates bone regeneration. Low estrogen levels inevitably affect metabolic processes in bone tissue, making them weak.
Incontinence when coughing, climbing stairs due to loss of elasticity of the vagina and urethra.

Types of Menopause

Premature (between ages 36 and 40 years).
Early (between ages 41 and 45 years).
Natural (between ages 45 and 55 years, the average age ranges between 49 and 52 years).
Late (after the age of 55).

4 Important Terms related to Menopause

Induced menopause — the period stops after the surgical removal of both ovaries (with or without the removal of the uterus). This category also includes ovarian dysfunction after medical treatment (for example, after chemotherapy or radiation therapy).
Perimenopause — a gradual drop in estrogen levels, irregular periods, the onset of menopause symptoms. It can last 2 to 8 years. On average, it starts at 45-51 years.
Postmenopause — the absence of periods for 2 or more years. The endometrium (the inner mucous membrane lining of the uterus) stops its renewal, the amount of vaginal discharge decreases, the uterus and appendages decrease in size. There is an increased risk of inflammation of the genitourinary system.
Climacteric syndrome is a phenomenon when the symptoms of menopause become severe. The main reasons are medical interventions, surgeries, diseases, hereditary factors. For example, a woman can suddenly enter menopause after removal of her ovaries, radiation therapy, intoxication, when the ovaries ceased to secrete female sex hormones. It has a serious impact on women's health and wellbeing.

Hormone Replacement Therapy (HRT) for Menopause

Hormone replacement therapy is a medication that helps women manage hot flashes, vaginal dryness, night sweats, and bone loss. HRT drugs are available as tablets, skin patches, a gel to rub into the skin, or implants. Despite a number of benefits, HRT has many contraindications. Therefore, doctors assess each woman individually when taking the decision to choose a patient's medication. They need to carefully consider all the pros and cons of the treatment plan.

Adjunctive Therapy for Menopausal Symptoms

Try to properly organize your daily schedule. It is important to free up more time for rest and night sleep during menopause.
Menopause is the time to try new things. You can create a healthy and delicious meal plan that will help improve the condition of skin, nails, and hair.
Try to make exercise part of your daily routine. Sport can help prevent problems with urination and digestion. It will also improve bowel motility and muscle tone in the bladder.
And most importantly, menopause is nothing to be afraid of. Continue to enjoy your life!