As a woman approaches her late 40's and early 50's her hormone levels naturally decline, causing the ovaries to become inactive and menstruation to stop. This is termed the menopause or 'change of life' - the body adjusts to a new situation. This change is weathered easily by some but most women notice differences themselves. The changes are not sudden but may take place over a few years. They usually start when a woman reaches her mid to late 40's, but can begin as early as the late 30's.
Certain symptoms - caused mainly by the sudden fall in oestrogen - may continue for some time. Though these symptoms are perfectly natural, all women should be aware how they affect their health. Symptoms include -
- Hot Flushes
- Night sweats
- Panic attacks
- Loss of concentration
- Incontinence / infections
- Muscle and joint pains
- Brittle nails
- Lack of confidence
- Memory lapses
- Your periods - as the menopause gets closer, periods tend to be heavier and last longer. They may also be more frequent. Later they become more irregular, with longer gaps in between until they cease altogether.
- Hot Flushes - the most common, and often troublesome, symptom of the menopause. Hot flushes frequently start before the periods stop and are harmless but a nuisance all the same. A hot flush can be accompanied by sweating and followed by a feeling of cold and shivering. Some women notice palpitations - an unpleasant feeling where the heart is beating rapidly. A hot flush may only last for three minutes but to some sufferers can feel like a lifetime!! Self Help Tips: wearing several layers of light cotton clothing, avoiding synthetic materials. Avoiding alcohol and caffeine drinks as these tend to make you flush. Take tepid showers rather than warm baths.
- Psychological symptoms - such as feeling low, anxiety, insomnia, poor memory and depression. Some people - mostly men - think the menopause is "just in your imagination". This is quite wring - physical symptoms are a direct result of the lack of oestrogen. This lack of oestrogen is also thought to be a link to the anxiety and depression often associated. Self Help Tips: overcome anxiety by learning to relax and control your breathing when you feel anxious or upset is beneficial.
Intermediate signs may occur along with early signs.
- Vaginal and urinary symptoms - lack of oestrogen means the lining can become thin and dry, itching and soreness may also occur.
- Changes to hair and skin - again, the skin and hair feels dry due to oestrogen loss.
Long Term Signs...
- Osteoporosis - bone thinning due to oestrogen drop. This is why women tend to shrink more than men as they get older and are more likely to suffer from fractures. Osteoporosis is preventable and bone loss can be halted with suitable treatment.
- Heart disease - oestrogen protects the heart against developing heart disease and so as levels drop the risk increases.
What can you do?
Hormone replacement therapy (HRT) can often help with managing symptoms. It is very effective in combating the early, intermediate and long term effects of the menopause. Taking HRT will help prevent the occurrence of the usual signs, such as hot flushes, vaginal dryness and thinning of the bones, all due to a lack of oestrogen.
What is an oestrogen?
Oestrogen is a hormone produced by the ovaries which ripens the eggs that are produced each month. In HRT preparations, low doses of oestrogen are used to replace the natural hormone that is no longer being produced by the ovaries.
What is a progestogen?
Progesterone is a hormone produced by the ovaries, which helps prepare the lining of the womb each month for a fertilised egg. During the normal menstrual cycle, the drop in progesterone at the end of the cycle causes the lining of the womb to be shed - a period.
Progesterone itself is not used in HRT tablets as it is rapidly broken down by the body when taken by mouth, and therefore has little effect. In view of this, synthetic forms of progesterone, called progestogens, are often used in HRT preparations.
Women who have a womb will be prescribed an HRT preparation that contains a progestogen since this has been shown to keep the lining if the womb healthy and reduce the likelihood of developing endometrial cancer.
Tablets - they either contain oestrogen alone (if you have had a hysterectomy) or of oestrogen and progestogen (if you still have a uterus).
Creams - a plastic syringe-like applicator is used to deliver a measured dose of oestrogen cream into the vagina.
Pessaries/tablets - oestrogen impregnated pellets or tablets are inserted directly into the vagina using an applicator.
Vaginal Rings - a ring impregnated with oestrogen is inserted high into the vagina and worn continuously for 3 months.
Patches - HRT is absorbed through the skin from adhesive patches.
Gels - oestrogen-containing gel is rubbed into the skin.
Implants - pellets containing a 6-month supply of oestrogen are inserted under the skin of the thigh or buttock.
- Examine your breasts monthly
- Tell your doctor about anything you think is unusual
- Look out for - lumps/bumps; puckering of the skin; nipple changes.
Cervical Smears -
- Have regular tests - these will reveal early signs of cancer or other abnormalities
- With early treatment, cervical cancer can be completely cured.
Unusual Bleeding -
- 'Spotting' between periods is common, but report unexpected bleeding to your doctor right away.
- Report any unusual vaginal discharge to your doctor.
- Symptoms are often due to infection (e.g. thrush)
- Don't treat a discharge yourself
- Wash your genital area with plain water and avoid tight, restrictive clothing.
Urinary Problems -
- For treatment of painful, frequent urination, or membrane irritation, see your doctor.
- Prolapse can be due to reduced oestrogen levels or a difficult labour
- Slight Prolapse - your doctor may suggest exercise or other treatments.
Looking and Feeling Good...
Eat Yourself Healthy
- A healthy diet is balanced and varied
- Cut down on fat and sugar
- Eat plenty of fresh fruit and vegetables, fish, lean meat, bread and cereals
- Crash dieting is dangerous and weight loss unlikely to be maintained
- Protects the heart, strengthens bones and helps keep blood pressure low
- Choose a form of exercise you enjoy
- Aim to do 20 minutes, three times per week.
Smoking Wastes Good Health
- Smoking increases the risk of many diseases: heart attacks, stomach ulcers and cancer.
- Your doctor can offer help and advice on how to stop
- Self-help groups, hypnosis, acupuncture, relaxation therapy can all help you give up.
- Relaxation techniques can relieve stress
- Talk things through with someone
- Feel comfortable with your body and the changes it is going through.
- Take time to look after your skin and hair
- Use moisturisers and sunscreens on your skin
- Look after your nails
- Choose clothes that are comfortable and flatter your figure
Time to Unwind
- Enjoy your friends and your family, but make time for yourself too
- Try a new hobby. Use the local library to investigate opportunities
- Get plenty of sleep.
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