The Menopause

An Explanation...

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
Dizziness
Night sweats
Panic attacks
Stress
Sleeplessness
Loss of concentration
Incontinence / infections
Muscle and joint pains
Brittle nails
Lack of confidence
Memory lapses

Early Signs...

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...

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.

Definitions

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.

HRT Preparations

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.

Body Maintenance

Breasts -

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.

Discharge -

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 -

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

Regular Exercise

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.

Think Positive

Relaxation techniques can relieve stress
Talk things through with someone
Feel comfortable with your body and the changes it is going through.

Looking Good

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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