The menopause has been called the change of life, an appropriate name because it marks the end of the fertile period of a woman’s life, and the end of menstruation. This is basically when a woman goes through the experience of having her periods come to an end. Menstruation is something that she’s lived with for about 40 years of her life, so it’s a significant experience and it can have some fairly major physical and psychological effects. But a woman’s periods don’t just stop overnight; they usually slow down, become less frequent, perhaps the odd period is missed, and then finally they stop altogether.
The average age at which a woman goes through the menopause is 52, although a very small number go through it before the age of 40. When a woman has not had a period for a year she is said to be postmenopausal.
The menopause isn’t a clearly defined thing, because it’s preceded by an experience known as the perimenopause, which is a period of time during which a woman undergoes hormonal and biological changes which are the precursor of the menopause itself. These hormonal changes can cause both physical and emotional symptoms including hot flushes, night sweats, and emotional mood swings. But though these mood swings are hormonally induced, there’s no doubt that another factor is the result of the transition that a woman goes through at this time in her life, when she is moving from a period of being fertile and being able to bear children, to a period when she’s infertile and her ability to produce new life has disappeared. Obviously the major physical aspect of menopause is the end of ovulation or egg production, which is the result of a reduction in levels of oestrogen in her blood.
About 8 out of 10 women experience various symptoms before they reach the menopause itself, about half of these women find the symptoms difficult to deal with. The usual symptom that signals the onset of menopause is a change the pattern of a woman’s periods, which may become more frequent, less frequent, or irregular; and the amount of menstrual discharge may change — most women find that it increases slightly.
There are other symptoms of the perimenopause (remember, that’s the period preceding the menopause itself): these include hot flushes and night sweats, where a woman suddenly feels hot and sweaty in her upper body; this feeling then spreads to other parts of the body including the face or abdomen and legs. The skin on the chest, neck and face may become red and begin to sweat, while a woman’s heart may beat more rapidly than usual, or more strongly than usual, or in an irregular way that we know as palpitations. This is not dangerous, but it can certainly be disturbing if it’s not expected. If these hot flushes occur at night, they are called night sweats and they can be very distressing since they can drench the body in sweat, and soak the bedlinen. However, most hot flushes only last for a few minutes, and they diminish in intensity and frequency after the first year following a woman’s final menstrual cycle.
Sleep disturbance is another common side-effect of the menopause, and it’s here that a holistic approach using both conventional medicine and alternative medicine can help a woman come to terms with both the physical and emotional symptoms that she is experiencing.
It’s also very important that a woman deals effectively with changes to lubrication in her vagina, since this may impact directly on her relationship. Without treatment, the lack of lubrication can cause pain and difficulty during intercourse, as well as leading to atrophy of the vaginal lining. Happily, localised treatment with oestrogen pellets nearly always reverses these changes and makes intercourse pleasurable and enjoyable once again.
It’s also possible that a woman may become more susceptible to urinary tract infections such as cystitis during the perimenopause and menopause, which once again emphasises the importance of a holistic approach to health care during this period of life.
It turns out that only about 10% of women actually seek medical help as they go through the menopause — in part, that’s because many don’t need any treatment, but it is also clear that there are many women who could be helped with symptoms that are actually bad enough to interfere with their daily life. Treatment options include hormone replacement therapy, vaginal lubricants, antidepressants, and drugs called tibolone and clonidine.
Incidenatlly, the final period is no guarantee not getting pregnant, so women should continue to use contraception for at least a year after their final period.
Although there have been some scares about the safety of hormone replacement therapy in the last couple of decades, it’s now a well proven and safe treatment regime for all women. The advent of low-dose HRT, combined with the possibility of localised administration of oestrogen to the vagina, means that no women need to experience discomfort during intercourse, hot flushes or mood swings.
We should mention in passing there are various synthetic hormones available, including tibolone and clonidine, which may be prescribed in some circumstances.
Thinking ahead, it’s important for women to realise that hormone replacement therapy isn’t just about convenience now — it’s also about preventing osteoporosis and maintaining quality of life in later years. With effective therapy, including localised HRT and the vagina, there’s essentially no reason why women’s lifestyle should change just because the menopause. One of the most respected experts on the menopause is Dr. Christiane Northrup menopause writer and expert who has written extensively about empowering women through adopting a holistic approach to the mental, emotional, and spiritual challenges of the menopause produces. For any woman who wants to sail through the menopause with an experience of positivity and joy, Dr. Northrop’s writings are essential reading.
Antidepressants can be useful during the menopause to prevent mood swings and irritability, although many people believe that a holistic approach using treatments such as acupuncture, reflexology, and careful nutrition can be just as effective.
Want to find out more about Dr Northrup’s menopause strategy?Visit Roberta Booth’s site on how to choose the best approach for your needs.