Menopause is defined as the natural cessation of a woman’s menses (menstrual cycle) for 12 consecutive months, usually between the ages of 45-56. Perimenopause refers to the period before menopause is reached, where many women begin to experience its symptoms.
Causes of menopause:
Menopause is a result of the natural decline of hormones. Over time, the number of ovarian follicles decreases, disrupting the normal biological mechanism that leads to ovulation. This in turn, disrupts the production of oestrogen and progesterone, leading to the cessation of the menstrual cycle. Although menopause is a process all women go through naturally at a certain time in their life, there are other causes of menopause. Surgery-induced menopause can occur with procedures such as bilateral oophorectomy or total hysterectomy, as these surgeries involve the removal of the ovaries. Removal of the ovaries causes an abrupt end to the production of oestrogen, causing menopausal symptoms without a perimenopausal phase.
Physical effects of menopause
The oestrogen deficiency that occurs due to menopause can affect many physical processes in a woman’s body, leading to often uncomfortable symptoms. Oestrogen deficiency causes vasomotor symptoms, and these include hot flushes, palpitations and migraines. The severity of the symptoms may differ between women however they can negatively impact quality of life. Other physical effects are related to genitourinary symptoms. With loss of oestrogen the vagina thins and loses its elasticity, causing vaginal dryness and itchiness. Sexual dysfunction, such as decreased libido, also occurs. As oestrogen also has effects on the bladder, urinary issues such as increased frequency and urgency can happen, as well as recurrent urinary tract infections. Weight gain is prevalent during this time, as the body’s metabolism slows down.
Psychological effects of menopause
Menopause can not only cause physical effects, but have significant psychological effects as well due to the change in hormones. Oestrogen has receptors in many parts of the brain and thus plays a big role in regulating emotions, mental state and cognitive functioning. In the perimenopausal and menopausal phase, symptoms of irritability, depression, anxiety and loss of concentration can occur.
Increased risk of disease after menopause
As oestrogen production decreases in the body, risk of cardiovascular disease increases. This is due to vascular dysfunction, increased blood pressure and increased weight gain. Going through the menopause earlier in life, for example due to surgical procedures, increases this risk even further. Oestrogen also works on bone health, and so menopause leads to more bone resorption, bone loss and osteoporosis.
Management of menopause symptoms
As menopause is a natural process, management involves alleviating the symptoms that occur as a result of the shift in hormones. As the lack of oestrogen is a driving force for the symptoms that arise, hormone replacement therapy (HRT) is used as a treatment. HRT can contain oestrogen only, or oestrogen and progesterone. It works to counteract the body’s decreased production of these hormones by working on the same receptors. It can be taken orally or transdermal to manage vasomotor symptoms. Local HRT in the form of vaginal creams can be used to manage genitourinary symptoms of dryness, itchiness and soreness. Like all medications HRT comes with some associated risks, such as increased risk of blood clots and breast cancer. Conversely, HRT provides bone protection so the risk of fragility fractures is reduced. Non-hormonal treatments can also be used, and these involve medications known as selective serotonin reuptake inhibitors (SSRIs) or serotonin and norepinephrine reuptake inhibitors (SNRIs) that work by blocking receptors in the brain, causing a chain of events that work to decrease vasomotor symptoms.
Alternative therapies to manage menopause symptoms
Many alternative therapies have been proposed to alleviate menopausal symptoms. Black cohosh, an extract of the black cohosh plant root, has been studied to be an effective treatment option. One study showed that treatment with Black cohosh was associated with increased improvement of overall menopausal symptoms as well as hot flushes compared with treatment with a placebo. Research has also suggested that Ginseng, a herb, may also help reduce these symptoms. Zingiber officinale, also known as ginger, is another traditional remedy used to alleviate menopause symptoms. One study showed that use of ginger power for three months led to a reduction in frequency and intensity of symptoms.
Conclusion
Although it is a natural part of a woman’s life, menopause can be a difficult and stressful time due to the symptoms it brings along with it. There are many treatment options available to help manage these symptoms and improve quality of life. If you are experiencing any of these symptoms, or think you may be going through the menopause and want more information, consult your doctor or GP.
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