Beloved, I pray that all may go well with you and that you may be in good health, as it goes well with your soul. 3 John 1: 2 (ESV)
Menopause is a natural change in a woman’s life when she experiences a cessation of her menstrual cycle. It is a step in the long, slow process of reproductive ageing. Some types of surgery may also bring on menopause. These are surgeries that involve the removal of both ovaries (bilateral oophorectomies). The severity of menopause that occurs following surgical removal of the ovaries is more than what you have when menopause naturally occurs. A simple hysterectomy would cost an abrupt cessation of menses but not necessarily the other feature of menopause unless both ovaries were removed concomitantly. Changing hormone levels can cause a variety of symptoms that may last a few months to a few years or longer. Some women may only have the slight discomfort while others may have little or no trouble at all.
Common Features Associated with Menopause or Perimenopause
Hot flashes and night sweats: Women may experience hot flashes as intense build up in body heat, followed by sweating. The hot flashes involve a sensation of getting warm in the face, neck and chest. Most flashes last between 30 seconds and five minutes but may be highly variable in frequency and duration, occurring many times in a day in some cases. Studies have shown that controlling stress and anxiety could lead to a reduction in the number and severity of hot flashes in most cases.
Changes in your monthly flow: This is one of the earliest signs. Many women have less regular cycles and lighter flows than normal. In some cases, there may be heavier flows which may go on for longer durations. There may be spotting between cycles. Women who have had problems with painful menses may find themselves relieved of such pains. If, however, your menstruation has stopped for 12 months in a row, and you are still spotting, you should see your doctor to rule out serious courses such as cancer.
Sleeping difficulties: This may lead to feeling tired, stressed and fatigued. The problem may be the inability to fall asleep easily all waking up too early. Hot flashes may also wake someone up from sleep.
Problems with vagina and bladder: With menopause, there is atrophy of the genital organs. The vaginal wall becomes thinner and smoother with a fall in its acidity. There is also a reduction in vaginal secretions resulting in painful sexual intercourse. Vaginal infection may be more frequent. Menopausal women are more prone to Urinary Tract Infection (UTI). They may also find it hard to hold their urine for a long time. In some cases, there may be easy leakage of urine that occurs during exercises, sneezing or coughing or laughing.
Mood changes: There may be mood swings such as depression and irritability in perimenopause or menopause. It is believed that these may result from a decreasing oestrogen trigger changes in the brain which results in depression. The mood changes may also be a fallout of sleep problems, hot flashes and other uncomfortable changes in the body that accompany menopause. Other things that could cause mood changes in menopause are:
- Increased stress
- negative feeling about menopause and getting older
- not being physically active
- not being happy in your relationship or not being in a relationship at all
- not having a job
- not having enough money
- a low self-esteem
- regretful you can’t have children anymore
- not having the social support, you need.
Osteoporosis: This refers to thinning of the bones.
Would everyone require treatment for symptoms of menopause? The answer is a clear NO! It would depend on the severity of the symptoms, and in any case, in some women, the symptoms simply go away without any treatment.
Difference Between Natural Menopause and Premature Menopause
With premature menopause, especially following the surgical removal of the ovaries, there is an immediate oestrogen crash. In natural menopause, oestrogen levels decline gradually over a period of 2 to 10 years. While women going through natural menopause may not experience vasomotor symptoms consistently, probably a bad month here or there, the symptoms in premature menopause and more drastic and severe and in most cases, would require some form of hormone replacement therapy (HRT).
What is Hormone Replacement Therapy?
These are prescription drugs that contain the type of hormones your body stops producing at menopause. These are mainly oestrogen and progesterone. The more important is oestrogen. Most of the symptoms of menopause are symptoms following the withdrawal of oestrogen. Hormone therapy may contain oestrogen alone or in a combination with progesterone (the latter is preferable for a woman will still has a uterus). Oestrogen therapy can be administered as a pill, skin patch, a cream or gel, or vaginal ring. How it is taken would depend on the purpose intended. We will come to this later.
Some of the positive benefits that can be obtained from HRT include slowing the loss of bone, treating vaginal dryness, reducing hot flashes, and decreasing mood swings. Hormone therapy is not without side effects. Some of these include bleeding, weight gain, breast enlargement with probable pains, headaches, nausea, and mood changes. Now there are some categories of women who should not be taking hormone therapy. These are women with liver disease, women have had a heart attack or stroke in the past, women who have had certain kinds of cancer, example breast or uterine cancer, and a woman who has had problems with vaginal bleeding. Any woman who is also at risk of any of the above-mentioned problems should not be using hormone therapy.