ISSN: 1391 - 0531
Sunday November 18, 2007
Vol. 42 - No 25
MediScene  

Understanding Menopause

By Smriti Daniel

After having lived with the discomfort of your monthly periods for over four decades, you may be surprised to find that you might actually miss them when they're gone. Here Dr. Nalinda Rodrigo, Consultant Obstetrician and Gynaecologist talks about menopause - the symptoms, common complications, and how women can help themselves through this challenging time.

"Menopause is a natural thing and almost all women will go into it between 45 and 52," says Dr. Rodrigo. Menopause occurs when there is a permanent cessation of the menstrual cycle. A natural biological process, menopause is not a medical illness but marks the end of a woman's fertility and a steady decline in the production of female hormones like estrogen and progesterone.

Though a woman may be considered menopausal only after she has spent a whole year without a period, the body may already be succumbing to symptoms of menopause, including insomnia, fatigue, mood swings and depression. During this period - known as the perimenopause - a woman makes the transition between different phases of her reproductive life.

Though adapting may prove challenging, it will do you good to remember that with some care, you can stay healthy and happy for decades to come, while you enjoy the absence of your periods and the accompanying inconvenience or discomfort.

In the post menopausal period, women are considered at heightened risk for several chronic medical conditions, warns Dr. Rodrigo. Aside from cases where regular check-ups are required (such as diabetes or cholesterol),if you are generally a healthy person, it is essential that you have a complete check-up -including scans of the stomach and the pelvis - at least once every five years.

Symptoms:

As many women will testify, menopause is far from being a walk in the park. "Due to a lack of estrogen there are changes happening in the psychological state, the brain function, bones, cardiovascular system and genital system," explains Dr. Rodrigo. Some of the common symptoms include:

  • Hot flashes and/or night sweats
  • Insomnia
  • Loss in bone density
  • Increased risk of heart trouble
  • Vaginal dryness, susceptibility to infections in the thinning vaginal lining and painful intercourse
  • Mood swings and depression
  • Trouble concentrating and some amount of memory loss
  • Less hair on head, more on face
  • Loss of breast fullness

You should also have a pap smear at least once every three years, while self examination for breast cancer is recommended at least once a month.

Cardiovascular disease: Declining estrogen levels can increase your vulnerability to cardiovascular disease. Crucial steps like quitting smoking, working to reduce high blood pressure, regular aerobic exercise, and a diet low in saturated fats and plentiful in fibre, whole grains, fruits and vegetables can work wonders.

Osteoporosis: In the post menopausal years, bone density is lost at a steady rate, increasing the risk of osteoporosis. Osteoporosis which makes your bones brittle and weak, can result in a fracture even after a comparatively small fall. Women in this condition are especially susceptible to fractures in the long bones, hip, wrist and spine, says Dr. Rodrigo. In this case, prevention is as simple as taking a table of 500 milligrams of elemental calcium every day, preferably from the age of 40. Weight-bearing exercises such as walking and swimming are recommended.

Women are particularly susceptible to cancer in the genital system during this period, says Dr. Rodrigo.

The emotional component:

What makes menopause particularly difficult for women is the emotional toll it takes on you. Menopause can be the straw that breaks the camel's back in a period where women already have a great deal on their plate. Children may be preparing to fly the nest and form families of their own, while retirement may loom large as one's professional career comes to an end.

Dr. Rodrigo explains that awareness of what is happening to your body can help you respond appropriately and also help your family support you. Remember, that though menopause may not be an illness, you can and should ask your doctor for advice if you're having severe symptoms.

Treatment

Treatment focuses on relieving discomfort or preventing or lessening chronic conditions that may occur with aging. Hormone therapy though controversial, is still one of the most effective ways of treating severe menopause symptoms, says Dr. Rodrigo. If your case warrants it, a specialist may prescribe estrogen therapy for a few months to provide relief. And while emotional symptoms may be treated with low-dose antidepressants, the best treatment at your disposal may be what you can do yourself.

Here are some suggestions to help you cope better:

  • Get regular exercise and plenty of sleep- at least 30 minutes of exercise every day, or 45 minutes every other day is recommended. Exercise can also help reduce stress as it produces endorphins that can also help you feel more upbeat.
  • Weight bearing exercises: Use Kegel exercises to strengthen the muscles of your pelvic floor and prevent urinary incontinence.
  • Does something in particular trigger your hot flashes? Triggers may include hot beverages, spicy foods, alcohol, hot weather and even a change in temperature.
  • Avoid caffeine and eat a balanced diet that includes a variety of fruits, vegetables and whole grains while limiting saturated fats, oils and sugars.
  • Quit smoking: Smoking increases your risk of heart disease, stroke, osteoporosis and cancer among many, many other health problems. It can also aggravate hot flashes and precipitate earlier menopause.
  • Schedule regular check-ups with your doctor. Find out how often you should have mammograms, Pap tests, lipid level (cholesterol and triglyceride) testing and other screening tests.

Certain surgical or medical treatments or conditions can bring on menopause earlier than expected. Some of these will require treatment. These include:

 

  • Premature ovarian failure: A small percentage of women will experience menopause before the age of forty, says Dr. Rodrigo, adding that this is considered a medical condition that must be explored and treated appropriately. In such cases, menopause is said to have resulted from premature ovarian failure which in turn may be attributed to genetic factors or auto-immune disease among other causes.
  • Hysterectomy: A hysterectomy - the surgery that removes your uterus - usually doesn't precipitate menopause, says Dr. Rodrigo, explaining that this is because most doctors will not remove your ovaries unless it is necessary. As a result of such surgeries, you will no longer have your periods but your ovaries will continue to release eggs and produce hormones. But an operation that removes both your uterus and your ovaries (total hysterectomy and bilateral oophorectomy) does bring on menopause minus the buffer of the perimenopausal phase.
  • Chemotherapy and radiation therapy: Cancer therapies can induce menopause, causing symptoms such as hot flashes during the course of treatment or within three to six months.
 
Top to the page
E-mail


Reproduction of articles permitted when used without any alterations to contents and the source.
© Copyright 2007 | Wijeya Newspapers Ltd.Colombo. Sri Lanka. All Rights Reserved.