Understanding Menopause

Understanding Menopause

 

What is menopause? Menopause is a stage in life that begins with infancy, childhood, adolescence, adulthood, and then menopause. Adolescence is the starting point where the ovaries produce hormones that lead to menstruation.

 

During menopause, the ovaries function less, resulting in a decrease in the production of hormones (estrogen, progesterone), which can cause some women to experience fewer periods. Some may experience a gap between periods until they stop altogether. These hormones help with menstruation, pregnancy, bone density, and cholesterol reduction.

 

When does menopause begin? Women aged 40 years and above can experience menopause, with an average age of 50 years. Women who smoke may experience menopause earlier than those who do not smoke. Women who have had their ovaries removed can also experience menopause immediately after the surgery.

 

What are the warning signs of menopause?

 

The symptoms of menopause can include irregular periods, such as coming early, coming late, being heavier or lighter than usual. Hot flashes are also common, where the patient feels a sudden heat that mostly affects the upper part of the body like the cheeks, neck, and back. This can be followed by sweating and feeling cold at night, and can last from 1-5 minutes.

 

Other problems can arise with the vagina and bladder, as the decreasing levels of estrogen can cause dryness and thinning of the vaginal walls. This can lead to discomfort during sex and increased risk of infection in the vagina. Additionally, there may be difficulty with holding urine, especially when coughing or sneezing.

 

Sleep problems are also common, with patients having difficulty falling asleep, waking up frequently at night, and sweating excessively. This can lead to fatigue during the day.

 

Mood swings, irritability, and lack of concentration are also common symptoms of menopause. Changes in body shape may occur, with a decrease in waist size and an increase in fat around the waist. Muscle mass may decrease while fat increases, and the skin may become thinner and less elastic.

 

Other issues may include headaches, memory loss, and body aches.

 

During menopause, women may be at an increased risk for certain health conditions. This is because the hormonal changes that occur during menopause can affect various parts of the body. Here are some of the diseases that can be more common in those suffering from menopause:

 

1. Osteoporosis: As estrogen levels decrease, women can experience bone loss, which can increase the risk of fractures and osteoporosis.

 

2. Cardiovascular disease: The risk of heart disease and stroke increases after menopause due to changes in hormones, such as decreased estrogen levels, which can affect blood pressure, cholesterol, and blood vessel health.

 

3. Urinary tract infections: Lower levels of estrogen can cause thinning of the vaginal walls, making it easier for bacteria to enter the urinary tract and cause infections.

 

4. Breast cancer: The risk of breast cancer increases with age, and menopause marks a significant change in a woman's hormone levels, which can increase the risk of breast cancer.

 

5. Depression and anxiety: Menopause can be a challenging time for women, both physically and emotionally. Hormonal changes can lead to mood swings, depression, and anxiety.

 

6. Insomnia: Sleep problems are common during menopause, and insomnia can increase the risk of various health problems, including cardiovascular disease, depression, and obesity.

 

It is important for women going through menopause to stay informed about these potential health risks and to talk to their healthcare provider about ways to reduce their risk and manage their symptoms.

 

As you enter your golden years, it is important to take care of yourself by following some healthy practices. You should consume high-calcium foods and reduce your intake of fats to lower your risk factors for heart disease. Additionally, quitting smoking and alcohol consumption is highly recommended. Using lubricants before sexual activity is also advised. Getting screened annually for breast and cervical cancer is also important.

 

When it comes to treating age-related illnesses, hormone replacement therapy should be considered after a thorough evaluation of the severity of the disease. For instance, symptoms like hot flashes and thinning bones should be taken into account. The risks associated with hormone replacement therapy, such as cancer, heart disease, and stroke, should also be considered before starting the treatment. Alternatives to hormone therapy should also be explored before proceeding with this treatment.

 

If you experience hot flashes during menopause, there are certain steps you can take to alleviate the symptoms. You can move to a cool place, lie down in a cool room, drink cold water, avoid spicy and hot foods, and avoid alcohol. Stress should also be minimized, and breathing exercises can help you relax. Dressing in layers and removing them when you feel hot is another helpful practice.

 

Some doctors recommend using vitamin E, which can reduce symptoms by 40%, and anti-depressant medications such as Prozac and Zoloft for relief. Foods that contain soybeans can also help reduce hot flashes. Dryness and pain during intercourse, as well as frequent urination, can be addressed by taking hormones. However, if there are restrictions on hormone replacement therapy or if the patient is not willing to take the risk of hormone therapy, estrogen can be applied topically to the vaginal area. Although the level of hormones in the bloodstream will be lower than if taken orally, the treatment will be more effective for the vaginal area, with a fourfold increase in efficacy. For the first-time use, apply the cream daily, and then adjust the frequency to 2-3 times per week as needed. In addition, some people may use a medication to increase moisture in the vaginal area without thickening the tissue.

 

For insomnia and mood swings, it is recommended to avoid stress, exercise, and abstain from drinking coffee, which can make it harder to sleep. The use of SSRI antidepressants can also be helpful, as they can modify serotonin levels in the brain and reduce symptoms of depression.

 

Giving hormone replacement therapy to elderly patients with certain medical conditions requires assessing the severity of their condition and associated risks, such as hot flashes, osteoporosis, and the potential for hormone-related diseases like cancer, heart disease, and stroke. Other treatment options should be considered as well. Some patients may benefit from taking birth control pills, which can alleviate hot flashes, regulate menstrual cycles, and reduce the risk of ovarian cancer.

 

However, the downside is that it may not be clear if the patient has reached menopause or not. If in doubt, birth control pills should be stopped for 4-5 months to see if menstrual periods resume. When patients enter true menopause, doctors may consider prescribing hormone replacement therapy that contains estrogen and progesterone, which can alleviate symptoms, prevent bone loss and protect against heart disease. However, doctors must be cautious of complications such as liver disease, high triglycerides, and breast cancer risk associated with the use of phytoestrogens found in various plants like grains, vegetables, and legumes that mimic estrogen. While these plants contain substances that have estrogen-like effects, they are not currently recommended for treatment because their efficacy and side effects have not been fully researched.

 

The Center for Obstetrics and Gynecology at Vibhavadi Hospital wishes to emphasize the importance of evaluating the potential benefits and risks of hormone replacement therapy in elderly patients with certain medical conditions before initiating treatment. Other options should be considered, and patients should be monitored for complications throughout their treatment.