Navigating Menopause With Insights and Support
Recent years have seen a significant shift in how menopause is perceived and managed. Once a topic shrouded in silence and stigma, there's now a growing awareness and understanding of its profound impact on women's lives. This change is reflected in more personalised treatment approaches and a societal move towards supportive and informed management of menopause.
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Understanding Menopause
Menopause is a natural biological process that marks the end of a woman's reproductive years. It most commonly occurs between the ages of 45 and 55, although the timing can vary widely. It is characterised by a series of hormonal changes that have profound effects on the body, resulting in a variety of physical and emotional symptoms. Understanding these changes and learning how to manage them is important for women as they transition through this significant life stage.
Hormonal Shifts Explained
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Oestrogen: This hormone's decline during menopause can cause symptoms like hot flushes, night sweats, and mood changes. Its presence in various body parts explains the wide-ranging impact of menopausal symptoms.
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Progesterone: Alongside oestrogen, progesterone's decrease affects menstrual regularity and contributes to menopausal symptoms.
- Testosterone: Although typically associated with men, testosterone plays a vital role in women's health, affecting bone density, muscle mass, and libido. Its reduction can lead to decreased energy and sexual desire.
What is Perimenopause?
The production of hCG commences soon after the embryo embeds itself in the uterus, with its levels typically doubling every 48 to 72 hours during the initial phase of a healthy pregnancy. While hCG levels can fluctuate, they are generally found to be between 5 to 50 mIU/mL in the early stages of pregnancy. These levels tend to rise, reaching their peak between the 8th and 11th weeks, before settling to a consistent level for the remainder of the pregnancy.
There are instances when monitoring hCG levels through a blood test becomes essential. Monitoring of hCG levels, when deemed necessary, typically occurs every 48-72 hours, though recommendations may differ among individuals. Although urinary and blood tests for hCG aim to identify the same hormone presence, a blood test yields a specific numerical value, allowing for more precise tracking. This precision is crucial, as unchanged or decreasing hCG levels may indicate complications like ectopic pregnancies or miscarriages.
It's crucial to note that lower hCG readings early in pregnancy could indicate problems such as a miscarriage or fetal demise. However, it's also essential to recognise that hCG levels can vary significantly among individuals. In cases of miscarriage or ectopic pregnancy, symptoms like abdominal pain or bleeding are often present, accompanying the hCG level indications.
Testing Hormone Levels
If you are over 45 years of age and eliciting typical signs of peri-menopausal or menopausal symptoms, doctors won’t usually recommend checking your hormone levels to make the diagnosis. This is because Follicle Stimulating Hormone (FSH) varies week by week and thus testing it is somewhat unreliable. Many women will also experience symptoms before seeing any rise in their FSH levels.
FSH levels are recommended in the 40-45 age group if perimenopausal symptoms are present and in cases of women under the age of 40 where Premature Ovarian Insufficiency (POI) is suspected.
Common Symptoms of Menopause
Oestrogen receptors are present all over the body, so menopausal symptoms can affect any system of the body. The severity of symptoms can vary hugely from person to person. Some of the most common symptoms include:
- Hot Flushes and Night Sweats: Perhaps the symptoms most commonly associated with menopause, and particularly detrimental to the quality of sleep.
- Mood Swings: Fluctuations in hormone levels can lead to mood changes, including irritability, anxiety, and depression.
- Vaginal Dryness: Decreased oestrogen levels can result in vaginal dryness, itching, and discomfort during sexual intercourse.
- Changes in Libido: Many women experience a decrease in sexual desire and arousal during menopause, often due to hormonal changes and other factors such as stress or relationship issues.
- Fatigue: Hormonal fluctuations and disrupted sleep patterns can contribute to feelings of fatigue.
- Brain Fog: A feeling of cognitive impairment, or a perceived inability to function at previous standards.
- Irregular Periods: Menstrual cycles may become irregular or stop altogether as hormone levels fluctuate during menopause.
Treatment Approaches
The path to managing menopause is as individual as the symptoms themselves. This part of the discussion focuses on Hormone Replacement Therapy (HRT) and its role in alleviating menopausal discomfort, alongside a look at alternative treatments and lifestyle adjustments that can complement or offer alternatives to HRT.
HRT can significantly alleviate symptoms by supplementing declining hormone levels. It's available in various forms, tailored to individual needs. HRT can help alleviate symptoms such as hot flushes, vaginal dryness, and mood swings. It can also help prevent bone loss and reduce the risk of fractures associated with osteoporosis.
As with many medical treatments, it is not without risks; long-term use of HRT has been associated with an increased risk of breast cancer, blood clots, stroke, and heart disease. But current medical thinking is that for most women the benefits of HRT outweigh the risks. It's important for women considering HRT to discuss these potential risks and benefits with their healthcare provider to make an informed decision.
There are other options if HRT is felt to be unsafe or unsuitable. These include:
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Non-Hormonal Medications: Various types of antidepressants, such as selective serotonin reuptake inhibitors (SSRIs) can help relieve hot flushes and mood swings in some women.
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Vaginal Oestrogen Therapy: For women experiencing vaginal dryness and discomfort during intercourse, topical oestrogen creams can help improve symptoms.
- Lifestyle Changes: Adopting a healthy lifestyle can help alleviate some menopausal symptoms. Regular exercise, a balanced diet rich in fruits, vegetables, and whole grains, and stress-reduction techniques such as yoga or meditation can all contribute to overall well-being during menopause.
Take Control of Your Menopause Journey
Menopause, a natural part of ageing, brings significant hormonal changes affecting both body and mind. With today's greater awareness and supportive treatments, women can approach menopause informed and empowered, maintaining their well-being through this life stage.
Understanding menopause and its effects enables women to navigate this phase with confidence. Seeking support, prioritising self-care, and staying informed about treatment options are key.
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Frequently Asked Questions
What can be expected during menopause?
Women can have vastly differing experiences of menopause. Some women may experience only very mild symptoms, whilst others may suffer debilitating effects on both physical and cognitive function.
What are the most common symptoms of menopause?
Menopausal symptoms can broadly be divided into physical and emotional symptoms. Hot flushes, night sweats and vaginal dryness are common, as are brain fog, fatigue, and mood swings.
How is menopause diagnosed?
Menopausal symptoms in a woman of the appropriate age are usually enough to confirm the diagnosis of menopause alone. Blood tests can be helpful if symptoms are atypical, or occurring in women under the age of 45 years.
What is the difference between perimenopause, menopause and postmenopause?
Menopause is technically when a woman’s periods stop until she has not had menstruated for 12 consecutive months. Postmenopause refers to the time after this, and perimenopause refers to the period leading up to menopause, where symptoms may still be present.
What is induced menopause?
Induced menopause is when medical treatments lead to an impairment of ovarian function before menopause would normally occur.
Should you still use contraceptives during menopause to avoid pregnancy?
It is still possible to become pregnant during perimenopause and menopause, so contraception needs to be considered. Some HRT regimes include the IUS such as the Mirena Coil, a device that offers both contraception and the progesterone necessary to protect the uterus during treatment.
Are there any health risks associated with untreated premature menopause?
Premature menopause is defined as the onset of menopause before the age of 40. Left untreated it can increase the risk of bone issues in the form of osteoporosis, and cardiovascular problems.
Can a hysterectomy affect menopause?
If a hysterectomy involves the removal of your ovaries, the production of oestrogen will drop dramatically. This is likely to result in the onset of symptoms. If you are prescribed HRT following a hysterectomy, your treatment regime may be different.
What is the relationship between oestrogen, testosterone, and menopause?
Testosterone plays a role in women’s health, helping to maintain bone density, muscle mass, and libido. Testosterone declines with increasing age, often more noticeably alongside falling oestrogen levels during menopause.
Does menopause increase the risk of heart disease?
Yes, it does. Oestrogen levels offer some protection against cardiovascular disease with an effect on blood pressure and cholesterol levels, so when levels drop during menopause, the risk increases.
How does menopause affect your mental health and moods?
Fluctuating oestrogen and progesterone levels can cause issues with mental health and mood disorders.
Does menopause cause bone loss?
Menopause can have significant effects on bone health. Oestrogen plays a crucial role in maintaining bone density by regulating the activity of osteoblasts (cells that build bone) and osteoclasts (cells that break down bone). When oestrogen levels fall during menopause, bone loss can accelerate, leading to a condition called osteoporosis.
Can menopause cause high blood pressure?
Oestrogen plays a role in maintaining the flexibility and health of blood vessels. As oestrogen levels decrease during menopause, blood vessels may become less flexible, which can lead to increases in blood pressure.