Menopause, the natural occurrence to signify the end of reproductive years
It is a natural occurrence and marks the end of the reproductive years, just as the first menstrual period during puberty marked the start. You will know that the menopause has taken place if you have not had any bleeding for 12 months.
Most women reach menopause between the ages of 45 and 55, the average being around 50. Menopause before the age of 40 is called ‘premature menopause’ and ‘early menopause’ before 45.
Menopause – what to expect?
- Menopause means the end of monthly periods.
- You may experience a range of symptoms.
- A healthy lifestyle will help to manage symptoms.
- You should have regular breast checks and Pap tests.
Hormone levels fluctuate as menopause approaches
As you approach menopause, the production of hormones (such as oestrogen) by the ovaries starts to slow down. Hormone levels tend to fluctuate and you may notice changes in your menstrual cycle.
- Cycles may become longer, shorter or totally irregular
- Bleeding may become lighter
- Bleeding may become unpredictable and heavy (seek advice from your doctor).
- Eventually your hormone levels will fall to a point where menstruation (periods) will cease altogether and the menopause is reached.
Although fertility after the age of 45 is low, you still need to use contraception to prevent pregnancy (even if only barrier contraception such as male or female condoms) until you have had one year without a natural period.
Other signs and symptoms
Some of the symptoms that women may experience include:
- Hot flushes
- Night sweats
- Aches and pains
- Crawling or itching sensations under the skin
- Lack of self-esteem
- Reduced sex drive (libido)
- Sleeping difficulty – wakefulness or waking hot and sweaty
- Urinary frequency
- Vaginal dryness
Long-term health risks
A decrease in female hormones after menopause may lead to:
- Thinning of the bones (osteoporosis) and an increased risk of fractures
- An increase in the risk of heart attack and heart disease, high blood pressure and stroke.
Managing the menopause
Unpleasant symptoms of the menopause can often be greatly reduced by improving your lifestyle with a healthy diet and regular exercise.
Suggestions for managing menopause symptoms through diet include:
- Choose a wide variety of foods, including plenty of fresh vegetables, fruits, cereals, whole grains and small portions of lean meat, fish or chicken.
- Increase fluids and eat low-fat dairy foods with high calcium content.
- Decrease caffeine and limit alcohol (aim for 1-2 standard glasses or less per day).
Regular exercise is important. At least 30-45 minutes on most days of the week will:
- Maintain your heart health and improve your general health
- Keep your bones healthy and prevent bone loss through osteoporosis
- Help maintain good balance and reduce the risk of injury from falls
- Provide a feeling of relaxation and wellbeing
- Possibly help improve hot flushes.
- Understand your body’s changes
It is important to understand the changes your body is going through during menopause. There are many different sources of information available. Make sure you seek out credible websites and brochures that provide up-to-date, non-biased information from organisations that specialise in women’s health.
It’s important to avoid smoking because of the associated risk of osteoporosis, coronary heart disease and lung cancer (which may soon exceed breast cancer as the leading cause of death in women). For help to quit smoking, call the Quitline on 131 848.
Some women experience mood changes such as mild depression and irritability. These symptoms are often related to physical changes such as hot flushes, night sweats and poor sleeping. It’s important to keep a positive outlook. Consult with your health practitioner or a psychologist if you are experiencing any significant or persistent changes in mood.
Regular Pap tests and breast checks
You should have:
- National Cervical Screening Test – see Dr Sharon Li.
- A two-yearly mammogram – this is a free, Australia-wide service for women over 40. Contact Breast Screen Australia on 132 050 for more information.
Hormone replacement therapy (also known as hormone therapy)
Hormone replacement therapy (HRT) effectively reduces many of the unpleasant effects of symptoms of the menopause and may be appropriate for short-term use in women with moderate to severe menopausal symptoms. Dr Sharon Li usually suggests using an oestrogen patch or natural progesterone such as Prometrium as it has the lowest incidence of long term side effects. Any hormone replacement therapy should be used in conjunction with diet and lifestyle modifications. Discuss the advantages and disadvantages of hormone therapy with your Dr Sharon Li.
It is important to have a check-up once a year to assess the specific risks and benefits you may experience as a result of the therapy.
For more information about gynaecological concerns, treatment options or to request a personalised consultation, please contact us.