We will be looking at the basics of menopause, some definitions, some expectations and what can be done to make the transition easier.

Menopause is the cessation of periods but being post-menopausal is a diagnosis that is made retrospectively once a woman has not had a period for 1 year and there is no other explanation for the absence of periods. The average age for menopause is just under 50 years old, however there can be a wide variation in the ages that woman go through menopause.

There are three stages of this transition. The first is perimenopause in which a woman may experience less frequent or irregular periods and intermittent symptoms of menopause. The next stage is the cessation of periods. Finally, a woman is post-menopausal 12 months after her last period.

Symptoms of this transition are a result of decreasing hormone production, which is caused by diminished ovarian follicle (egg) reserve. Lower estrogen levels are for the most part the cause of the symptoms experienced by women going through or in menopause.

These symptoms include

  • Hot flushes
  • Headaches
  • Mood changes
  • Difficultly sleeping
  • Decreased sex drive
  • Vaginal dryness
  • Painful sex

Some women may never experience any symptoms, some may experience them for a short length of time and some women may have symptoms that greatly affect their lives for many years. Sometimes these symptoms may be so distressing that they may result in relational and social challenges and may compound feelings of low mood and self-esteem or may result in decreased productivity.

Fortunately, the consequent decreased sense of wellness and quality of life can be addressed, and women can live relatively symptom free.

This is an opportunity to make positive changes in all aspects a women’s life.

Lifestyle changes such as a healthy diet and regular exercise are a great way to help manage these symptoms and also have multiple other health benefits. Stopping smoking and lowering alcohol intake are also great ways to increase well-being. Thinking about ways to decrease stress and allow yourself time to do the things that you enjoy, such as spending time with family and friends and engaging in hobbies that may have been forgotten, will also help you relax and improve your mental well-being and quality of sleep.

Medication

Medication used to combat the symptoms of menopause include herbal or natural remedies, other non-hormonal medication and hormonal replacement therapy (HRT).

Currently there is no evidence to suggest that herbal remedies aid in control of menopausal symptoms and one has to be careful of the potential problems with unregulated and untested medication.

Venlafaxine, which is an antidepressant, is the only non-hormonal medication that is proven to be of some benefit in treating symptoms of menopause. This may be a reasonable alternative for women who have contraindications to HRT (such as a personal history of estrogen dependant breast cancer). It may also be helpful for women who predominantly have mood symptoms due to menopause.

HRT is the most effect treatment in addressing the symptoms caused by menopause. There is a lot of data available on the safety and the effectiveness of HRT and I will be addressing this in a later blog.