Let's help women understand menopause better

A study from University College London found that an astonishing 90% of women who have gone through menopause had no prior knowledge about it. Additionally, 60% of these women only sought help after they started experiencing symptoms. It’s no surprise that around 30% of women nearing menopause dread about the changes ahead. These challenges are real and valid, and it’s important to acknowledge them.

This article is designed to give you a comprehensive understanding of what to expect before menopause and why these changes happen. Understanding the changes that lie ahead and the potential challenges can significantly aid in preparing for this transition. Embracing this phase of life is key to making the most of these moments. Remember, you’re not alone in this journey!

What is menopause?

Menopause is the stage of life when a woman is no longer reproductive, meaning she will not be able to get pregnant and has not had her period for 12 consecutive months. It’s a natural part of life that every woman goes through, a natural transition that should be embraced and not feared.

According to the WHO, most women reach menopause at an average age of 52, though it is possible for some women to hit menopause much earlier or later, typically between 45-55 years of age. Remember, everyone’s journey is unique.

Infographic showing age women may reach menopause

She enters a new phase of life marked by the absence of menstrual cycles. That is not all; she may also find changes in her body, such as dry skin, hair loss, increased weight around the abdomen, changes in breast shape, etc.

What is more important to know is that your body undergoes several changes much before the actual menopause.

While menopause is a natural process of ageing, some women may reach menopause before 40, which is called premature menopause. Reasons include smoking, chemotherapeutic drugs, radiation, or surgery that impairs blood supply to ovaries. In some women, the ovaries are removed in case of ovarian cysts or cancer. Menopause in such women is called Surgical menopause.

Why does menopause happen?

Menopause occurs when the ovaries stop releasing eggs due to declined ovarian follicular function.

The process also sees changes in two important hormones in the female body: estrogen and progesterone. Both hormones are made in women’s ovaries, and both play crucial roles in puberty, pregnancy, menstrual cycles, and menopause.

Estrogen fluctuates fairly predictably during a woman’s reproductive years. However, as she nears menopause, the levels start declining gradually.

Progesterone, on the other hand, will be declining from a woman’s 20s. After the 30s, there will be a significant drop, with almost nil when she reaches menopause.

Low levels of estrogen and progesterone will slow the normal functioning of ovaries, resulting in fewer release of eggs over time and eventually stopping completely, leading to menopause (absence of menstrual cycles).

Three stages of menopause

Menopause has three main stages.

Perimenopause

First up is perimenopause, which is the time when your body prepares for menopause. This transition period that leads into menopause can be from a few months to even about ten long years before the woman reaches menopause.

During transition, your ovaries make different amounts of estrogen and progesterone than usual, resulting in low levels. Due to this, many women start having symptoms such as night sweats, hot flashes, irregular periods, mood swings, etc., with varying intensities. These symptoms can be extremely bothering in some women. For others, they are hardly noticeable.

Menopause

Then there’s menopause itself, which is basically when you’ve gone a full year without a period. Your ovaries stop producing eggs, and estrogen levels drop too low.

Postmenopause

Finally, postmenopause is the phase that comes after that last period, and you live in this phase for the rest of your life. While other symptoms that occur in perimenopause start waning just after menopause, low estrogen levels are a cause of concern as it increases the risk of osteoporosis and cardiovascular diseases in postmenopausal women.

How do you know if you are transitioning into menopause?

Perimenopause can bring a variety of changes and symptoms. However, you may not experience all of them. Also, how a person feels about the symptoms also widely varies. Some may hardly notice the discomfort, while others are significantly affected, potentially interrupting their daily schedule. Changes in hormonal levels cause the symptoms. The menopause symptoms can be physical, psychological, and urogenital.

Some signs that tell that you are transitioning into menopause are:

Typically, irregular periods are the first symptom. Your menstrual cycles may become erratic. You may even go for months without a period. You may also notice that your periods are longer or shorter than usual.
Your menstrual flow may get unusually heavier or lighter than before.
Hot flashes, also called vasomotor symptoms, are a sudden feeling of warmth, particularly in the face, neck and chest. They can occur at any time and can particularly be concerning for women if they happen at work.
Difficulty in sleeping, including trouble falling asleep and staying asleep or waking up in the middle of the night and unable to go back to sleep
Irritability and mood swings occur due to hormonal imbalances
Frequent urge to pee
Worsening PMS (Premenstrual syndrome)
Breast tenderness and change in breast shape
Dry skin, dry mouth, or dry eyes
Hair loss
Some may experience difficulty concentrating and may have memory problems
Weight gain, particularly in the abdomen
Some women may experience changes in their sexual health during menopause. Many women lose interest in sex, and for some, vaginal sex becomes painful due to vaginal dryness.

Also Read: 13 Most Common Menopause Symptoms And Useful Tips To Manage

Other symptoms that are hard to notice

During perimenopause, estrogen levels drop low, resulting in low bone density in some women. This may lead to osteoporosis, a condition that makes bones weak and breaks easily. Low estrogen levels can also affect your cholesterol levels, increasing your risk of cardiovascular diseases.

Also Read: 5 Useful Ways To Prevent & Manage Post Menopausal Osteoporosis

How long will menopause symptoms last?

Infographic - time for which menopausal symptoms may last

Symptoms may occur anywhere between a few months and up to ten years. However, the symptoms start to ease and are completely gone once you hit menopause.

Why are menopause symptoms worse in some?

The severity of menopause symptoms can largely depend on genetics, lifestyle, age, self-esteem, profession, relationship, and more.

In a prospective study involving 2,500 menopausal urban Korean women, several factors were found to affect or not affect the severity of their symptoms. A few interesting ones are:

Women learn to respond to menopause based on cultural perspectives. For example, while the youth-centred culture of the Western world saw menopause as a disease, most Asian cultures saw it as a positive event. Hence, women from non-Western societies tend to have fewer menopausal symptoms due to their positive orientation towards menopause and ageing.
Menopausal women with low or unstable self-esteem experience more anxiety than women with better self-esteem.
Depression had a negative correlation with dyadic consensus. This means that harmonious relationships were associated with a lower risk of depression than less harmonious ones.
Women with higher levels of education experienced fewer menopausal symptoms.
Women with stable relationships are likely to face fewer menopausal symptoms than women who are divorced/single/widowed.
Employed women reported experiencing milder menopausal symptoms compared to unemployed women.
Alcohol consumption might increase the severity of physical, psychological, and urogenital symptoms.
Women who have a history of PMS(Premenstrual syndrome) tend to have more menopausal symptoms.
Longer perimenopause means more time for your body to adjust to the change, hence less severity of symptoms.
A positive attitude towards menopause prepares women to face the change better. Hence, the severity of symptoms was significantly low.

Though this study is limited to a small number of women from a particular demography, the study provides some clarity that the severity of menopause symptoms might vary based on sociodemographic characteristics, lifestyle, relationship status, and general physical and psychological health of the woman.

How do you manage menopause?

As said earlier, every woman may experience menopause in her own way. Some may have more symptoms with less severity, hardly noticing a few of them. Some may have fewer symptoms with more severity and may find them challenging. When they bother, the woman may opt for treatments to manage the symptoms.

Typically, menopausal symptoms are treated with either hormonal treatments or nonhormonal treatments.

1. Hormone therapy

As your body prepares for menopause, it experiences hormonal fluctuations, which can lead to a variety of symptoms. Women finding it difficult to cope with the symptoms may opt for hormone therapy, which is essentially boosting hormone levels.

Women who still have uteruses and are transitioning into natural menopause may be prescribed Estrogen progesterone therapy, also called combination therapy.
Women who do not have uteruses removed by surgery (hysterectomy) and are having surgical menopause may be prescribed Estrogen therapy.
Women who reach premature menopause (before the age of 40) are typically suggested with Hormone Replacement Therapy (HRT).

While there are risks associated with hormone therapy, it may be a suitable option when the benefits outweigh the risks.

2. Other ways to manage symptoms during menopause (Nonhormonal ways)

i) Foods you take impact how severe your symptoms are

Cutting down caffeine and spicy foods can reduce the severity of hot flashes.

Also, including more foods containing phytoestrogens (mimicking estrogen-like properties) can be helpful in reducing the severity of menopausal symptoms. Some of such foods are:

Soybeans
Chickpeas
Lentils
Grains
Beans
Flaxseeds
Fruits
Vegetables

Also Read: 8 Amazing Hormone Balancing Foods To Eat To Correct Hormonal Imbalance

ii) Identify the triggers for hot flashes

Certain things in your daily life might trigger hot flashes. Avoiding and working around them helps reduce the frequency and severity of hot flashes.

Workarounds may include:

Keeping your bedroom cool can help prevent triggers for hot flashes. Additionally, have an extra blanket on hand if you feel too cold!
Wearing layers of dress, so when you experience hot flashes you may remove one or two of the layers.
Quitting smoking, as smoking worsens menopausal symptoms.
Maintaining a healthy weight can lessen the occurrence of hot flashes.
Exercising helps not only in reducing hot flashes but can lessen other menopausal symptoms as well.

iii) Support groups

Joining support groups reassures you that you are not alone, that this phase will be over soon, and that you will be alright.

Seeing women go through the same kind of difficulties and getting tips from them to cope with menopausal symptoms go a long way than you would expect.

So join support groups, meet women of your age, and be in touch with them. However, take care not to be misguided as well.

iv) Prescription medications

Nonhormonal prescriptions can help mitigate some menopausal symptoms. Some of them are:

Birth control pills to help balance hormones
Antidepressants to manage mood swings
Medications to treat hot flashes and overactive bladder
Topical creams and lubricants to treat vaginal dryness

When to see a healthcare provider

While menopausal women can try to manage symptoms like hot flashes, night sweats, and mood swings with lifestyle changes, you must visit your healthcare provider in certain cases like:

You skip periods before the age of 45
Your periods are much heavier than usual
You pass several large blood clots during your period
Your periods last longer than seven days
Your menstrual cycle is less than 21 days, meaning the time between your periods is less than 21 days
You experience bleeding or spotting between periods
You bleed after having sex
Finally, you have symptoms that are interrupting your everyday routine

Some questions you can ask your healthcare provider

Are my symptoms really due to menopause? How do I know?
What are the lifestyle changes that can help lessen and manage menopausal symptoms?
What kind of treatments can help my symptoms?
If hormone therapy is an option for me, what are the benefits and risks?
How long will these symptoms last?

Conclusion

Menopause is a natural process that every woman typically experiences in her late 40s or early 50s. Understanding this process, the causes of its symptoms, and the various ways and treatments to manage the symptoms can help the woman navigate this transition more easily.

Joining support groups, talking to other women experiencing menopause, and discussing your concerns with your healthcare provider are all important steps that help you embrace menopause.

menopause

Let’s help women understand menopause better

Here are some ways to inform women about menopause and its symptoms.