Menopause and its implications
In my previous column I discussed some important aspects of the topic and expressed my surprise that so little was discussed or published on October 20 – World Menopause Day. Hormones were discussed – what they are and what role they play – especially in the lives of women between the ages of 35 to 60, varying from one individual to another and often depending on race and location.
The two hormones that play a crucial role in pre-menstrual, menstrual and post-menstrual phases in a woman’s life – oestrogen and progesterone – were mentioned; the first stimulating the release of eggs, the second in preparing a woman’s womb for impregnation and to help protect the lining of the uterus.
“As you age, significant internal changes take place that affect your production of the two female hormones, viz oestrogen and progesterone. The hormones which are important in the menstrual cycle and in having a successful pregnancy, are produced by the ovaries, two small, oval-shaped organs found on either side of the uterus” (Family Health – British Medical Association Handbook, Guild Publishing, London, New York, Sydney, Toronto, 1990).
What exactly is menstruation? It is the periodic shedding of the lining of the uterus, accompanied by bleeding, that occurs in a woman who is not pregnant. Menstruation identified the fertile years of a woman’s life. It begins at puberty (between the ages of 10 and 16) and is called menarche. It continues until menopause (usually between the ages of 45 and 55). In the western world, the typical age of menopause is between 40 and 61 and the average age for the last period is 51 years of age. In India and the Philippines, the median age of natural menopause is considerably earlier, at 44 years.
Menstruation is the end result of a complicated series of hormonal interactions. At the beginning of the menstrual cycle, oestrogen hormones cause the lining of the uterus to thicken to prepare for the possibility of fertilisation; this is known as the proliferative or follicular phase. Ovulation (egg release) usually occurs in the middle of the menstrual cycle and is accompanied by the increased production of progesterone hormones. The effect of this is to cause the cells of the lining of the uterus to become swollen and thick with retained fluid. These changes, which occur during the secretory phase of the menstrual cycle, enable a fertilised egg to implant in the lining (endometrium) of the uterus. If the woman does not get pregnant, the production of oestrogen and progesterone from the ovaries diminishes. The fluid-filled endometrium is not required and is shed about 14 days after the start of ovulation. Uterine contractions force the menstrual discharge to be expelled in the vagina. Blood loss varies from cycle to cycle and from woman to woman, averaging 60 millilitres. The menstrual cycle, which is counted from the first day of bleeding to the last day before the next menstrual period, lasts between 24 to 35 days in 95 percent of women, the average being 28 days, with the average length of bleeding being five days.
The term ‘peri-menopause’, meaning ‘around the menopause’ refers to the transition years, a span of time both before and 12 months after the date of the final episode of flow. This transition usually lasts from four to eight years. During this period, oestrogen levels are about 20 to 30 percent higher than during pre-menopause. Most women only become aware of the transition many years after the actual beginning of the peri-menopausal window. ‘Pre-menopause’ is the period leading up to the last period when the levels of reproductive hormones are already becoming more variable and lower, and the effects of hormone withdrawal are present
Medical professionals often define menopause as having occurred when a woman has not had any menstrual bleeding for a year. It may also be defined by a decrease in hormone production by the ovaries. In those who have had surgery to remove the uterus but still have ovaries, menopause may be viewed to have occurred at the time of surgery or when hormone levels fall.
Following the removal of the uterus, symptoms typically occur earlier, at an average of 45 years of age. Before menopause, a woman’s periods typically become irregular which means that the menstrual period may be longer of shorter in duration, or be lighter or heavier. During this period, women often experience hot flushes lasting from a few seconds to a few minutes, and may be associated with shivering, sweating and reddening of the skin. Hot flushes often stop occurring after a year or two. Other symptoms may include vaginal dryness, trouble sleeping and mood swings.
The severity of symptoms varies between women. Symptoms that may occur during menopause and continue through post-menopause include dryness, thinning of the sexual membranes and urinary tract problems.
Other physical symptoms may include lack of energy, joint pains, stiffness, back pain, breast enlargement, pain in breasts, heart palpitations, headache, dizziness, dry and/or itchy skin, thinning and/or tingling of the skin, weight gain, urinary incontinence, urinary urgency, interrupted sleep patterns and hot flushes with heavy night sweats. Fortunately, not every woman experiences all these symptoms, some even hardly noticing the onset of menopause.
On the psychological side, symptoms include anxiety, poor memory, an inability to concentrate, depression, irritability, mood swings, lessening of libido, frequent fights with partner, finding imaginary faults with partner, interest in younger men, an urge to commit suicide and other depression-related problems. (Wikipedia)
Menopause is a natural phenomenon and not a disease. Specific treatment is not usually needed. However, some symptoms may be improved with treatment. It is an important matter that should be discussed between patients and doctors (gynaecologists). It can occur earlier on in women who smoke. Other causes of early occurrences include surgeries that remove both ovaries and some types of chemotherapy. On a physiological level, menopause happens, as described earlier, due to a decrease in the ovaries’ production of the hormones oestrogen and progesterone.
The two hormones that play a crucial role in pre-menstrual, menstrual and post-menstrual phases in a woman’s life – oestrogen and progesterone – were mentioned; the first stimulating the release of eggs, the second in preparing a woman’s womb for impregnation and to help protect the lining of the uterus.
“As you age, significant internal changes take place that affect your production of the two female hormones, viz oestrogen and progesterone. The hormones which are important in the menstrual cycle and in having a successful pregnancy, are produced by the ovaries, two small, oval-shaped organs found on either side of the uterus” (Family Health – British Medical Association Handbook, Guild Publishing, London, New York, Sydney, Toronto, 1990).
What exactly is menstruation? It is the periodic shedding of the lining of the uterus, accompanied by bleeding, that occurs in a woman who is not pregnant. Menstruation identified the fertile years of a woman’s life. It begins at puberty (between the ages of 10 and 16) and is called menarche. It continues until menopause (usually between the ages of 45 and 55). In the western world, the typical age of menopause is between 40 and 61 and the average age for the last period is 51 years of age. In India and the Philippines, the median age of natural menopause is considerably earlier, at 44 years.
Menstruation is the end result of a complicated series of hormonal interactions. At the beginning of the menstrual cycle, oestrogen hormones cause the lining of the uterus to thicken to prepare for the possibility of fertilisation; this is known as the proliferative or follicular phase. Ovulation (egg release) usually occurs in the middle of the menstrual cycle and is accompanied by the increased production of progesterone hormones. The effect of this is to cause the cells of the lining of the uterus to become swollen and thick with retained fluid. These changes, which occur during the secretory phase of the menstrual cycle, enable a fertilised egg to implant in the lining (endometrium) of the uterus. If the woman does not get pregnant, the production of oestrogen and progesterone from the ovaries diminishes. The fluid-filled endometrium is not required and is shed about 14 days after the start of ovulation. Uterine contractions force the menstrual discharge to be expelled in the vagina. Blood loss varies from cycle to cycle and from woman to woman, averaging 60 millilitres. The menstrual cycle, which is counted from the first day of bleeding to the last day before the next menstrual period, lasts between 24 to 35 days in 95 percent of women, the average being 28 days, with the average length of bleeding being five days.
The term ‘peri-menopause’, meaning ‘around the menopause’ refers to the transition years, a span of time both before and 12 months after the date of the final episode of flow. This transition usually lasts from four to eight years. During this period, oestrogen levels are about 20 to 30 percent higher than during pre-menopause. Most women only become aware of the transition many years after the actual beginning of the peri-menopausal window. ‘Pre-menopause’ is the period leading up to the last period when the levels of reproductive hormones are already becoming more variable and lower, and the effects of hormone withdrawal are present
Medical professionals often define menopause as having occurred when a woman has not had any menstrual bleeding for a year. It may also be defined by a decrease in hormone production by the ovaries. In those who have had surgery to remove the uterus but still have ovaries, menopause may be viewed to have occurred at the time of surgery or when hormone levels fall.
Following the removal of the uterus, symptoms typically occur earlier, at an average of 45 years of age. Before menopause, a woman’s periods typically become irregular which means that the menstrual period may be longer of shorter in duration, or be lighter or heavier. During this period, women often experience hot flushes lasting from a few seconds to a few minutes, and may be associated with shivering, sweating and reddening of the skin. Hot flushes often stop occurring after a year or two. Other symptoms may include vaginal dryness, trouble sleeping and mood swings.
The severity of symptoms varies between women. Symptoms that may occur during menopause and continue through post-menopause include dryness, thinning of the sexual membranes and urinary tract problems.
Other physical symptoms may include lack of energy, joint pains, stiffness, back pain, breast enlargement, pain in breasts, heart palpitations, headache, dizziness, dry and/or itchy skin, thinning and/or tingling of the skin, weight gain, urinary incontinence, urinary urgency, interrupted sleep patterns and hot flushes with heavy night sweats. Fortunately, not every woman experiences all these symptoms, some even hardly noticing the onset of menopause.
On the psychological side, symptoms include anxiety, poor memory, an inability to concentrate, depression, irritability, mood swings, lessening of libido, frequent fights with partner, finding imaginary faults with partner, interest in younger men, an urge to commit suicide and other depression-related problems. (Wikipedia)
Menopause is a natural phenomenon and not a disease. Specific treatment is not usually needed. However, some symptoms may be improved with treatment. It is an important matter that should be discussed between patients and doctors (gynaecologists). It can occur earlier on in women who smoke. Other causes of early occurrences include surgeries that remove both ovaries and some types of chemotherapy. On a physiological level, menopause happens, as described earlier, due to a decrease in the ovaries’ production of the hormones oestrogen and progesterone.
