Menopause

Overview

Menopause occurs when the menstrual cycle stops, when women in their 40s or 50s failed to have their menstruation for 12 consecutive months.

Menopause is not a disease or a disorder. The body produces varying level of estrogen and progesterone hormones which affects the period. It is a natural cycle of life which signals the end of female reproductive years. Natural menopause has three stages: perimenopause, menopause and postmenopause.

Although menopause is a normal component of aging, it still affects the physical, emotional and mental state of an individual. As the body processes this change, women may experience hot flashes, lack of energy, difficulty sleeping and mood changes. The symptoms can be managed through hormone therapy and lifestyle changes. The transition period typically lasts for 7 to 14 years.

Symptoms

Depending on the individual’s lifestyle, the following signs and symptoms are experienced as the menopausal transition begins:

• Irregular or skipping periods
• Vaginal dryness or pain during sex
• Hot flashes
• Chills
• Night sweating
• Difficulty sleeping
• Moodiness and irritability
• Skipping periods
• Unwanted weight gain
• Hair loss or thinning
• Tenderness of breast
• Reduced sex drive

Some women may experience more symptoms than the others. The duration and changes of symptoms may last from months to years depending on the lifestyle factors such as race, ethnicity, smoking habits and age the person starts menstruating. Often times, women will have changes in their menstrual cycle before it stops.

The menstruation will become irregular when the body transitions or in perimenopause stage. The ovaries produce changing levels of hormones that affect the menstrual cycle. Usually, the period stops for a month and returns, and then stops again for a few months and returns. Periods also typically occur on shorter cycles, making them more frequent. Pregnancy is still possible during perimenopause. Pregnancy tests are necessary to confirm whether it is menopausal transition or pregnancy.

Preventive healthcare for women includes regular check-up before, during and even after menopause as changes in the hormones never stops. Post-menopausal, a person should no longer have a period. If bleeding reoccurs, it is recommended to visit a gynecologist or a family doctor for proper diagnosis.

Health screening tests for women start with annual visits with the gynecologist. Available preventive services are breast exam, pelvic exam, colonoscopy and mammogram, triglyceride screening, thyroid testing and other tests that the doctor may require depending on the individual’s risk factors.

Maintain routine appointments with a family doctor or gynecologist to screen for medical issues to help avoid health problems in the future.

Causes

Menopause is caused by:

• Decrease in hormone production: Changes in the menstrual cycle is common during menopause. As the person gets older, monthly periods may get heavier, shorter, or more frequent. At around age 51, the ovaries stop producing eggs, and women cease having periods.

Menstruation is influenced by the hormones that the ovaries produce. As the person gets older or enters perimenopause, lesser estrogen and progesterone are available to regulate the period which reduces fertility in women.

• Oophorectomy: Is a surgical procedure to remove the ovaries. After the surgery, menopause sets in right away. As the period ends, women may suffer from common menopausal symptoms such as hot flashes and vaginal dryness. Due to hormonal changes, symptoms will occur instantly rather than gradually. The removal of ovaries deprives the body of estrogen and progesterone hormones which are responsible for menstruation.
• Hysterectomy: This is a surgical procedure to remove the uterus. Without the uterus, the period stops but the body will continue to release eggs and generate estrogen and progesterone. This procedure may also be combined with oophorectomy. If the ovaries remain intact, a person is still susceptible to symptoms of menopause but not immediately.
• Chemotherapy and radiation therapy: In radiotherapy, if the radiation is not focused on the ovaries or is administered in other parts of the body, its function as well as the course of menopause would not be affected.

In chemotherapy, it is during or after the treatment that women may experience menopausal symptoms such as irregular periods and hot flashes. However, this can be only temporary. In some women, menstruation may return months or years after the chemotherapy ends.

• Primary ovarian insufficiency: Most women naturally experience menopause at age 40s or 50s. If a woman’s ovaries failed to function earlier or before the age 40, she may experience premature menopause. Primary ovarian insufficiency, which can be brought on by autoimmune disease or hereditary causes, is a condition in which the ovaries are unable to generate the appropriate amounts of reproductive hormones, which can lead to premature menopause. Women who experience this are advised to undergo hormone therapy to restore normal hormone levels and prevent complications. This condition happens in about 1% of women and in most cases, the cause is unknown.