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Perimenopause And Menopause

What Do You Know About Perimenopause and Menopause?

Menopause occurs when a woman goes without menstruating for 12 months straight, signifying a “pause” in her menstrual cycle. Perimenopause, on the other hand, is the phase during which a woman transitions from her normal reproductive menstrual cycle to reaching menopause. These are both natural biological processes that happen to every woman regardless of ethnicity, socioeconomic background, or geographical location.

What Causes Menopause?

  • A decline in natural levels of reproductive hormones: The ovaries begin producing less oestrogen and progesterone; the hormones that control menstruation, as a woman approaches her 40s. Fertility also begins to wane at this time, and finally, the ovaries cease producing eggs, resulting in the cessation of periods.
  • Oophorectomy (ovaries removal surgery): The ovaries generate the hormones: oestrogen and progesterone, which regulate the monthly cycle. After the surgical removal of the ovaries, menopause immediately begins. Due to hormonal changes occurring suddenly rather than gradually over many years, signs and symptoms might be severe.
  • Chemotherapy and radiation treatment: As ovarian function may have been disrupted by the course of treatment, particularly those directed at the ovaries or organs surrounding the ovaries, such as the womb, intestines, and bladder, menopause may be an unintended side effect.
  • Primary ovarian insufficiency: Menopause occurs in about 1% of women before the age of 40 (premature menopause). Primary ovarian insufficiency, which can be caused by genetic causes or autoimmune disorders like systemic lupus erythematosus (SLE), can cause premature menopause by preventing the ovaries from producing enough quantities of reproductive hormones. But frequently, there is no known cause for premature menopause.

Of What Benefit Is This Information?

  • The hormone, oestrogen, which protects the heart and blood vessels, decreases during menopause, increasing the risk of heart disease and stroke. If the menopausal transition occurs at a younger age, the risk is higher.
  • In addition, oestrogen supports bone health and strength, while menopause increases the risk of osteoporosis (weak and fragile bones).

What Are the Signs and Symptoms of Perimenopause/Menopause?

Women can experience a range of symptoms during the perimenopause and menopause stages, with some individuals not experiencing any symptoms at all, while others may feel significantly overwhelmed by their symptoms.

 These are the symptoms that are commonly reported:

  • Vaginal dryness leading to painful sex.
  • Temperature dysregulation which causes women to feel inappropriately hot or cold leading to:
    • Hot flushes (characterized by a sudden feeling of heat in the upper part or all of the body).
    • Chills (usually accompanies the hot flushes).
    • Night sweats.
  • Sleep problems.
  • Mood changes.
  • Brain fog and concentration problems.
  • Weight gain and slowed metabolism.
  • Loss of skin elasticity.
  • Drier skin & hair.
  • Drier skin & hair.
  • Breast changes.

Complications of Perimenopause/Menopause

It is important to understand that whilst menopause is a natural process, there are some physical health issues that can occur as a result of hormonal changes in the body. Some of them include:

  • Heart and blood vessel (cardiovascular) disease: Oestrogen protects the heart and blood vessels and also helps reduce cholesterol build-up in the vessels. The drop that occurs during menopause can lead to an increased risk of having heart disease.
  • Osteoporosis: Oestrogen also protects the bones. Therefore as the levels drop, it can cause the bones to become brittle and weak, leading to an increased risk of fractures.
  • Cognitive decline and dementia: For reasons that are not fully understood, we see an increase in dementia and cognitive decline in post-menopausal women. There is some evidence that oestrogen deficiency contributes to this and more research is ongoing.
  • Genito-urinary Syndrome of the Menopause: As the tissues of the vagina and urethra lose elasticity due to reduced oestrogen, one may experience frequent, abrupt, strong urges to urinate, followed by an involuntary leak of urine (urge incontinence), or release of urine with coughing, laughing or, lifting (stress incontinence). There can also be an increase in urinary tract infections.
  • Sexual dysfunction: Vaginal dryness brought on by decreased moisture production and suppleness from reduced estrogen, can produce discomfort and contact bleeding during sexual intercourse. Furthermore, many women report low libido which can heighten this.
  • Heavy bleeding: There are a variety of changes that can occur in the perimenopausal period. Many women report a change in their bleeding pattern; this can range from lighter and less frequent bleeding to heavier and more frequent bleeding. This can be hugely distressing as women may flood constantly and unpredictably, impacting their ability to function. Furthermore, women can get increased pain with their bleeding and complications from anaemia (low Haemoglobin/red blood cell count) such as fatigue, lightheadedness and palpitations. It is important to see a doctor if you are suffering from these as urgent investigations and treatments may be needed.

The Impact Of A Heavy Mental Load on Perimenopause And Menopausal Symptoms

The mental load that a woman carries can impact her experience of perimenopausal and menopausal symptoms. It can also affect her ability to cope with symptoms. Often,  we observe that the heavier the mental load, the more challenging the symptoms and the impact. This effect can be enhanced by current or previous trauma, as well as, a pre-existing physical or mental health burden. There is also developing evidence that multi-generational trauma can be inherited through a process known as epigenetics and this can also cause women to have earlier and more severe symptoms. This  effect is particularly notable in black women. You can read more on mental load and it’s impact on women’s health here.

Tips To Ease the Symptoms

There are steps to help make this transition a smoother and healthier ride. They include:

  • Up your physical activity: Studies have shown that 30 to 45mins of exercise each day gets your heart pumping and prevents heart disease. Keep in mind that heart disease is the leading cause of death worldwide, so this really is a boon for your current and future physical and mental wellbeing. It also reduces hot flushes, boosts your mood, and can help to achieve a healthy weight. Strength-building exercises are also important for muscle, joint and bone health and flexibility exercises such as Pilates, Yoga and TaiChi can also help with this, as well as, calming down the mind and reducing stress. Remember, all movement counts. Many modern perimenopausal and menopausal women are time-poor, so if all you can do is try to sit less and walk more, that’s a great start! Another tip is to build it into your lifestyle such as incorporating physical activity into social events with friends and family or as specially scheduled, and prioritized, “me time”.
  • Review your mental load and aim for a manageable amount.
  • Prioritize self-care.
  • Quit smoking: this protects you from cancers, heart disease, stroke, and diabetes.
  • Ensure a healthy diet.
  • Take a vitamin D supplement (usually 1000IU daily) if you do not have adequate sunlight exposure and a calcium supplement if you do not have enough intake of this in your diet.
  • Consider carrying a portable fan if you experience hot flushes
  • Strengthen your pelvic floor muscles: this is achieved by Kegel exercises.
  • Minimize your intake of:
    • Spicy, fatty, and processed foods
    • Alcohol and caffeine

   These have been implicated in worsening the experience of hot flushes and other menopause symptoms.

  • Change your perspective about menopause: A negative outlook on menopause can be associated with more frequent and severe symptoms. Having a positive outlook on the transition can improve your experience.

When To See a Doctor

Menopause generally requires no medical treatment because it is neither a disease nor a disorder.  However, the mental load a woman carries, can greatly impact her experience of and ability to manage the symptoms of the menopause. Also, if you are high risk for any of the complications of the menopause, it is important to consider whether you need treatment. Therefore, if your symptoms become unbearable or affect your quality of life, or if you are undergoing early menopause, or worried about menopause complications, it’s time to book an appointment with your doctor.

In Conclusion

If  you are experiencing symptoms of the perimenopause or menopause, and are struggling to cope, please seek help and book a consultation with a healthcare professional health. It can be potentially life-changing for your current and future health.  We will be sharing future posts with more detail on treatment options for the perimenopause and the menopause. You can also join our waiting list to find out more about our upcoming online  perimenopause and menopause clinic.

1 Comments on “Perimenopause And Menopause”

  1. Pingback: Hormone Replacement Therapy: A Myth-Busting Guide - Dr Sho Cares

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