|AGE Most common between the ages of 45 and 55||GENDER|
|LIFESTYLE Smoking may lower the age at which the menopause occurs||GENETICS Sometimes runs in families|
Menopausal problems are symptoms associated with the normal changes that take place in a woman's body as her period of fertility ends.
The menopause, the time at which a woman stops menstruating, is a normal consequence of the aging process. Around the menopause, about three-quarters of women experience symptoms, which tend to last for about 2 years. In the other quarter of women, symptoms persist for longer.
The onset of the menopause usually occurs between the ages of 45 and 55, although some women develop symptoms before or after this time (the time leading up to the menopause is known as the perimenopause). Smoking can lower the age at which the menopause takes place. A woman is generally considered to be menopausal if she has not had a period for at least 6 months and there is no other underlying cause. The tendency to have either an early or a late menopause can run in families.
What are the causes of menopausal problems?
As women age, their ovaries gradually become less active and produce smaller amounts of the sex hormone oestrogen. The menopause occurs as a result of this reduction in oestrogen levels. As levels of oestrogen in the body decline, the pituitary gland begins to secrete more follicle-stimulating hormone (FSH) to try to stimulate the ovaries. Most of the symptoms associated with the menopause are a consequence of the reduced levels of oestrogen or increased levels of FSH. These tend to be more severe when the menopause takes place prematurely or abruptly. A sudden menopause can be brought about by surgical removal of the ovaries or anticancer treatments that can damage the ovaries, such as chemotherapy and radiotherapy.
What are the symptoms of menopausal problems?
Menopausal symptoms may begin up to 5 years before menstruation finally stops and usually last for a year or two. Many women find that one of the first signs of the menopause is irregularity in their menstrual cycle. Menstrual bleeding may also become heavier (see Menorrhagia). Increased levels of FSH in the body cause many of the other common menopausal symptoms. These include:
- Hot flushes, in which the head, chest, and arms become red and feel hot, lasting from a couple of minutes to as long as an hour.
- Heavy sweating, which is often especially troublesome at night.
- Feelings of anxiety, panic, or depression, which may be made worse if the menopause coincides with a stressful life event such as the departure of adult children from the home.
The longer-term effects of a decline in oestrogen levels include:
- Drying of the skin, which encourages the formation of wrinkles.
- Vaginal dryness and discomfort during sexual intercourse as a result of thinning of the lining of the vagina.
- Urinary infections that occur due to thinning of the lining of the urethra.
The decline in oestrogen levels following the menopause may also increase your risk of developing certain longterm conditions, such as coronary artery disease and age-related thinning of the bones (see Osteoporosis).
What might be done?
Hormone replacement therapy (Index), commonly known as HRT, may help to relieve many of the symptoms that occur at the menopause. However, HRT is usually only advised for short-term use around the menopause and is no longer normally recommended for long-term use nor for the treatment of osteoporosis because of the increased risk of disorders such as breast cancer and thromboembolism (see Thrombosis and embolism).
Alternative treatments are available in the form of oestrogen creams, which help to control vaginal dryness and discomfort, and the drug clonidine, which can be used to relieve hot flushes. Some women find complementary therapies, such as homeopathy, helpful.
The process of the menopause normally lasts between 1 and 5 years, after which symptoms usually disappear.
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