Menopause

Menopause is the time when women stop having periods due to the hormonal changes in their body. This usually happens in their late 40s or 50s but may happen earlier depending on their diet or metabolism. Periods usually begin to happen less frequent over a few months or years before they stop completely. Also, sometimes they can stop instantly.

Menopause is a natural part of aging that usually occurs as women’s estrogen levels begin to decline. Most women will experience menopausal symptoms. Some of these can be quite severe and have a strong impact on their everyday activities.

Sometimes menopause is called “the change of life” as it marks the end of a woman’s reproductive life. At menopause, ovulation no longer occurs and production of estrogen and progesterone ceases. The word “menopause” refers to the last or final menstrual period a woman experiences. When a woman has had no periods for 12 consecutive months, then she is considered to be “postmenopausal”.

What happens during menopause?

If you were born with a uterus and ovaries, then menopause is quite natural and very normal process for your life. Also, if you are between the ages of 45 and 55, and you haven’t had your period for a year, you aren’t pregnant, and you don’t have a serious illness, then you most likely are going through menopause.

Not everyone goes through menopause only due to aging. Sometimes other health conditions may kickstart the process of menopause. For instance, if your ovaries are removed through surgery, you may experience instant symptoms of menopause instead of the gradual change that would happen naturally.

What are the Symptoms of Menopause?

In the months or years leading up to menopause, women might experience some symptoms caused by:

• Hysterectomy. A hysterectomy which removes your uterus yet not your ovaries generally doesn’t cause sudden menopause. Despite the fact that you never again have periods, your ovaries still discharge eggs and create estrogen and progesterone. In any case, a medical procedure that removes both your uterus and ovaries does cause sudden menopause. Your periods stop instantly, and you are probably going to have hot flushes and other menopausal signs and symptoms that might be serious as those hormonal changes happen unexpectedly rather than over months or years.
• The natural decay of reproductive hormones. As women approach their late 30s, their ovaries begin to make less estrogen and progesterone — the hormones that regulate monthly cycle – and their fertility decreases. In their 40s, their periods may turn out to be longer or shorter, heavier or lighter, and frequent, until eventually, all things considered, by age 51 —their ovaries quit delivering eggs, and they have no more periods.
• Primary ovarian insufficiency. Around 1% of women encounter menopause before age 40 (premature menopause). Menopause may result from primary ovarian insufficiency — when your ovaries neglect to create ordinary dimensions of reproductive hormones — stemming from genetic elements or autoimmune disease. However, generally no reason can be found. For these women, hormone therapy is recommended at any rate until the point that the normal period of menopause with the end goal to secure the brain, heart, and bones.

Psychological Symptoms:

• Dietary Changes
• Fatigue
• Thining of hair
• Dry skin
• Weight Gain

Cognitive Symptoms:

• Difficulty concentrating
• Memory lapses

Sexual Symptoms:

• Loss of libido
• Vaginal dryness
• Loss of breast fullness

 

Symptoms, such as the changes in menstruation, are distinctive for each woman. In all likelihood, you’ll encounter some abnormality in your periods before they end.

Skipping periods during perimenopause is normal and anticipated. Frequently, menstrual periods will skip a month and return, or skip a few months and then begin again for another few months. Periods also will generally occur on shorter cycles, so they are closer together. Even though menopause causes irregular periods, the chance of pregnancy is still a possibility. If you’ve skipped a period but aren’t sure you have started the menopausal change, consider a pregnancy test.

How menopause affects your sexual life?

The loss of estrogen and testosterone following menopause can prompt changes in a woman's body and sexual drive. Menopausal and postmenopausal women may see that they're not as easily aroused, and they might be less sensitive to touching and stroking. That can prompt less enthusiasm for sex. 

Additionally, reduced dimensions of estrogen can make a drop in blood supply the vagina. That can influence vaginal lubrication, making the vagina be excessively dry for agreeable sex -- however, there are solutions for that.

Other factors may play a role in a woman’s level of enthusiasm in sex during menopause and after. These factors include:

• Sleep disturbances
• Stress
• Bladder control issues
• Anxiety or depression

However, even though menopause may affect your sex drive indirectly, menopause does not lower sex drive in all women. Some postmenopausal women say they have an enhanced sex drive. That might be because of less anxiety connected to a dread of pregnancy. Additionally, numerous postmenopausal women frequently have less child-rearing obligations, enabling them to relax and appreciate closeness with their partners.

Vaginal dryness during menopause

During and after menopause, vaginal dryness can be treated with water-soluble lubricants, for example, Astroglide or K-Y Jelly. 

Try not to utilize non-water-soluble lubricants, for example, Vaseline, since they can weaken latex, the material used to make condoms. You or your partner should continue utilizing condoms until the point that your doctor affirms you're never again ovulating -- and to counteract getting an STD. Non-water-soluble lubricants can likewise give a medium to bacterial development, especially in a man whose susceptible system has been weakened by chemotherapy. 

Vaginal moisturizers like Replens and Luvena can likewise be utilized for immediate relief to rehydrate dry cells and help the vagina naturally moisturize. You can likewise converse with your doctor about vaginal estrogen treatment. 

An oral drug which is taken once every day, Osphena, makes vaginal tissue thicker and less fragile, bringing about less pain for women during sex. However, the FDA cautions that Osphena can thicken the endometrium (the lining of the uterus) and raise the danger of stroke and blood clots.

Menopausal Hormone Treatment

At menopause, a decrease in estrogen levels can cause women unique symptoms; for example, hot flushes, vaginal dryness, negative state of mind and sleep changes. If your symptoms are annoying you and you might want to find out about menopausal hormone therapy, you can find a medical expert to help you out in finding the best treatment for your symptoms and your hormone levels regarding the changes in your body and offer alternatives for dealing with your symptoms. 

Menopausal Hormone Therapy or MHT (also called Hormone Replacement Therapy or HRT) is the best method for reducing menopausal symptoms. MHT can likewise enhance your wellbeing by enhancing bone density and lessening the danger of fractures. MHT may also decrease the danger of stroke and heart disease for some women. On the off chance that you have had hormone-dependent cancer, you should not take hormone therapies. Talk with your doctor about other non-hormonal prescription drugs.

MHT is available as tablets, patches, gels or vaginal treatments. The type of MHT required and the related issues vary as indicated by your age, whether you have had a hysterectomy, and whether you have other health conditions. 

Your medical experts can provide you with the type of hormone therapy most appropriate to you. If you had early menopause you should proceed with treatment at least until the normal period of menopause (51 years).

Types of Menopausal Hormone Therapy

There are a few different plans and hormones accessible as MHT. These incorporate estrogen-only MHT, combined MHT, estrogen in addition to bazedoxifene and tibolone. 

You may need to try different types of menopausal hormone therapy before you discover which one suits you well.

Estrogen-only MHT

Estrogen-only MHT (also called unopposed estrogen replacement therapy) is only prescribed for women who have had a hysterectomy (removal of the uterus). That's because estrogen alone can build up the risk of cancer of the lining of the uterus (endometrial cancer). 

A progestogen (an engineered type of the female sex hormone progesterone) should be included into estrogen to ensure the appropriate lining of the uterus in women with an intact uterus. 

You should note that progestogens don't help relieve the negative symptoms of menopause.

Combined MHT

Combined MHT contains estrogen in addition to a progestogen. It tends to be given in 2 forms: cyclical or constant. 

Cyclical combined MHT is typically given in the event that you have menopause symptoms but are still getting periods or have not yet had an entire year without periods. It includes taking estrogen constantly and including progestogen for 10–14 days every month. Since cyclic combined HRT mimics your typical menstrual cycle, you ought to have a withdrawal drain (similar to a period) every month. 

Constant combined MHT is typically prescribed for women who have had more than an entire year without periods. It includes taking estrogen and progestogen consistently, yet the portion of progestogen is frequently lower than for cyclical combined MHT. You should not encounter bleeding once treatment is built up, which may take 3-6 months. 

Combination MHT is accessible as tablets and skin patches. On the off chance that you utilize an estrogen-only tablet or skin patch and you have not had a hysterectomy, you'll have to likewise take progestogen in some shape (tablets or IUD).

Tibolone

Tibolone is an option for women who have experienced menopause. It's a synthetic steroid, and acts like estrogen on some body tissues, however it acts like progesterone and testosterone on others. 

Tibolone might be less effective than combined MHT in relieving menopausal symptoms. In any case, it might diminish the risk of osteoporosis and help enhance sex drive and disposition. It isn't recommended for women who have had breast cancer. Tibolone may likewise increase the risk of stroke in women older than 60.

Estrogen with bazedoxifene

Estrogen in addition to bazedoxifene is a more up to date treatment option for women with moderate-to-severe hot flushes. It prevents osteoporosis and is less potent than MHT that contains estrogen and medroxyprogesterone.

Before starting MHT

Before starting to take menopausal hormone therapy, your medical expert will suggest a gynecological examination. They may also recommend an HPC and a mammogram.