What’s going on with your body?
For some women, the absence of a monthly cycle when they first start menopause is a relief, but for others, it presents a whole new set of issues for them to deal with. While every woman’s experience is different, all can usually agree that it isn’t an overly pleasant one. What is going on in your body? Can you do anything to manage the symptoms?
Definition
Menopause is a naturally occurring process that signifies the end of a woman’s menstrual cycles. It usually happens in your 40s or 50s due to a natural decline in hormone production. Your ovaries make estrogen and progesterone and as you age, the amount that is produced decreases until eventually there isn’t enough being produced to support the formation eggs. This is why after you go through menopause you don’t have a menstrual cycle any more. It is diagnosed after you’ve gone 12 months without one. During the process, some women have irregular cycles with skipping some, having them more frequently or having them closer together. It is important to note that because of this fluctuation, it is possible to get pregnant. Besides irregular cycles, some symptoms can include vaginal dryness, hot flashes, chills, night sweats, mood changes, weight gain, slow metabolism, thinning hair, dry skin and loss of breast fullness.
It is possible to have menopause start for reasons other than the natural decline of hormones. If you have a full hysterectomy (removal of uterus and both ovaries), you will have immediate menopause. If you have a partial hysterectomy (only removal of uterus), you don’t go through this because your ovaries are still making estrogen and progesterone. Chemotherapy and radiation therapy to treat cancer can cause menopause to occur. However, in these cases, it isn’t always permanent. Another possibility is a condition called primary ovary insufficiency, which is when your ovaries fail to produce enough hormones to sustain normal levels. This is can be a cause if you experience menopause before the age of 40 and is thought to be caused by genetic factors or an autoimmune disorder.
Treatment
Since it is typically a naturally occurring process, menopause doesn’t require treatment. Instead, the focus is on relieving the symptoms and managing conditions that can occur as the result of your body going through menopause. Hormone replacement therapy is the most common method and is when you replace the estrogen and, in some cases, the progestin that is lacking. This helps to reduce hot flashes (the most common symptom). Estrogen replacement also helps to minimize bone density loss. Some women are unable to take replacement hormones, so your doctor may prescribe a low-dose SSRI (selective serotonin reuptake inhibitor) antidepressant, gabapentin or clonidine to help with the hot flashes. Your doctor may also prescribe medication to prevent or treat any osteoporosis, especially if you can’t take hormone replacement medication. Sometimes, hot flashes are triggered by certain things, such as hot beverages, alcohol, caffeine or hot weather. If you can pinpoint a trigger for your hot flashes, you can try to avoid them. Besides doing this, you can dress in layers, that way you can take some off if you get too hot or if it is hot outside, go inside to a cooler environment.
Besides the bone loss that occurs when your estrogen levels drop, you become at increased risk for cardiovascular problems. Also, your metabolism slows. This is why it is important to exercise regularly, eat healthy and inform your doctor if anything changes with your body. Urinary incontinence becomes more prevalent due to the decrease of elasticity in the tissue of your urethra and vagina because of the decreased estrogen levels. It is a good idea to practice strengthening your pelvic floor muscles by doing Kegel exercises. If you are having severe incontinence, your doctor can provide some guidance in finding a solution to minimize it. Another common complaint is vaginal dryness, which can be treated by administering an estrogen-containing cream, tablet or ring directly into the vagina.
Prevention
Unfortunately, menopause is a natural part of aging for women, so there is no way to prevent it. By managing your symptoms and knowing your triggers, you can decrease the severity of your discomfort. The key thing to prevent are the complications that can arise from conditions that result from the changes that occur in menopause, such as increased risk of cardiovascular problems or loss of bone density.
Menopause isn’t something that most women look forward to going through. The nice thing to know is that you aren’t the only one experiencing it and it will get better. If you have any questions or concerns about it, please speak with your doctor. If you would like more information, please visit the Office of Women’s Health Menopause page at https://www.womenshealth.gov/menopause/