Menopause: “the change of life”

According to global health reports, an estimated 1,2 billion women are more likely to be menopausal or post-menopausal by 2030.

In Latin, “meno” means month and “pause” means stop. Menopause is defined as the last normal menstrual period in womanhood. Affectionately known as “the change of life”, menopause is a natural biological process for women.

Clinically, menopause is confirmed after a 12-month absence of normal menstrual cycles. It may start anywhere from the 40s to the early 50s. But generally starts between 47 and 53 years.

Of note, symptoms of menopause are different for every woman.

And prior to menopause, vaginal dryness, hot flashes, chills, night sweats, sleep problems, mood changes, weight gain, dry skin and loss of breast fullness are very common.

More often, menstrual periods will skip a month and return, or skip several months and come again for a few months.

Periods become closer together, happening on shorter cycles. Pregnancy is very possible despite irregular periods.

As such, a pregnancy test must be considered after skipping a period especially if a woman is not sure of the menopausal transition.

Biblically, Sarah and Elizabeth were healed after they had reached their “change of life” and bore children.

Fortunately, a variety of effective treatments are available. These include lifestyle adjustments to home therapy.

Menopause is usually caused by a natural decline of reproductive hormones, hysterectomy, primary ovarian insufficiency, chemotherapy and, or radiation therapy.

Natural decline of reproductive hormones is the primary cause of menopause.

As a woman approaches late 30s, ovaries start making less oestrogen and progesterone – menstruation regulating hormones – and fertility declines.

In the 40s, menstrual periods may become longer or shorter, heavier or lighter, and more or less frequent.

By the age of 51 on average, ovaries stop producing eggs and periods eventually vanish.

Hysterectomy refers to the partial or total surgical removal of the uterus.

With partial hysterectomy, ovaries remain in situ and menopause does not follow immediately.

Although periods inevitably disappear, ovaries continuously release eggs and produce oestrogen and progesterone.

Surgically, a total hysterectomy immediately induces menopause. This is due to the removal of the uterus and ovaries.

As soon as the periods stop, women often experience signs and symptoms of menopause.

Hysterectomy-induced menopause is often severe, owing to the abrupt hormonal imbalances.

Primary ovarian insufficiency usually stem from genetic factors or auto-immune disease. Auto-immune disease is a condition in which the body’s immune system attacks healthy cells.

According to research, about one percent of women reportedly experience menopause before 40 years of age.

When ovaries fail to produce normal levels of reproductive hormones, premature menopause may result.

Normally, hormone therapy is exclusively prescribed until the natural age of menopause. Hormone therapy is expertly recommended to protect the brain, heart and bones.

Chemotherapy and radiation therapy can cause menopause.

Cancer therapies can cause symptoms of menopause such as hot flashes during or shortly after treatment.

However, the halting of menstruation is not always permanent. And birth control measures may still be desired.

Cardio-vascular diseases, osteoporosis, urinary incontinence, sexual dysfunction and weight gain are some of the complications of menopause. Cardiovascular diseases refer to physiological disorders of the heart and blood system.

Across the globe, heart disease is the leading cause of death in both men and women. Physiologically, the reduction in oestrogen levels exposes women to heart diseases.

Regular exercises, a healthy diet and maintaining a normal body weight will probably reduce complications of menopause.

Osteoporosis is a medical condition that causes bones to become brittle and weak.  Usually, there is rapid loss of bone density a few years after menopause. So the chances of developing osteoporosis highly increase.

Consequently, post-menopausal woman are exposed to fractures of the spine, hips and wrists.

On the face of it, calcium supplements are particularly prescribed to strengthen bones. Calcium intake can alternatively increase by eating spinach, milk, cheese, orange juice and white beans.

Urinary incontinence is the frequent, sudden and strong urge to urinate. It is usually a sign of loss of vaginal and urethral elasticity.   

Strengthening pelvic floor muscles with Kegel exercises and using a topical vaginal oestrogen may help relieve symptoms of incontinence.

Similarly, hormone therapy can be an effective treatment option for menopausal urinary tract and vaginal changes which can lead to urinary incontinence.

Sexual dysfunction is often a result of vaginal dryness and loss of elasticity. Dryness and loss of elasticity can cause discomfort and slight bleeding during sexual intercourse.

Naturally, decreased sensation may reduce the desire for sexual activity. Water-based vaginal moisturisers and lubricants may help significantly in this case.

Weight gain during the menopausal transition is typically related to slowed metabolism.

Essentially, eating less and exercising more will possibly help maintain the desired weight.

It is evident that menopause can be a stressful transition. However, it is not all doom, gloom, and despondency.

Interestingly, some women reportedly experience an enhanced sense of well being and enjoy opportunities to pursue goals postponed because of child rearing.

Therefore, recommended lifestyle changes can significantly help relieve symptoms and improve quality of life during menopause transition.

Accordingly, women must quit smoking. Smoking tobacco is associated with early menopause.

Concurrently, alcohol must be limited. Research has scientifically proven the link between alcohol consumption of more than three alcoholic drinks per day to breast cancer.

Equally, a low-salt, low-fat, low-sugar, high fibre diet, with fruits and vegetables is highly recommended to prevent common complications of menopause.

Coupled with exercises, dietary measures essentially help to reduce the risk of developing severe signs and symptoms.

Eventually, menopause is neither a disease nor a state of being not well, but, “just a normal age-related physiological transition”.

Everisto Mapfidze is a registered general nurse who holds a Bsc Honours in Sociology (UZ). For feedback: [email protected]