Menopause

Menopause (or literally ‘the last period’) normally occurs between the ages of 45 and 55 and starts when the ovaries gradually stop developing eggs and there is a progressive decline in hormone levels, most notably, oestrogen.  Menopause symptoms can begin gradually over two to six years before the last menstrual period. Perimenopause is the time when periods fluctuate until they stop.

Not all women suffer from signs of menopause, in fact 20 per cent have no symptoms. Some 60 per cent have mild symptoms, while only 20 per cent suffer severe symptoms.

Menopause encompasses a range of physical and emotional symptoms and changes in the body, due to the decrease in the hormone oestrogen.

Some physical symptoms that occur with the onset of menopause include:

• irregular menstrual periods 
• hot flashes 
• night sweats 
• disturbed sleep patterns 
• vaginal dryness and shrinkage of genital tissues, sometimes resulting in discomfort or pain during sexual intercourse 
• dry skin 
• more frequent urination or leakage of urine

The physical and external changes that are occur at this stage can result in emotional and psychological stress.

Psychological symptoms may include:

• anxiety 
• depression 
• tearfulness, irritability 
• sleeplessness 
• less desire for sex 
• lack of concentration 
• more trouble remembering things

MANAGEMENT

Menopause is a natural progression in life cycle and may not need any treatment at all, however, because hormone levels are lower, the risk of heart disease and osteoporosis increases.

The following lifestyle tips may be useful for general mental and physical well being during menopause:

• Eat more foods that are high in calcium, such as dark green vegetables and non-fat (skim) milk and dairy products 
• have plenty of fresh vegetables, fruits, cereals and whole grains
• drink six to eight glasses of water daily 
• decrease intake of caffeine (coffee, tea, cola, chocolate) 
• limit alcohol to one to two standard glasses, or less, per day 
• include lean meat, fish or chicken in your diet 
• phytoestrogens (plant oestrogens) replace some natural oestrogens lost during menopause, and may reduce symptoms, cholesterol and blood pressure. Good sources include soy and linseed bread, soy beans, tofu, whole grains and legumes.
• Reduce saturated fats in your diet. Check labels for product content before you buy them 
• Get regular physical exercise. Exercise will help you fight depression and maintain good circulation, mobility, bone density, and a sense of wellbeing 
• Keep using birth control during sexual intercourse to avoid pregnancy as the onset of menopause does not mean that you won’t get pregnant.
• Wear cotton sleepwear to reduce discomfort from night sweats 
• Use a vaginal lubricating cream or jelly if intercourse is painful. This problem is usually caused by a lack of oestrogen and should be discussed with your healthcare provider 
• Talk and share feelings with a friend or family member who understands what you are experiencing 
• Join a support group for women who have been or are going through menopause 
• Have regular pap smears and mammograms (free when over 40yrs) 

Hormone therapy (HT) (also known as hormone replacement therapy – HRT)

Hormone therapy can help relieve the symptoms of menopause, but no treatment is without side effects.  Any decision about HT is an individual one, so talk to your health practitioner about risks, benefits, concerns and other alternatives. It is important that all women using HT be reviewed once a year by their health practitioner

Natural therapies

Women often use natural therapies to manage menopause symptoms.  See a qualified naturopath for long-term guidance, as some natural herb and plant medications can have side effects.  Natural therapies can often be taken in conjunction with HT, but it’s important to let both your health practitioner and naturopath know exactly what each has prescribed.

References:

Better Health

Jean Hailles Foundation for Women’s Health:

• Fact sheet – Menopause
• Multilingual fact sheets
• Fact sheet – Perimenopause

Managing Menopause: Midlife and Beyond

Early Menopause

Women's Health Queensland Wide