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The average age for the onset of menopause is 45 years old. There are however some women who go through menopause in their late 30s while others remain fertile up to 50. One woman in Los Angeles is well documented as having given birth to a baby daughter at the age of 57 years in October 1976.
Women usually associate the onset of menopause with what they term “hot flushes,” whereby they sweat a lot. The cessation of menstrual periods may take up a year to be confirmed and the menopause may begin in several different ways. At the simplest, the regular monthly periods just stop. An expected menstrual period fails to come again and no period ever comes again. In some cases, the interval between the periods, normally 28 days or so, becomes gradually longer and longer, until eventually they no longer occur. In some women the amount of menstrual flow may gradually dwindle until flow ceases entirely.
If menopause does not happen in the ways mentioned above, then women should report it to their doctors immediately. Menstrual periods should never occur after the menopause, if bleeding does reappear suddenly after a couple of years this is not simple menstruation which has returned, but bleeding due to an abnormality of the womb which requires treatment. Every woman should remember that after menopause, cancer of the womb occurs quite frequently. The earlier the cancer is diagnosed the better are the chances of success in treatment.
In terms of “hot flushes” mentioned above, there are simply transient feelings of heat, accompanied by sometimes a visible blushing of the skin, usually occurring in exposed areas of the body, such as the face and neck but sometimes spreading over the whole body. This is sometimes accompanied by profuse perspiration.
These phenomena are due to lowered levels of oestrogen circulating in the body. Oestrogen normally has a role in keeping the body cool by causing the expansion of small blood vessels in the deeper layers of the skin, so that more blood passes into the skin and is cooled by the air passing over it.
When insufficient oestrogen is available to cause this response to anything which causes the body to become overheated, an alternative method of cooling must be employed, under the influence of the nerves in the skin the more superficial blood vessels suddenly expand. Because these are the vessels which normally cause blushing, the whole skin suddenly becomes pink, and may feel hot and perspire so that heat is dissipated.
“Hot flushes” can be caused by excitement, exercise, eating or emotional tension all which can cause an increase in the amount of heat produced by the body. Such factors as warm weather, excessive clothing or bedclothes which are too heavy and hamper the normal loss of heat from the body surface may also cause “hot flushes.”
Symptoms associated with menopause include nervousness, irritability headaches, insomnia, inability to concentrate, spells of anxiety and depression and overall decline in the normal feelings of mental and bodily well-being. Such disturbances naturally affect some women more than others. Only a very small proportion of women need psychiatric help to see them through, but for these women, menopause may well be a traumatic experience.
Men should also be aware of these changes of their partners’ lives and should render moral support. There is often a short period when menopausal women develop loss of sexual desire and their partners should equally understand this. This is often a result of the psychological changes outlined above. It is unfortunate that too many women instinctively regard menopause as the end of a vital part of their life and as a diminution of themselves as women. Menopause must be taken positively as it marks a new phase in women’s lives, which provides an opportunity for a reinforcement and extension of the emotional bond between partners.
Women should also share with their partners the problems and difficulties they experience during menopause. Sexual relationships should not end with menopause but should be even more exciting as there are fewer worries about young children and getting pregnant again. During menopause, a large number of men rediscover the delight of having their wives undivided love and attention. This should be a period where couples should celebrate the tests of marriage over the years and enjoy the fundamental freedom it brings
* Vaidah Mashangwa is the provincial development officer for Bulawayo in the Ministry of Women Affairs, Gender and Community Development. She can be contacted on 0772 111 592/09 889 224
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