Understanding menopause

Menopause is not a disease, but that does not mean women should simply suffer through it

Dr Tendai Zuze
Health Matters
AUGUST is widely recognised as a month for focusing on women’s health, making it a good time to talk about menopause.
Menopause is a normal stage of life that every woman eventually goes through, but for some, the symptoms can significantly affect sleep, work, relationships and general quality of life.
Menopause is not a disease, but that does not mean women should simply suffer through it.
Menopause occurs when the ovaries gradually stop producing eggs and oestrogen levels fall.
A woman is considered to have reached menopause after 12 consecutive months without a menstrual period. The transition leading up to this is called perimenopause and can last several years.
Most women experience menopause between 45 and 55 years of age.
The first obvious change is often the menstrual cycle. Periods may become irregular, heavier or lighter before eventually stopping.
But menopause can cause much more than changes in periods. Hot flushes and night sweats are common, as are poor sleep, tiredness, headaches, mood changes, anxiety, difficulty concentrating and what many women describe as brain fog.
Some women develop joint and muscle aches.
Falling oestrogen can also cause vaginal dryness, discomfort during sex, reduced sexual desire and urinary symptoms.
There is a lot that can be done to make this transition easier.
Regular exercise is important, particularly weight-bearing and resistance exercise, because it helps maintain bone strength and also benefits sleep, mood and cardiovascular health.
A balanced diet with adequate calcium and vitamin D is important. Maintaining a healthy weight, avoiding smoking and keeping alcohol intake low are also worthwhile.
Women should also take this opportunity to monitor their blood pressure, blood sugar and cholesterol, as cardiovascular risk increases with age and after menopause.
Hot flushes can sometimes be reduced by identifying personal triggers.
Hot weather, warm rooms, spicy foods, caffeine, alcohol and stress can make symptoms worse in some women. Keeping the bedroom cool and wearing light clothing can help with night sweats.
For women whose symptoms are troublesome, hormone replacement therapy (HRT) can be very effective, particularly for hot flushes and night sweats. It replaces some of the hormones the body is no longer producing.
However, it is not suitable for everyone and should be considered individually, taking into account age, symptoms, medical history and personal risks.
Women who have a uterus generally need both oestrogen and a progestogen, while those who have had a hysterectomy may be able to use oestrogen alone.
Women who cannot or do not want to use HRT have other options.
There are non-hormonal treatments for some symptoms, while vaginal moisturisers and lubricants can help with dryness and discomfort.
Low dose vaginal oestrogen can also be very effective for urinary and vaginal symptoms in appropriate women.
In our environment, it is also important to be cautious about herbal remedies marketed as natural treatments for menopause. Natural does not automatically mean safe, and the strength and contents of some preparations are uncertain.
They can also interact with prescribed medicines.
Menopause is therefore not something women should be embarrassed about or simply endure. It is a normal transition, but troublesome symptoms deserve attention.
This stage of life is also an opportunity to take better care of overall health through exercise, good nutrition, appropriate screening and regular medical checks.
Menopause is therefore not the end of a woman’s health or productive life. It is simply another stage of life, and with the right information and support, most women can go through it well.