Menopause
All women will at some stage go through the menopause.
While some women sail through with barely a warm moment some of us can literally feel like they are in hell, with no sleep, debilitating hot flushes/night sweats, not to mention feeling paranoid or angry most of the time. It's no wonder menopausal women have a reputation for being difficult to be around.
Overview
What is the Menopause
The word Menopause just means the last menstrual period.
Why do women have a Menopause
The pituitary gland in the brain produces follicle stimulating hormone (FSH) and luteinising hormone (LH) over time the ovaries become less able to respond to these hormones due to the decline of egg cells in the ovaries, this in turn stops the ovaries producing enough oestrogen and progesterone to stimulate the lining of the womb (endometrium). The endometrium stays thin and monthly periods (menstruation) ends.
Stages of the Menopause
Perimenopause
This is a very important stage, this is where a women is experiencing some if not all menopausal symptoms, but is still having either monthly or intermittent menstruation. This usually starts around the age of 45 (although that is just a guide and is very flexible).
Natural Menopause
A women has the maximum number of egg cells before birth and during the years these will decline, after the age of 40 there is a rapid decline and on average the UK woman will have her Menopause (last menstruation) around the age of 51.
Medical Menopause
Menopause can be brought on by medical conditions, either through hysterectomy, removal of the ovaries or by medical treatments for other conditions such as chemotherapy or radiotherapy.
Early/Late Menopause
The menopause is not set in stone, women can experience early menopause (before the age of 45), premature menopause (before the age of 40) and late menopause (after the age of 54). There is no real set rule but according to the ladies at menopausematters.co.uk “80% of women will have stopped having periods by the age of 54”.
Everlasting Menopause
There are a number of women experiencing this condition, although how many is disputed at the moment. Even though these women are postmenopausal the symptoms do not seem to subside and the women continue to suffer hot flushes, night sweats and the other conditions associated with the menopause well into their 60’s and even 70’s.
Post menopause
This is the medical term where a woman has not had monthly period (menstruation) for 12 months.
What is needed to help women thorough the menopause
Individual tailored advice is needed for women in this stage of their life as well as Menopause clinics, unfortunately, research is woefully under funded at the moment.
HRT is the main treatment offered for women suffering menopause symptoms although there are other treatments available, St Johns Wort is considered by many to help. Alternate options can be discussed with your doctor or the websites below can also help you decide if you want some further help or advice before you make that doctor's appointment.
British Menopause Society
Menopause Matters
NHS Choices: Menopause
Common Symptoms
Common symptoms
You Tube Videos about the Menopause
What you can do
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Eat plenty of oestrogen rich foods: broccoli, soy isoflavones, flaxseed lignans and omega-3 oils. In addition, B vitamins, vitamin D, SAMe (methionine), magnesium, N-aceytyl cysteine (NAC), glutamine, glycine and the herbs rosemary, turmeric or chrysin are known to decrease breast cancer risk by promoting healthy oestrone metabolism.
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Dress in layers
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Let people know (no one should feel alone)
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Do your research, there are plenty of websites available
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Speak to your doctor. Even if you decide against HRT there are many other treatments available
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Hot Flushes
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Night Sweats
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Weight gain
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Loss of shapeliness at the waist
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Headaches
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Heart Palpitations
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Insomnia
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Snoring
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Feeling tired all day long
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Memory lapses (foggy brain)
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Irritability, Mood swings
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Depression, Panic attacks
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Joint pain, Lower back pain
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Varicose veins
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Hair loss on the top of the head
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Strange dreams
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Indigestion
Most of these symptoms are linked to estrogen deficiency according to http://easyhealthoptions.com.
These symptoms can have a knock on effect with night sweats for example exacerbating Insomnia. Lack of sleep can leave you feeling tired with a foggy brain and make you irritable throughout the day. Also, if your sleep is constantly being disturbed it is difficult for your body to do essential cell repairs which mainly happen when you are in a deep sleep.
What are Hot flushes and night sweats? And why do we get them?
The body’s temperature as well as sex hormones, sleep cycles and your appetite is controlled by the part of the brain called the hypothalamus. As a woman’s menopause reduces oestrogen production this has a direct effect on the hypothalamus and confuses it. Everyone’s bodies have minor temperature fluctuations during the day and night, unfortunately when the hypothalamus is starved of oestrogen it can over react, even with a very minor temperature rise, it sends an urgent message to the bodies cooling system, the heart, blood vessels and nervous system to quickly reduce the body’s temperature. You start to sweat, blood is sent to the skin to dissipate heat bring down the core body temperature and your heart starts to pump faster. Many women report cold chills after a hot flushes because the body has cooled down unnecessary.
Also if the hypothalamus controls not only temprature but appetite it doesn't take a genious to see that a womans weight might also be affected as well as her sleep cycle and sex drive.
Latest research
Although not enough research is being done in this area, there was a clinical study carried out by the Department of Medicine, Indiana University in 2011(1). According to the report “The median duration of moderate to severe hot flushes was 10.2 years and was strongly associated with menopausal stage at onset.” There conclusion was “The median duration of hot flushes considerably exceeded the time frame that is generally accepted in clinical practice”.
According to breastcancer.org “Some women's skin temperature can rise six degrees Centigrade during a hot flush.”
HRT
HRT helps you cross the bridge that is the menopause it provides a small amount of hormones which levels you out a bit and and helps you in that transititon period.
Just for clarity, HRT is given as a transition drug releasing a small amount of hormones from perimenopause to a few years after post menopause, to help with menopause symptoms. Contrary to popular belief HRT doesn't delay symptoms of the menopause, it masks them, so time off from symptoms is just that, you will not be delaying the whole thing. HRT helps with hot flushes/night sweats thereby aiding sleep, and the estrogen helps improves your mood.
There are two main types of HRT generally perscribed by your GP:
Combination HRT; contains the hormones oestrogen and progesterone (2 strengths are available). These are manly prescribed for women who are still having menstruation or intermittent bleeds and will give you a period. Unlikely to be perscribed if you have had a period in the last 12 months.
Oestrogen-only HRT; which contains only oestrogen, is generally prescribed for women who are defined as Postmenopausel. This HRT does not give you a period and the doctors need to ensure that the lining of the uterus is thin enough for you to be prescribed this type of HRT.
Consult your doctor, and if this is the way you want to go do not take no for an answer, fight your corner, some doctors can be stubbon, but if you do your research, and are informed they should be OK about it. If not, change your doctor, there are plenty of doctors that will. Find a female doctor who specialised in women's issues is the best way to go. Although there are minor risks to HRT they have been over egged in the media.
The current thinking is that the benefit out ways the risk for women under 60. According to cancer.org “if 10,000 women took combination HRT containing the hormones oestrogen and progesterone for a year, this would add up to about 8 more cases of breast cancer per year than if they had not taken hormone therapy (HT). The longer HT was used, the more the risk increased”(2)
According to the American FDA out of 10,000 women taking combination HRT there will be:
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6 fewer cases of colon cancer
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5 fewer cases of hip fracture
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8 more cases of breast cancer
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7 more cases of heart attacks
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8 more cases of stroke
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18 more cases of blood clots in the lungs and legs
(1)http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3085137/
http://www.womens-health-concern.org/help/factsheets/fs_hrtrisksbenefits.html.
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Vaginal itching
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Vaginal dryness
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Loss of sexual interest
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Painful intercourse
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Urinary tract infections
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Frequent urination
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Urinary leakage
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Bloating and flatulence
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Osteoporosis
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Dizzy spells
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Hair growth on face
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Skin feeling crawly
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Dry or irritated eyes
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Wrinkles around eyes
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Vertical lines above the mouth
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Sore breasts
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Breasts that shrink or sag