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23 November, 2009

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Menopause

Menopause is the final menstrual (monthly) period in a woman’s life. It is a natural occurrence and marks the end of the reproductive years, just as the first menstrual period during puberty marked the start. Menopause is also known as ‘the change of life’. You will know that the menopause has taken place if you have not had any bleeding for 12 months.

Most women reach menopause between the ages of 45 and 55, the average being around 50. Menopause before the age of 40 is called ‘premature menopause’.

Hormone levels fluctuate as menopause approaches
As you approach menopause, the production of hormones (for example oestrogen) by the ovaries starts to slow down. Hormone levels tend to fluctuate up and down, however, and you may notice changes in your menstrual cycle. For example:

Cycles may become longer, shorter or totally irregular
Bleeding may become lighter
Bleeding may become unpredictable and heavy (seek advice from your doctor).

Eventually your hormone levels will fall to a point where menstruation (periods) will cease altogether and the menopause is reached.

Although fertility after the age of 45 is low, you still need to use contraception (even if only barrier contraception such as male or female condoms) until you have had one year without a natural period.

Other signs and symptoms
The most common symptom of menopause is the hot flush. Women sometimes experience other symptoms, which may include:

Night sweats
Aches and pains
Crawling or itching sensations under the skin
Forgetfulness
Headaches
Irritability
Lack of self-esteem
Reduced sex drive (libido)
Sleeping difficulty
Tiredness
Urinary frequency
Vaginal dryness.

Long-term health risks
A decrease in female hormones after menopause may lead to:

Thinning of the bones (osteoporosis) and an increased risk of fractures
An increase in the risk of heart attack and heart disease, high blood pressure and stroke.

Managing the menopause
Unpleasant symptoms of the menopause can often be greatly reduced by improving your lifestyle habits. A healthy diet and regular exercise can help you manage your menopause symptoms.

Healthy diet
Suggestions for managing menopause symptoms through diet include:

Choose a wide variety of foods, including plenty of fresh vegetables, fruits, cereals, whole grains and small portions of lean meat, fish or chicken several times a week.
Increase fluids and eat low fat dairy foods with high calcium content.
Decrease caffeine and limit alcohol (aim for 1–2 standard glasses or less per day).

Exercise
Regular exercise is important. At least 30–45 minutes on most days of the week will:

Maintain your heart health and improve your general health
Keep your bones healthy and prevent bone loss through osteoporosis
Help maintain good balance and reduce the risk of injury from falls
Provide a feeling of relaxation and wellbeing
Possibly help improve hot flushes.

Understand your body’s changes
It is important to understand the changes your body is going through during menopause. There are many different sources of information available. Make sure you seek out credible websites and brochures that provide up-to-date, non-biased information from organisations that specialise in women’s health.

Avoid smoking
It’s important to avoid smoking because of the associated risk of osteoporosis, coronary heart disease and lung cancer (which may soon exceed breast cancer as the leading cause of death in women). For help to quit smoking, call the Quitline on 131 848.

Think positive
Some women experience mood changes such as mild depression and irritability. These symptoms are often related to physical changes such as hot flushes, night sweats and poor sleeping. It’s important to keep a positive outlook. Consult with your health practitioner or a psychologist if you are experiencing any significant or persistent changes in mood.

Regular Pap tests and breast checks
You should have:
Two-yearly Pap tests – see your doctor.
A two-yearly mammogram – this is a free, Australia-wide service for women over 40. Contact BreastScreen Australia on 132 050 for more information.

Hormone replacement therapy (also known as hormone therapy)
Hormone replacement therapy (HRT) effectively reduces many of the unpleasant effects of symptoms of the menopause and may be appropriate for short-term use in women with moderate to severe menopausal symptoms. Discuss the advantages and disadvantages of hormone therapy with your doctor.

If you are one of the 10 per cent of women who have severe symptoms lasting 10 years or more, you may continue longer term use of HRT. It is important to have a check-up once a year to assess the specific risks and benefits you may experience as a result of the therapy.

Natural therapies
These can be of benefit to some women. It is important to remember that ‘natural’ herb and plant medications can have unpleasant side effects in some women, just as can prescribed Western medications. A registered naturopath may provide long-term guidance and balance through the menopausal years.

Natural therapies can often be taken in conjunction with hormone therapy. It is important to let both your doctor and naturopath know exactly what each has prescribed and to consult your doctor before taking any herbal treatments or dietary supplements. Some natural therapies may affect or interact with other medications you may be taking.

Where to get help

The Jean Hailes Foundation Tel. 1800 151 441
Your doctor
Your local community health service
Specialised women’s health clinic
BreastScreen Australia Tel. 132 050
Quitline Tel. 131 848

Things to remember

Menopause means the end of monthly periods.
You may experience a range of symptoms.
A healthy lifestyle will help to manage symptoms.
You should have regular breast checks and Pap tests.
Mammogram screening is free if you are over 40.

You might also be interested in:
Food and your life stages.
Libido - relationship issues.
Libido – medical issues.
Menopause - hormone replacement therapy.
Menopause - premature (early) menopause.
Menopause and complementary therapies.
Menopause and osteoporosis.
Menopause and sexual issues.
Menopause and weight gain.
Menstrual cycle.
Nutrition - women's extra needs.
Pap tests and older women.
Pap tests explained.
Pap tests for all women.
Reproductive system.

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