A woman’s reproductive years, that is the period she can ovulate, get pregnant, and have children is not indefinite. It has a fixed time period which varies for different women. However, it starts from puberty and ends at menopause for all women. Menopause is characterized by cessation of ovulation. This will also lead to cessation of the menstrual cycles. It marks the end of the reproductive career of a women.
Menopause is often defined as a time period, and is usually viewed as three events. The first is the peri-menopausal period which marks the beginning of menopause. The early symptoms of menopause begin to show here. It starts as scanty menstrual flow which are far in between, and gradually gets scantier and less frequent until it eventually stops. The menopausal transition most often begins between ages 45 and 55. It usually lasts about seven years but can be as long as 14 years. The duration can depend on lifestyle factors such as smoking, age it begins, and race and ethnicity. During perimenopause, the body’s production of estrogen and progesterone, two hormones made by the ovaries, varies greatly. The person is then said to be menopausal if the menstrual period does not occur after 12 full months. This is the second phase. The third phase is the post-menopausal phase which is any period after actual menopause has occurred.
The natural menopausal period usually starts after the age of 40 years, though the actual age may differ. In some women however, menopause can occur before the age of 40 and is described as premature ovarian failure. This is not normal and can be due to certain disease states or surgeries where the ovaries and uterus are removed.
Because the ovaries which are responsible for ovulation, also secrete the hormones progesterone and estrogen, there are other changes that accompany menopause which is related to the decline in the function of the ovary to secrete these hormones.
The health problems associated with menopause can be grouped as:
Symptoms attributable to the menopausal process itself. They are:
- Irregular periods which can be confusing and distressing, they are however usually lighter periods, not heavier periods
- Vaginal dryness which can result in itchy and discomfort in the vagina. This, together with the decreased ability to lubricate naturally during sex can affect the sexual enjoyment of the woman. Healthy lubricants can be used to enhance sexual enjoyment during this period as the woman
- Hot flashes which can be very discomforting. Severe cases are often associated with poor quality of life or maladjustment problems. There are medical treatments for such severe cases
- Night sweats
- Sleep problems, usually poor sleep and difficulty falling asleep or maintaining more than 5 hours of sleep
- Mood changes, depression, sadness, low mood
- Weight gain and slowed metabolism
- Thinning hair and dry skin
- Loss of breast fullness and sagging breasts
The other health problems are as a result of increased risk of certain diseases
Higher risk of heart disease and stroke. Predisposing factors like higher cholesterol, high blood pressure, more belly fat, are often increased around this time.
Bone thinning (osteoporosis). The bone naturally gets thinner with age. This increases around menopause, and is linked to ovaries making less estrogen. This predisposes menopausal women to issues like fractures and osteoarthritis.
Diabetes. The risk for getting prediabetes and type 2 diabetes increases with age. This may be higher in obese people, people that do not exercise (sedentary people), and people with a family history of type 2 diabetes.
Thyroid problems. The peri-menopausal and menopausal period can also predispose women to hypothyroidism.
Even though these health problems can be distressing, they can be successfully managed and one can have a hassle-free menopausal period.