Menopause is the time that marks the end of your menstrual cycles. It’s diagnosed after you’ve gone 12 months without a menstrual period.
Most women reach the menopause between the ages of 45 and 55, although an estimated one in 100 will experience menopausal symptoms below the age of 40, which is generally termed ‘premature menopause. Most signs and symptoms of menopause include, difficulty sleeping, poor concentration, loss of libido, headaches, memory problems, depressed mood and general aches and pains (for example, joint pain). Hot flashes are reported to be one of the common and most distressing symptoms experienced by women. These occur in over 75% of menopausal women and are often described as episodes of recurrent flushing, sweating, and an intense heat that begins on the face and upper chest. These episodes vary widely in frequency and duration, some women experiencing them several times each day, others less frequently. Menopause transition is a progressive process and consists of fluctuating ovarian function, which occurs two to eight years before menopause and up to one year after the final menses, culminating in ovarian failure (Perry, 2019).
Symptoms vary from person to person:
• Irregular menstrual cycles
• Heavy bleeding might occur for a day or two
• Excessive sweating during night
• Hot flashes
• Vaginal dryness, itching and pain during sexual intercourse
• Frequent urinary tract infections
• Mood swings
• Weight gain due to uneven fat distribution
CHANGES IN SKIN
Collagen as the key protein in the skin and bones; it significantly contributes to the thickness and resilience of the skin, forms the bulk of the dermal tissue, and its depletion results in thinning, laxity and dehydration. The greatest loss of collagen occurs in the early post-menopausal years; it is estimated that as much as 30% of skin collagen is lost within the first 5 years. Peptide-based products can repair the skin and reinforce firmness and tone around the eye area. The application of skin care containing alpha hydroxy and poly hydroxy acids increases epithelial cell turnover and resurfacing the skin. Antioxidants can also prevent damage from free radicals and oxidative stress, in turn delaying premature ageing of the skin (Warren, 2014).
Menopause requires no medical treatment. Instead, treatments focus on relieving your signs and symptoms and preventing or managing chronic conditions that may occur with aging.
- Eat a balanced diet of fruits, vegetables and whole grains. Limit saturated fats, oils and sugars. You may need calcium or vitamin D supplements to help meet daily requirements.
- Get enough sleep.
- Avoid caffeine, which can make it hard to get to sleep, and avoid drinking too much alcohol, which can interrupt sleep.
- Avoid smoking. Smoking increases your risk of heart disease, stroke, osteoporosis, and cancer.
- Regular physical activity or exercise to help protect against heart disease, diabetes, osteoporosis and other conditions associated with aging.
- Add soy to your diet.
Estrogen deficiency after menopause promotes weight gain and fat accumulation in the waist region which ultimately leads obesity in some post-menopausal women. Numerous studies have shown beneficial effects of soy isoflavones against the inflammatory associated cardiovascular diseases and accelerates endocrine and metabolism predisposing to obesity in postmenopausal women (Sankar, et al., 2017).
- Treatments may include:
- Hormone therapy. Estrogen therapy is the most effective treatment option for relieving menopausal hot flashes. Depending on your personal and family medical history, your doctor may recommend estrogen in the lowest dose and the shortest time frame needed to provide symptom relief for you. If you still have your uterus, you’ll need progestin in addition to estrogen. Estrogen also helps prevent bone loss. Long-term use of hormone therapy may have some cardiovascular and breast cancer risks, but starting hormones around the time of menopause has shown benefits for some women. You and your doctor will discuss the benefits and risks of hormone therapy and whether it’s a safe choice for you.
- Vaginal estrogen. To relieve vaginal dryness, estrogen can be administered directly to the vagina using a vaginal cream, tablet or ring. This treatment releases just a small amount of estrogen, which is absorbed by the vaginal tissues. It can help relieve vaginal dryness, discomfort with intercourse and some urinary symptoms.
- Low-dose antidepressants. Certain antidepressants related to the class of drugs called selective serotonin reuptake inhibitors (SSRIs) may decrease menopausal hot flashes. A low-dose antidepressant for management of hot flashes may be useful for women who can’t take estrogen for health reasons or for women who need an antidepressant for a mood disorder.
- Gabapentin (Neurontin, Gralise, others). Gabapentin is approved to treat seizures, but it has also been shown to help reduce hot flashes. This drug is useful in women who can’t use estrogen therapy and in those who also have nighttime hot flashes.
- Clonidine (Catapres, Kapvay, others). Clonidine, a pill or patch typically used to treat high blood pressure, might provide some relief from hot flashes.
- Medications to prevent or treat osteoporosis. Depending on individual needs, doctors may recommend medication to prevent or treat osteoporosis. Several medications are available that help reduce bone loss and risk of fractures. Your doctor might prescribe vitamin D supplements to help strengthen bones.
Fact or Fiction:
Can Calcium and Vitamin D prevent osteoporosis in post-menopausal women?
Calcium and Vitamin D are the most widely used therapies for Osteoporosis. The Efficacy of use of Calcium and Vitamin D in all post menopausal women in terms of the prevention of fracture is uncertain. Use of calcium and vitamin D supplements is very common, with more than half of postmenopausal women taking them.
In the video below, Katie Couric discusses if calcium and vitamin D supplements can benefit post-menopausal women with Dr. Rebecca Brightman, MD OB/GYN
Every woman is unique and may not experience the same menopause symptoms.
Talk with your Doctor to Discuss the treatment plan that works best for your individual needs.
Perry, M. (2019). Menopausal symptoms and hormone replacement therapy. Journal of Community Nursing, 33(3):61-66.
Warren, L. (2014). Treating the menopausal patient: the role of hormones and physiological changes. Journal of Aesthetic Nursing, 3(7):322-330.
Sankar, P., Bobby, Z., & Mirza, A.A. (2017). Soy Isoflavones (from Glycine max) in Menopause Health and Diseases. Biochem Physiol 6: 225.