Menopause

How it shows

The female body is set up for a regularly repeating, cyclical supply of sex hormones. When their production falls and a shortage arises, the change of life, or climacteric, begins. Disorders of the menstrual cycle occur. The cycle may be irregular, and periods last for different lengths of time and vary in heaviness. Over time, periods stop completely and the menopause occurs.

Hot flushes are also among the typical symptoms. Fluctuating hormone levels lead to feelings of heat, tension, flushes and weakness. Blood pressure often fluctuates, accompanied by headaches or feelings of malaise and fatigue. Because brain functions are also affected by hormone levels, a woman going through the change may experience irritability, insomnia, nervousness, restlessness and mood swings.

A significant problem is the increased incidence of vascular and heart disease in menopausal women, especially ischaemic heart disease. Female sex hormones act as a kind of protector of the blood vessels during a woman's reproductive years. That is why, up to the age of fifty, heart and vascular diseases are more common in men. In the menopause, however, after the level of female sex hormones falls, the situation changes and the risk of a heart attack or stroke in women rises sharply.

The effect of the menopause on a woman's reproductive organs leads to more frequent bacterial infections and inflammation. There may be unpleasant sensations and pain when urinating, unpredictable leakage of urine, and the breasts may shrink and lose their firmness.

Another factor associated with the menopause is a change in the way fat is stored. It begins to accumulate outside its typical locations in women, and the number of obese women increases significantly. The increased storage of fat is also linked to a frequent rise in cholesterol and other fats in the blood, which increases the risk of heart and vascular disease.

A major problem associated with the change is a change in bone quality. As a result of hormonal changes, total bone mass decreases. Loss of calcium can develop into thinning of the bones, so-called osteoporosis. This is associated with pain in the back, the weight-bearing bones, the limbs and so on. This pain is considerably bothersome, long-lasting and difficult to influence. If osteoporosis is not treated correctly and in time, so-called pathological fractures can occur in the course of the condition after falls that would not normally cause them.

How to ease these problems

Most of the problems associated with the change are due to a reduced level of sex hormones. Logically, therefore, one option is to bring these needed hormones into the woman's body from outside. This step is called hormone replacement therapy. However, even this treatment is not without risk and has its pitfalls. The decision to start it must always be made by a gynaecologist. Before hormone replacement therapy is started, a gynaecological examination and a mammogram must be carried out.

The most modern hormonal preparations are low-dose, which means that at low doses of hormone they have the maximum effect on all the accompanying phenomena of the menopause. At present it is recommended to start low-dose cyclical HRT already at the beginning of the climacteric, which induces regular periods and eases or completely removes the symptoms described above. Later it is possible to switch to low-dose continuous (uninterrupted) hormone replacement therapy, in which periods no longer occur. Consult your gynecologist about the suitability of hormone replacement therapy and the choice of a suitable preparation.

It is also possible to use natural remedies containing herbal extracts, so-called phytoestrogens. Their effects are weaker, but they are completely harmless and sufficient for many women.