Menopause

Menopause is sometimes known as the ‘change of life’, and is
defined as the ending of menstruation (when a woman’s periods
stop).

DESCRIPTION

Menopause is the end of egg production (ovulation). This
occurs as a result of declining levels of the female sex hormone,
oestrogen, which regulates menstruation. The ovaries also start to
make less of other hormones such as progesterone and
testosterone.

 

A woman’s periods usually become less frequent or irregular,
rather than stopping suddenly. A woman is said to have reached
Menopause after an absence of periods for one year. After this
point, a woman is considered to be in her post-menopausal stage of
life. The time leading up to Menopause is known as
peri-menopause.

• Perimenopause: The hormonal changes associated with Menopause
  actually begin prior to the last menstrual period, during a three
  to five year period called perimenopause. During this transition, a
  woman may begin to experience menopausal symptoms and may lose bone
  density, even though she is still menstruating. 
• Premature Menopause or premature ovarian failure is defined as
  a woman’s last period occuring before the age of 40. In many cases
  no cause will be found. Medical conditions such as Addison’s
  disease and hypothyroidism and medical treatments and procedures
  such as hysterectomy and chemotherapy can cause premature
  Menopause. In rare cases, infections such as tuberculosis and mumps
  can be responsible. In approximately 5 to 15 percent of cases a
  woman may still have intermittent ovarian function, which means
  that her ovaries still release eggs once in a while, and she may
  still be able to conceive.

SIGNS AND SYMPTOMS

The early stages of Menopause (perimenopause) causes
fluctuating hormone levels. The following symptoms may occur;

• Menstrual cycles becomes longer, shorter or
  irregular 
• Bleeding may become lighter 
• Bleeding may become unpredictable and heavy (seek advice from
  your doctor).

Eventually hormone levels will fall to a point where
menstruation will stop altogether and Menopause is reached.
Although fertility after the age of 45 is low it is still possible
to become pregnant and contraception is recommended 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.

TREATMENT OPTIONS

As with all medical conditions it is advisable to consult your
Doctor for an accurate diagnosis and treatment. If you are having
menopausal symptoms that are interfering with your daily life,
there are treatments available that can help.

 

Medical treatment for symptoms of Menopause can include
hormone replacement therapy (HRT) and other therapies. The kind of
treatment your Doctor will recommend will depend on your symptoms,
medical history and your own preferences. For more information
about HRT, see the HRT topic.

 

Bone loss and osteoporosis are natural features of ageing, but
declining oestrogen accelerates the process in post-menopausal
women. Short, frequent sessions of weight-bearing exercise, eating
plenty of calcium, giving up smoking and moderating alcohol
consumption can all help to decrease the risk of osteoporosis. If
your diet is inadequate, calcium supplements are available from
your Pharmacy. See your Doctor for advice about nutritional
supplements and any new exercise regime you may be
considering.

DIET HINTS

A balanced diet is recommended. A low-fat, high-fibre diet,
with plenty of fruit vegetables and whole-grains, will help you to
achieve and maintain your ideal, healthy weight. The diet should be
high in;

• Foods rich in calcium (such as low-fat milk, cheese and other
  dairy products) and
• Phyto-oestrogens (naturally occurring plant compounds
  chemically similar to oestrogen such as soy and linseed)

VITAMINS/MINERALS/HERBS

Nutritional supplements may be of use if dietary intake is
inadequate.

• Vitamin D is crucial with Calcium as it can assist the body to
  absorb calcium from foods, and prevents calcium loss in the urine.
   
• Calcium is necessary for maintaining strong bones and is
  commonly prescribed to prevent and treat postmenopausal
  osteoporosis (bone thinning).
• Black cohosh (Cimicifuga racemosa) can help alleviate a number
  of menopausal symptoms such as hot flashes, headaches, heart
  palpitations, insomnia, depression .
• Magnesium is essential for assisting bone in creating new
  calcium crystals.
• Phyto-oestrogenic supplements such as  Red clover has been
  shown in some studies to reduce the symptoms of menopause.
• St. John’s Wort (Hypericum performatum) can be beneficial in
  treating mild depression which can occur with menopause .
• Sage can prevent sweating associated with hot flashes, which
  can be a common symptom of menopause.

PHARMACIST’S ADVICE

Ask your Pharmacist for advice.

1. Follow the Diet Hints. 
2. If you need help reaching an ideal weight ask your Pharmacist
   for advice. See the diets on this Healthpoint.
3. If you have queries about your medication ask your
   Pharmacist.
4. Ask your Pharmacist about cholesterol checks and bone density
   tests.
5. Ask your Pharmacist for products which may help relieve the
   symptoms of hot flushes and vaginal dryness.
6. To help manage hot flushes and disturbed sleep; wear lighter
   clothing, keep your bedroom cool at night, try to reduce your
   stress levels, and avoid potential triggers, such as spicy food,
   caffeine, smoking and alcohol. 
7. Consider some nutritional supplements if dietary intake is
   inadequate.