Menopause

Menarche marks the beginning of fertility and healthy reproductive life. After menarche, every month a female goes through normal hormonal changes that may or may not lead to pregnancy. However, after a certain age, a woman may lose her ability to become pregnant even after successful and periodic intercourse. This transition is referred to as menopause and it usually occurs (in most women) by age 50- 55 years. In United States of America the average age for menopause is 51 years. Medically, menopause can be defined as “no menstruation for more than 12 consecutive months”
It is imperative to understand that just like menarche, menopause is also physiological. It may end the fertility period but you can live a normal life (both physically and sexually) after menopause.  Due to transition in the secretion and metabolism of female hormones, you may develop certain disturbing sign and symptoms that may interfere with some day to day activities; but you can manage the symptoms easily with lifestyle modification and dietary changes.
 

Signs & Symptoms of Menopause

Menstrual irregularities (8 Menstrual Cycle Facts and Myths) are fairly common in women who are in peri-menopausal age group (years preceding complete cessation of menstruation). Based on different factors, such as your diet, overall physical and sexual health and weight, some women may experience more severe menopausal symptoms.
Few most notable ones are:

• Hot flashes (HOT FLASHES | Causes | Remedies Learn More)

• Night sweats

• Sleep problems (mostly insomnia) (Getting Back to Sleep Learn More)

• Thinning of hair and dry skin

• Loss of breast fullness

• Mood changes (Women Hormone Balance | Natural Hormone Balancing)

• Irregular period

• Vaginal dryness (Vagina | Vaginal Laxity Learn More)

• Weight gain and changes in metabolism (Body Weight | Psyche Learn More)

Causes of Menopause & Menopausal Symptoms

In order to manage menopausal symptoms, it is very important to understand the pathophysiology of menopause:

• Low serum levels of reproductive hormones: With advancing age, the rate of secretion of different female reproductive hormones decreases (Estrogen Deficiency in Men and Women) (especially estrogen and progesterone). These hormones regulate the menstruation and overall female reproductive cycles. Reduction in levels of these hormones decreases fertility (Five Foods That Help Extend Your FertilityLearn More) and duration and concentration of periods. Eventually, menstrual cycle ceases when the ovaries stop producing eggs by the age of 51.

• Complete Hysterectomy: It is a procedure that is performed on medical or personal request.. It is imperative to keep in mind that total hysterectomy (Hysterectomy Wiki Page) with bilateral oophorectomy i.e. removal of uterus and ovaries both, leads to immediate menopause without peri-menopausal stage (regardless of the age and other factors). This sudden change in the hormonal biochemistry may cause abrupt and more severe signs and symptoms of menopause.

Other causes are:

• Chemotherapy and radiation: Menopause can also be a complication of cancer of ovaries (or radiation therapy of ovaries).

• Ovarian insufficiency: Premature menopause (termination of periods before 40 years of age) is reported in a very small percentage of women. It is a complication of autoimmune damage to ovaries or certain genetic conditions in which ovaries doesn’t produce sufficient amount of hormones i.e. primary ovarian insufficiency. It can be treated with hormone replacement therapies to preserve vital functions.

Managing Menopause & Menopausal Symptoms

Menopause is a natural physiological process so it does not require any medications but in order to manage the disturbing symptoms and to alleviate complications (cardiovascular issues, osteoporosis, psychiatric issues and depression); several holistic and pharmacological therapies are available.

• Vaginal estrogen: Irritation, urinary problems (Female Urinary Retention Learn More), vaginal dryness and problems during sex (such as vaginal dryness) can be managed by direct administration of estrogen creams in the vagina. Suppositories and creams are available that are readily absorb-able on local application.

• Hormone replacement therapy: The best and the most effective treatment for relieving menopausal symptoms is to get the hormones levels back up (since progesterone and estrogen deprived body is the primary cause of the physical and emotional ailments). Although, research data suggest that hormonal replacement therapy may increase the risk of malignancy, it is imperative to understand that HRT can improve bone density and may protect against cardiovascular diseases.

• Gabapentin: It is an anti-epileptic drug (used for seizure management) but it can also relieve various menopausal symptoms such as hot flashes and migraine.

• Anti –depressants: Hot flashes may be due to the neurotransmitter serotonin, thus you can control menopausal depression and hot flashes by consuming SSRI’s (selective serotonin reuptake inhibitors).

Menopause Natural Remedies

Certain natural remedies are also fairly effective at improving menopausal symptoms in females:
Vaginal discomfort: Use of lubricants (Lubricant & Sperm Quality Learn More) and vaginal moisturizers can relieve irritation and dryness and may also help in staying sexually active.
Sleep pattern: Getting sufficient amount of sleep and rest can minimize your risk of developing night sweats, hot flashes and sleeping disorders. Avoid caffeine and other CNS stimulants and other activates when you are about to sleep.
Relax: Adopt relaxation techniques to stay stress free (Yoga Sexual Benefits For Your Life) and healthy. Adoption of healthy lifestyle and exercise especially yoga may help a lot.
Eat healthy: Green vegetables and fresh fruits (Fruit And Veg Learn More) are good for skin. Include organic and chemicals-free ingredients in your balanced diet. Increase your intake of vitamin D foods. You can also initiate Vitamin D supplements after speaking to your healthcare provider. Likewise, consume multi-vitamins and other supplements as well
Quit smoking: Cardio vascular diseases, stroke, osteoporosis and cancer can be prevented or delayed by quitting smoking (Smoking Risks, It’s Time to Stop Smoking) as early as possible.
Staying fit: Staying in shape with yoga and regular exercise can help prevent cardiovascular diseases, diabetes, osteoporosis and other menopausal related condition.
 

References:

Rocca, W. A., Grossardt, B. R., & Shuster, L. T. (2011). Oophorectomy, menopause, estrogen treatment, and cognitive aging: clinical evidence for a window of opportunity. Brain research, 1379, 188-198.
Hayes, L. P., Carroll, D. G., & Kelley, K. W. (2011). Use of gabapentin for the management of natural or surgical menopausal hot flashes. Annals of Pharmacotherapy, 45(3), 388-394.
Goodman, N. F., Cobin, R. H., Ginzburg, S. B., Katz, I. A., & Woode, D. E. (2011). American Association of Clinical Endocrinologists medical guidelines for clinical practice for the diagnosis and treatment of menopause. Endocrine practice, 17, 1-25.