What is menopause?
The menopause is when you stop having your periods. It happens when your ovaries stop releasing eggs or your ovaries have been removed and the amount of oestrogen hormone in your body is reduced. Menopause can also occur after surgical removal of the ovaries. If menopause occurs before the age of 40 then it is called early menopause or premature ovarian failure. Perimenopause is the period before menopause during which the hormonal imbalance irregular periods occur. The average age of menopause for European women is 51 years of age which does not appear to change over time. The menopausal period accounts to about one third of a woman’s life, therefore it is really important for every woman to be aware of the effects of menopause on her health, as well as the way in which these could be prevented.
What changes occur in menstrual cycles?
The first change observed is the menstrual cycle duration which last from 2-5 days and its regularity it is not usually affected. For example, a woman who had a period every 28 days, begins to have a period every 22-24 days. This change occurs because ovulation happens earlier. The latter means, that although at his stage the woman’s fertility is significantly reduced, contraception must be continued if not planning for a pregnancy.
In the next phase, ovulation does not occur in every cycle, resulting to erratic periods. The greatest hormonal change is observed in this phase; the increased levels of oestrogen in the blood which subsequently increase the blood flow. In the later phase when the oestrogen levels decrease, menopausal symptoms appear, periods become more infrequent gradually until they stop permanently.
Menopausal symptoms
The menopausal symptoms are mainly caused by the decreased oestrogen production by the ovary and they can last for 4-5 years in most women and for a small percentage might last longer. These symptoms are divided into 4 categories:
a)Vasomotor
Hot flushes are the sudden increase in upper body temperature accompanied by tachycardia and redness of the face, which can last for a few seconds and then subsides with heavy sweating. This can happen many times during the day, but also at night. This means that women’s sleep is often interrupted and they feel tired the following day.
- b) Psychological
- Mood swings
- Crying outbursts
- Loss of interest in daily activities
- Irritability
c)Psychosomatic
- Diffuse joint pain
- Fatigue
- Muscle aches
- Headaches
- Tachycardia
d)Urogenital
Urogenital symptoms are those related to the atrophy of the vagina, bladder and external genitalia due to the lack of oestrogens. These are:
- Vagina dryness
- Itching or burning sensation in the vagina
- Pain (dyspareunia) or even blood (postcoital bleeding) from the vagina during sexual intercourse
- Cystitis and vaginitis from vaginal bacteria, which reappear despite antibiotic treatment.
These symptoms, unlike the symptoms above, persist throughout menopause and are more common when a woman is sexually active. Menopause is also accompanied by a significant decrease in the desire for sexual intercourse.
Dr Efterpi Tingi
Consultant Obstetrician and Gynaecologist
