Hot flushes,joint pains, mood swings and forgetfulness. Besides, it’s a new month already and you have missed your period again. Then you ask yourself; ‘what is going on with my body?’ This could mean many things, one of which is menopause, a dreaded word among older women. For many women, being on the brink of menopause is a time of discomfort, insecurity, or even anxietydue to the various symptoms that can accompany it, especially when they don’t have enough information to help them. Menopause is a feminine milestonethat marks a transition to another period of life that affects a woman’s self-image, sexual identity, and quality of life. Each woman’s experience is different. Some may cruise through it with a few problems, othersmay have symptoms as dire as to make life intolerable. Some may feel liberated by the wholemonthly periods, whileothers may be sad that they can no longer get pregnant. Whatever the case, menopause is a natural part of every woman’s life cycle but how you cope may well depend on what else is going on with your lifestyle.
What is menopause?
Menopause refers to that time in every woman’s life when her periods stop and her ovaries lose their reproductive function. According to a study carried out on 534 Nigerian women and published in the National Center for Biotechnology Information,an average Nigerian woman starts the menopause transition at 48. Another study carried out on 402 women by experts in the department of obstetrics and gynecology, University of Nigeria teaching hospital, Enugu, put the average menopausal age for Nigerian women at 49. Reports from other parts of the world also show differences in age but it usually occurs between the ages of 45 and 55, except for a few cases where some women become menopausal in their 30s, or even younger. This is then known as a premature menopause, or premature ovarian failure.According to the study at the University of Nigeria teaching hospital, early menopause was significantly associated with lower education attainment, being unmarried, law parity and birth of the first child after 30 years. Menopause is regulated by hormones, or more correctly, by a change in hormone levels. During a woman’s fertile years, her ability to produce an egg each month is determined by the release of three reproductive hormones (oestradiol, oestrone and oestriol), that are referred to collectively as oestrogen.
Oestrogen is mainly produced by the ovaries, though small amounts are also made by the adrenal glands and by the placenta of a pregnant woman. It is oestrogen which stimulates female characteristics at puberty and controls a woman’s reproductive cycle: the development and release of an egg each month (ovulation) for implantation in the uterus (womb), and the way in which the lining of the womb thickens to house a fertilized egg. The monthly period happens because no implantation has taken place, there is no pregnancy and the lining of the womb is shed. As women get older, their store of eggs in the ovary decreases and their ability to conceive diminishes. At this time, less oestrogen is produced, causing the body to behave differently. However the body does not stop producing oestrogen overnight, and the process can even take several years, during which symptoms arise gradually. This gradual change is called the ‘peri-menopause’. At around the age of 50-55 years, the monthly cycle stops completely, so no more ovulations, no more periods and no more pregnancies. This is the menopause.
What happens and how does it feel?
For some women this loss of reproductive ability may be deeply felt, and for all women, menopause is a personal experience, not just a medical condition. However, the diminishing release of oestrogen from the ovary as women advance into their 40s is often the cause of symptoms which can be distressing andsometimes may need medical attention. According to a questionnaire survey of 108 randomly selected menopausal women in the Lagos metropolis, the most common menopausal symptoms reported were hot flushes (83.7 per cent) and vaginal dryness (49.0 per cent) and psychosomatic symptoms like irritability, insomnia, dizziness and depression.Other common symptoms include night sweats, irritated skin, urinary incontinence and urinary tract infections and a reduced interest in sex.
All the common symptoms of menopause are associated with a decrease in the body’s production of oestrogen. Oestrogen levels can affect many parts of the body. Oestrogen affects the brain, causing changes in emotional well-being and on the skin, influencing its elasticity and thickness. Once the ovaries have ceased their production of oestrogen, other changes take place which may have more of an effect on long-term health. Most commonly, these changes affect the strength and density of bones, increasing the risk of the bone-thinning disease osteoporosis. Like tissue in the vagina, the bones of the female skeleton depends on oestrogen to maintain their strength and resistance to fracture. However, while there’s no mistaking a hot flush or vaginal dryness, there are no obvious symptoms of steoporosis and the first sign is usually the fracture of a bone. It’s for this reason that osteoporosis has been called ‘the silent epidemic’. There is also some evidence that oestrogen deficiency is the cause of some chemical changes in the body which makes women after the menopause, vulnerable to heart disease and stroke.
Coping with menopause
Menopause is not an illness, so medication may not be necessary if you’ve reached the menopause stage and don’t have severe symptoms. However, if the symptoms are severe, it’s best to see a doctor. Many women are able to ease their menopausal symptoms by making simple changes to their lifestyle and diet.
Diet: Healthy eating can prevent or reduce certain conditions that may develop during and after menopause, including obesity, type 2 diabetes, heart disease, certain types of cancer, and osteoporosis. Menopausal women should be reminded of healthy eating and should use menopause as an opportunity to make healthy changes. More on diet will be on our nutrition page.
Exercise: As well as eating a healthy diet, regular exercise also plays a crucial part in ensuring you remain healthy both during and after the menopause.Maintaining muscle mass and bone strength are two key areas for menopausal women. This means your exercise programme should include aerobic activities, such as walking, running, and swimming, as well as strength and flexibility exercises.Experts advice 150 minutes of moderate exercise each week. If you have osteoporosis (brittle bones), it may be recommended that you avoid high impact activities. This is because of the increased risk of falling and fracturing your bones.
Easing hot flushes and night sweats: To improve hot flushes and night sweats you should, take regular exercise, wear light clothing, keep your bedroom cool at night, try to reduce your stress levels, avoid potential triggers, such as spicy food, caffeine, smoking and alcohol.To reduce sleep problems, avoid exercising late in the day and go to bed at the same time every night. To improve mood swings, make sure you get plenty of rest, as well as getting regular exercise.
Hormone therapy: The most controversial option is menopausal hormone therapy. Previously known as hormone replacement therapy, this treatment involves taking estrogen and/or progesterone to help with menopause symptoms and prevent bone loss. However, hormone therapy does carry risks including increased chance of breast cancer, heart disease, and stroke, all of which needs to be discussed with your doctor. On the whole, women experience menopause in widely varying ways. Some women breeze through a problem-free menopause, but most experience some symptoms ranging from mild to severe. The important thing is to be aware of any changes and to consult your doctor for advice. Above all, bear in mind that like puberty, it is simply another stage of life with new challenges and rewards. Your health is your responsibility and that you are in charge.