Is that Menopause?

Menopause is the time that marks the end of your menstrual cycles.

It is the permanent cessation of menstruation usually in older women.

Menopause is diagnosed after you’ve gone for 12 consecutive months without a menstrual period.

In Kenya, it can happen in your 40s or 50s, but the average age is 51.

Menopause is a natural biological process. But the physical symptoms, such as hot flashes, and emotional symptoms of menopause may disrupt your sleep, lower your energy or affect emotional health.

Peri-menopause:

It is the period immediately before menopause. It is characterized by irregular menses and presence of menopausal symptoms. It lasts 4-8 years.

Post menopause:

It is the period after menopause. Menopausal symptoms disappear within 2-5 years. Some women may experience hot flushes for up to 10years.

SYMPTOMS

In the months or years leading up to menopause (perimenopause), you might experience these signs and symptoms:

• Irregular periods
• Vaginal dryness
• Painful intercourse
• Loss of libido
• Urinary incontinence
• Hot flashes
• Chills
• Night sweats
• Sleep problems
• Mood changes
• Depression
• Memory loss
• Anxiety
• Weight gain and slowed metabolism
• Thinning hair and dry skin
• Loss of breast fullness

Signs and symptoms, including changes in menstruation can vary among women. Most likely, you’ll experience some irregularity in your periods before they end.

Skipping periods during perimenopause is common and expected. Often, menstrual periods will skip a month and return, or skip several months and then start monthly cycles again for a few months. Periods also tend to happen on shorter cycles, so they are closer together. Despite irregular periods, pregnancy is possible. If you’ve skipped a period but aren’t sure you’ve started the menopausal transition, consider a pregnancy test.

Causes

Menopause can result from:

• Naturally declining reproductive hormones. As you approach your late 30s, your ovaries start making less estrogen and progesterone — the hormones that regulate menstruation — and your fertility declines.

In your 40s, your menstrual periods may become longer or shorter, heavier or lighter, and more or less frequent, until eventually — on average, by age 51 — your ovaries stop releasing eggs, and you have no more periods.

• Surgery that removes the ovaries (oophorectomy). Your ovaries produce hormones, including estrogen and progesterone that regulate the menstrual cycle. Surgery to remove your ovaries causes immediate menopause. Surgery that removes your uterus but not your ovaries (hysterectomy) usually doesn’t cause immediate menopause. Although you no longer have periods, your ovaries still release eggs and produce estrogen and progesterone.
• Chemotherapy and radiation therapy. These cancer therapies can induce menopause, causing symptoms such as hot flashes during or shortly after the course of treatment. The halt to menstruation (and fertility) is not always permanent following chemotherapy, so birth control measures may still be desired..

Primary ovarian insufficiency. About 1% of women experience menopause before age 40 (premature menopause). Premature menopause may result from the failure of your ovaries to produce normal levels of reproductive hormones (primary ovarian insufficiency), which can stem from genetic factors or autoimmune disease. But often no cause of premature menopause can be found. For these women, hormone therapy is typically recommended at least until the natural age of menopause in order to protect the brain, heart and bones.

MANAGEMENT

If you experience abnormal uterine bleeding, uterine incontinence and loss of libido you can talk to a health care provider.

You can book an appointment with us on https://hellodaktari.co.ke and we shall be able to advise you accordingly through an online consultation.

There are many effective treatments available, from lifestyle adjustments to hormone therapy.

If you are experiencing vaginal dryness, you can use water based vaginal creams (which are very common in Kenya), estrogen vaginal creams and also practice regular sexual intercourse.

Regular exercise, socializing, relaxation exercises would all help with mood swings and anxiety.

All menopausal women should receive calcium supplements.

Preventive health care as you age may include recommended health screening tests.

• Screen for breast cancer, cervical cancer and non-communicable diseases

Complications

After menopause, your risk of certain medical conditions increases. Examples include:

• Heart and blood vessel (cardiovascular) disease. When your estrogen levels decline, your risk of cardiovascular disease increases. Heart disease is the leading cause of death in women as well as in men. So it’s important to get regular exercise, eat a healthy diet and maintain a normal weight
• Osteoporosis. This condition causes bones to become brittle and weak, leading to an increased risk of fractures. During the first few years after menopause, you may lose bone density at a rapid rate, increasing your risk of osteoporosis. Postmenopausal women with osteoporosis are especially susceptible to fractures of their spine, hips and wrists.
• Urinary incontinence. As the tissues of your vagina and urethra lose elasticity, you may experience frequent, sudden, strong urges to urinate, followed by an involuntary loss of urine (urge incontinence), or the loss of urine with coughing, laughing or lifting (stress incontinence). You may have urinary tract infections more often.

Strengthening pelvic floor muscles with Kegel exercises and using a topical vaginal estrogen may help relieve symptoms of incontinence. Hormone therapy may also be an effective treatment option for menopausal urinary tract and vaginal changes that can result in urinary incontinence.

• Sexual function. Vaginal dryness from decreased moisture production and loss of elasticity can cause discomfort and slight bleeding during sexual intercourse. Also, decreased sensation may reduce your desire for sexual activity (libido).

Water-based vaginal moisturizers and lubricants may help. If a vaginal lubricant isn’t enough, many women benefit from the use of local vaginal estrogen treatment, available as a vaginal cream, tablet or ring.

• Weight gain. Many women gain weight during the menopausal transition and after menopause because metabolism slows. You may need to eat less and exercise more, just to maintain your current weight.