WHAT IS MENOPAUSE?
- Menopause is the permanent cessation of menstruation resulting in the loss of ovarian follicle development.
- The age at menopause appears to be genetically determined and is unaffected by race, socioeconomic status, age, or number of prior ovulations. Factors that are toxic to the ovary often result in an earlier age of menopause; for example, women who smoke experience an earlier menopause, etc. Women who have had surgery on their ovaries, or have had a hysterectomy, despite retention of their ovaries, may also experience early menopause. Although menopause is associated with changes in the hypothalamic and pituitary hormones that regulate the menstrual cycle, menopause is not a central event, but rather a primary ovarian failure.
- At the level of the ovary, there is a depletion of ovarian follicles. The ovary, therefore, is no longer able to respond to the pituitary hormones, that is, follicle-stimulating hormone (FSH) and luteinizing hormone (LH), and ovarian estrogen and progesterone production cease. Androgen production from the ovary continues beyond the menopausal transition because of sparing of the stromal compartment.
- Menopausal women continue to have low levels of circulating estrogens, principally from peripheral aromatization of ovarian and adrenal androgens. Adipose tissue is a major site of aromatization, so obesity affects many of the sequelae of menopause. The ovarian-hypothalamic-pituitary axis remains intact during the menopausal transition; thus, FSH levels rise in response to ovarian failure and the absence of negative feedback from the ovary.
WHAT ARE THE SYMPTOMS OF MENOPAUSE?
- Menopausal transition, is a defined period of time beginning with the onset of irregular menstrual cycles until the last menstrual period, and is marked by fluctuations in reproductive hormones.
- This period is characterized by:
- Menstrual irregularities
- Prolonged and heavy menstruation intermixed with episodes of amenorrhea
- Decreased fertility
- Vasomotor symptoms and insomnia. Some of these symptoms may emerge 4 years before menses ceases.
- During the menopausal transition, estrogen levels decline and levels of FSH and LH increase. The menopausal transition is characterized by variable cycle lengths and missed menses, whereas the postmenopausal period is marked by amenorrhea. The menopausal transition begins with variability in menstrual cycle length accompanied by rising FSH levels and ends with the final menstrual period.
- Principal health concerns of menopausal women include vasomotor symptoms, urogenital atrophy, osteoporosis, cardiovascular disease, cancer, psychiatric symptoms, cognitive decline, and sexual problems. However, it has been difficult to distinguish between symptoms that result from loss of ovarian function and those from the aging process or from the socio-environmental stresses of midlife years.
- Many symptoms are found related to postmenopausal syndrome:
- Hot flushes
- Irritability
- Mood swings
- Insomnia
- Dry vagina, difficulty concentrating
- Mental confusion
- Stress incontinence
- Urge incontinence
- Osteoporotic symptom
- Depression
- Headache
- Vasomotor symptoms
- Insomnia etc.
- The idea of menopause has long held negative connotations in our society, and for many women the thought of menopause often brings to mind an array of unwelcome symptoms, which is often heightened by the media, but the transition to menopause can be a time of reflection and inspiration and have a positive impact in life. It’s a normal and natural part of a woman’s life, and a period of life that can be just as well lived as earlier stages. Although transitions of any kind can be inherently difficult, many women experience a newfound sense of freedom and anticipate personal growth.
HERE ARE SOME IDEAS AND TIPS FOR MAKING YOUR MENOPAUSE A POSITIVE EXPERIENCE:
1. Make a choice. Face menopause angrily and in denial or accept and embrace it and make the most of the transition period to set yourself up for the remainder of your life.
2. Watch your thoughts. Stay positive. There is growing evidence that the absence of positive thoughts has a greater negative impact on our health and well-being than does the presence of negative ones.
3. Stay connected. Social support is vital to health and can even help you live longer. And by talking with other women about these changes, you can create new and lasting bonds that are forged through womanness.
4. Reawaken your purpose. For many women, menopause is a time of redefinition of roles, interests, and reawakening of purpose. It is also often a time for reflection about where they have been and where they are headed.
5. Embrace the clarity of vision. Menopause is a crossroads, a time to rebirth yourself, change your focus, and start exploring your own needs more.
6. Accept yourself. It will be harder to do some things, such as keeping off weight. But rather than complaining about this, accept the change. You are perfect exactly as you are.
7. Make Time for Yourself. When women actually make themselves a priority, dramatic changes can occur. By combining positive thoughts, exercise, eating right and incorporating relaxation into daily life, many women are changing the menopause experience.
8. Become informed. Use books or the internet to research other women’s experiences, the physical and emotional symptoms and understand the variety of possibilities during menopause. Knowing what to expect will help your understanding of what’s happening to you. Learning from others will reassure you that you’re not experiencing menopause alone.
9. Seek out a variety of stories. You will find many stories about the dreadful journey women go through when experiencing menopause, but there are as many positive ones. Read books and articles that reflect good or neutral experiences, rather than simply bad ones.
10. Trust what you know. Information is power that leads to wisdom. As you absorb information on menopause, trust your own intuition, your critical thinking skills, and especially your body to tell you what is true for you. You probably know much more than you think!
11. Stay in the Moment. Try to be mindful of each and every moment of your life. This practice prevents you from worrying about the future or dwelling on the past.
12. Laugh. Laughter brings us closer to people, moves us into more positive mindsets, can stimulate our immune system, enhance our learning and memory, and help us cope better with the stressors in our lives. Laughter is a great menopause help.