Menopause
What is menopause?
Menopause is a natural biological process that marks the end of a woman's menstrual cycles. Menopause is a normal part of aging and represents the transition from the reproductive years to the non-reproductive phase of life. The process involves hormonal changes, particularly a decrease in the production of estrogen and progesterone by the ovaries.
The three stages of menopause
Menopause can be broadly divided into three distinct stages: perimenopause, menopause, and postmenopause.
Perimenopause
Perimenopause, also known as the menopausal transition, typically begins several years before menopause. During this stage, the ovaries gradually produce less estrogen, and women may start to experience menopausal symptoms such as irregular periods, hot flashes, and mood swings. Perimenopause can last anywhere from a few months to up to 10 years.
Menopause
Menopause is defined as the point in time when a woman has not had a menstrual period for 12 consecutive months. This stage marks the official end of menstrual cycles and fertility. It typically occurs in women between the ages of 45 and 55. During this stage, the ovaries produce very low levels of estrogen and progesterone.
Postmenopause
Postmenopause is the stage that follows menopause and lasts for the rest of a woman's life. During postmenopause, symptoms like hot flashes and night sweats may continue for some time but generally become less frequent and severe. However, the decrease in estrogen levels can lead to an increased risk of certain health issues such as osteoporosis and cardiovascular disease, making it important for women to maintain a healthy lifestyle and consult with their healthcare provider for ongoing management.
Symptoms of menopause
According to the American Journal of Medicine, 85% of women experience at least one symptom when transitioning into menopause¹.
Hot Flashes
Sudden feelings of warmth, often most intense over the face, neck, and chest, which can cause sweating and discomfort. Hot flashes are believed to be caused by hormonal changes that occur during menopause, specifically fluctuations in estrogen levels. While some women may only experience mild hot flashes, others may have more severe and frequent episodes.
Night Sweats
When hot flashes occur at night, they’re called night sweats. Night sweats can disrupt sleep, so it’s important to wear breathable sleepwear, use cool bedding, and maintain a cool sleeping environment.
Irregular Periods
As menopause approaches, menstrual cycles often become irregular, with variations in flow and frequency before ceasing altogether.
Mood Swings
Emotional instability, including irritability, depression, and anxiety, is frequently reported during this transition period.
Sleep Disturbances
Difficulty falling asleep or staying asleep, often exacerbated by night sweats.
Vaginal Dryness
Reduced estrogen levels can cause vaginal dryness, leading to discomfort or pain during intercourse.
Weight Gain
Metabolic changes can contribute to weight gain and an increase in abdominal fat.
Thinning Hair
A decline in estrogen can lead to hair becoming thinner and more brittle.
Memory Issues
Some women experience memory lapses or difficulties with concentration.
How is menopause diagnosed?
A registered dietitian (RD) is a healthcare professional who specializes in nutrition to promote health. They are qualified to turn scientific nutrition information into practical advice, having completed a bachelor's degree in a relevant field, a supervised internship, and a national exam by the Commission on Dietetic Registration.
Unlike general nutritionists, RDs can legally diagnose and treat nutritional problems, making them essential in healthcare for individual dietary planning, public health promotion, and medical nutrition therapy. They must also maintain their certification through ongoing education.
Lifestyle changes to manage menopause symptoms
Diet and supplements
Modifying diet or taking supplements for menopause can be beneficial in managing menopause symptoms for many women. Including foods rich in phytoestrogens like chickpeas, flaxseeds, sesame seeds, cashews, almonds, peanuts, broccoli, kale, and peaches may help alleviate hot flashes and night sweats by mimicking the effects of estrogen in the body.
Physical activity
Exercise helps reduce hot flashes, regulate hormone levels, increase bone mass, improve mood through the release of endorphins, maintain a healthy weight, and promote better sleep patterns. To best manage menopause symptoms, women are encouraged to try the following: walking, biking, dance, elliptical, resistance band exercises, squatting, and t’ai chi.
Prescription medications
Antidepressant medications can assist in reducing mood swings and managing menopausal symptoms, such as insomnia. It is important for women to consult with their healthcare provider to determine the most suitable prescription medication based on their individual symptoms and health history.
Treatment for menopause
Hormone Therapy
MIMIT Health offers hormone therapy to make the transition into menopause more manageable. Hormone therapy for menopause, also known as hormone replacement therapy (HRT), involves taking medication to supplement the hormones that the body no longer produces in adequate amounts during menopause.
Estrogen only
Estrogen-only hormone therapy for menopause involves the use of estrogen to help alleviate symptoms such as hot flashes, vaginal dryness, and mood swings. It is typically prescribed for women who have had a hysterectomy, as estrogen by itself can increase the risk of developing endometrial cancer in women with a uterus. Estrogen therapy can be administered in various forms, including pills, patches, creams, or vaginal rings. While estrogen can effectively manage menopausal symptoms, it is essential to discuss the potential risks and benefits with a healthcare provider to determine the most appropriate treatment plan for each individual. Regular monitoring and follow-up are crucial to ensure the therapy's safety and efficacy over time.
Estrogen and progesterone
Estrogen and progesterone are commonly used in hormone therapy to alleviate symptoms associated with hormonal imbalances. Progesterone is often prescribed in combination with estrogen to reduce the risk of endometrial cancer in women who still have a uterus. Hormone therapy is personalized based on individual needs and health considerations, and it is essential for patients to discuss the potential benefits and risks with their healthcare provider before starting treatment.
References
McKinlay S.M., Brambilla D.J., Posner J. The normal menopause transition. Maturitas.1992;14:103-115
