What is:
MENOPAUSE / PERIMENOPAUSE
....and what's all the fuss?
Definitions
Menopause is the final period in a woman's life, which signifies the conclusion to her reproductive years. The average age of menopause in Australian women is 51 years of age.
After menopause, a woman is post-menopausal for the remainder of her life.
Perimenopause is the time, usually years (average 4-8 years) leading up to the menopause, when often periods change in regularity or some other way, and the ovarian production of reproductive hormones become more unpredictable and erratic.
Why the fuss?
The menopause transition is a major biological change, which has more impact on health and ageing than chronological age.
Our reproductive hormones oestrogen and progesterone have many functions and roles in the body which keep us feeling well, as well as protecting from disease. Effects range from temperature, moods or anxiety regulation; to brain, cardiovascular, bowel, bladder and sexual function support; to joint, muscle, skin and hair effects.
Due to the erratic and overall falling levels of hormones through this transition, women commonly experience a range of symptoms or changes in their body, which are often troublesome. The selection of symptoms and severity can be highly variable between individuals and for some, can be so severe that it leads to life altering consequences such as divorce, job loss or social withdrawal. Longer term there is an increased risk of osteoporosis and/or fractures, cardiovascular disease, diabetes and in the case of untreated premature menopause, also increased dementia/cognitive impairment and premature death.
Recently there has been a welcome movement in that menopause has become more topical in the news and in conversations between friends. This is important because menopause affects all women, ie. half the population and is deserving of attention, which ultimately leads to more research, funding and development of effective, safe treatments and meaningful support.
What are the symptoms?
Each individual is different but the some of the more common symptoms are:
- Hot flushes and/or night sweats
- Unexplained fatigue
- Disturbed sleep
- Moodiness
- Irritability
- Anxiety
- Brain fog
- Changing body shape
- Muscle/joint aches or inflammation syndromes
- Dry skin
- Hair changes or loss
- Vaginal dryness with/without painful sexual intercourse
- Urinary frequency or more UTIs
- Libido changes
What are the treatments?
Hormones
Within the category of MHT, there are many varying formulations and routes, and these differ in benefits and risks.
There are also ‘natural’ or ‘herbal’ hormones in the form of phytoestrogens, mainly made from soy or yam products. Compared to MHT, the evidence for both effectiveness and safety of these products is less strong.
Non-hormonal treatments
There are several prescription medications which are non-hormonal that may help to address specific symptoms, such as heat symptoms, or moods, or sleep, or bladder function. They tend to assist with a narrower range of symptoms, eg night sweats/hot flushes but not brain fog, etc.
Psychological therapies can assist with moods/anxiety, stress, sleep and cognitive difficulties.
Lifestyle measures
Dietary factors and nutrition, type and amount of physical activity, alcohol intake, cigarette smoking, stress levels and sleep hygiene all need attention and likely adjustment.
Other treatments
Where do I start?
The most important step is to have a discussion with a menopause doctor who has the right knowledge and experience. Each woman’s journey through the menopause transition is different and the path continues to evolve over time. A thorough initial assessment, and indeed regular re-evaluation over time, is important to decide the best and safest treatment for each woman and in accordance with personal goals.
Is your GP an AMS member?
Visit the Australasian Menopause Society (AMS) website to find local health professionals with a special interest in women’s health during midlife and menopause.
