General Information on Menopause

Menopause

Just as a woman’s body undergoes hormonal changes at puberty, so also, as she ages, her body slowly starts reducing the production of hormones like estrogen and progesterone that aid her ability to reproduce. Her periods become erratic, irregular and then stop completely. A woman who has not had a period for 12 consecutive months is said to have reached menopause after her last period, provided there are no other causes like illness or pregnancy for this change.

Menopause is the natural cessation of the female reproductive cycle and on an average, normally occurs between the age of 45 to 55 years. It is not a sudden event; it comes on gradually as the body undergoes changes. This time of change leading up to menopause is known as the ‘perimenopausal’ stage and how long it lasts differs from individual to individual. For some women, menopause is indicated by the sudden stop in regular periods. Other women may experience symptoms that could point to their approaching menopause.

The most common symptoms may include:

• Changes in the pattern of the menstrual cycle like shorter or longer periods, decreased or increased bleeding, spotting and/or shorter or longer gaps between periods.
• Vaginal dryness.
• Hot flushes – the experience of suddenly feeling hot, usually in the upper half of the body.
• Night sweats.
• Trouble sleeping through the night.
• Mood swings, tearful spells, increased irritability, reduced ability to focus, some loss of memory and/or feelings of being confused or mixed-up.
•Reduced libido.

Sometimes, due to problems like endometriosis or cancer, younger women may need to undergo hysterectomy, a surgical procedure that removes the uterus and in some cases, one or both ovaries. If only the uterus is removed, the woman stops having periods immediately and reaches menopause a year or two earlier than she normally would have. However, if the ovaries are removed, the woman goes through immediate menopause (called surgical menopause) and may experience much more severe menopausal symptoms and would need the help of her health provider in dealing with them.

Menopause can affect women differently at the emotional level too. For some women, reaching menopause gives them a feeling of freedom and of being sexier. Others experience an increased sense of maturity and wisdom. And some others go through feelings of loss of the ability to create life.

So, how does one manage menopause?

Most women do not require any special treatment to deal with menopause. For some the symptoms simply disappear after a while (there’s no specifying exactly when, though). Others may need some help.

For those who have a tough time dealing with their menopausal symptoms, there are various treatments available including HRT (Hormonal Replacement Therapy). While most of these provide relief, opinion is divided on whether some of the treatments and their possible side-effects warrant their use. It is best to discuss one’s condition and concerns with a qualified health professional who will advise you on the best treatment options available and will help you make wise choices.

There are some general do’s and don’ts that all women should follow after menopause in order to stay in good health. These include:

1. Eat a healthy, well-balanced diet that is high in fiber, low in fat and includes all the necessary vitamins and minerals. Have appropriate quantities of fruits, vegetables and whole grains. Ensure you get enough vitamins and minerals, either in your diet or as supplements.
2. If you smoke, quit.
3. Make sure you are physically active for general health and exercise regularly at least 3 times a week to maintain healthy bones. Your exercise could include brisk walking, jogging, dancing or a variety of other exercise methods.
4. Ensure you maintain the weight that is healthy for you. During menopause, the ovaries start shutting down their production of estrogen. (Estrogen helps prevent bone loss and aids in keeping the heart healthy). The adrenal glands and fat cells produce some quantities of estrogen to compensate for the reducing levels from the ovaries. So, while being overweight is not advisable, in the long run, being extra-slim isn’t the best option either.
5. Reduced estrogen levels can also possibly lead to osteoporosis and/or heart disease. Talk to your health provider and find out what tests you should take to prevent and/or treat potential heart or bone related problems.
6. Use a water-based vaginal lubricant or moisturizer to deal with the problem of vaginal dryness.
7. Stay positive. There’s a whole lot of living to be done post-menopause.

Male Menopause

Just as women, as they grow older, experience changes due to a drop in their hormonal levels, many men are also reporting similar symptoms as they age. While it is clear that the changes women experience are because they are approaching menopause, the medical community is still debating about whether the symptoms men go through are because they are going through what can be defined as ‘male menopause’.

Women have a clearly defined end of their fertile period after their ovaries stop producing hormones that will help them reproduce. A woman is born with all the eggs she will ever have, and these either get used or discarded in the course of her reproductive life. Once her ovaries discontinue the production of estrogen and progesterone, any remaining eggs are also discarded and the woman stops having regular menstrual periods. Once this stage is reached, the woman is said to have gone through menopause. While some women just stop having periods, others experience various symptoms that indicate approaching menopause.

Men, on the other hand, have no clearly-defined end time to their ability to produce healthy sperm. The decline in the ability of the testes to produce testosterone (androgen) is a slow process and occurs gradually. In fact, a healthy male can produce sperm well into his eighties, and in some cases, even longer Since men, as they age, do not have a clear end to their fertility, some members of the medical fraternity refer to the decline in testosterone (androgen) and the resulting changes, as male menopause or andropause.

These changes occur gradually over time and a decline in testosterone may include changes in erectile function, production of sperm or changes in testicular tissue. As a result of these changes, men going through ‘male menopause’ may experience symptoms such as fatigue, lack of energy, weakness, depression, decreased libido and other sexual problems like impotence.

A decline in testosterone may not always be due to aging alone. Diabetes, cardiovascular diseases and hypertension and the medications to treat these diseases can also lead to andropause. It is a myth that common symptoms of male menopause means that testosterone levels are low. It is important to work with your health provider to find out the the real reasons for your experiencing the symptoms and to find out if your testosterone levels are low. Diagnostic tests, including blood tests to find out hormonal levels (including blood testosterone levels), will help determine whether low testosterone production is the cause of your experiencing symptoms of male menopause.

Like women undergo hormone replacement therapy to compensate for diminished hormone levels, Testosterone Replacement Therapy is sometimes used to combat symptoms like fatigue, depression and decreased libido. However, Testosterone Replacement Therapy carries with it the potential for suffering side effects like worsening of prostate cancer, for example.

Consulting your health provider is imperative before undertaking Testosterone Replacement Therapy. Sometimes, lifestyle changes like a new diet or exercise regimen, or changing your medication can help deal with symptoms of male menopause. The bottom line here is, don’t try to treat yourself, consult your medical advisor if you have concerns about male menopause.