The menopause marks the end of a woman's fertility, and the end of her menstruation. This is a significant point in her life as her periods come to an end; the absence of something that she's lived with for the majority of her adult life can cause some fairly major physical and emotional effects. However, the fact that a woman's periods don't stop overnight gives her time to adjust as her menstrual cycle becomes less regular and finally stops altogether.
Most women go through the menopause at the age of about 52. After a year without a period, a woman is said to be postmenopausal. Some women, however, experience the menopause much earlier: if a woman goes through the menopause before she reaches 45 years of age she is said to have experienced a premature menopause. About one woman in a hundred goes through the menopause before the age of 40, and a very tiny number experience it before the age of 30.
Although we tend to think of the menopause as a defining event, it isn't really that clear. The period before the menopause is known as the perimenopause, and it's a period of time during which the initial stages of hormonal changes can produce irregular periods and the initial symptoms of menopause such as emotional mood swings. When a woman's hormones really begin to decrease, she's likely to experience more intense mood swings, possibly hot flushes and night sweats, and some change to the lubrication in her vagina. Some of the mood swings are hormonally induced, but others are certainly the result of coming to terms with the transition from fertility to infertility.
The majority of women will experience various symptoms of the menopause in the perimenopause, and about half of these women will find them difficult to deal: the most usual symptom of the perimenopause is an irregularity of the menstrual cycle and a change in the amount of menstrual discharge.
Of course there is no clear division between the perimenopause and the menopause itself, even though we traditionally think of the perimenopause as a period leading up to the menopause: in fact, the symptoms are very much the same, including night sweats, hot flashes, irregular menstrual cycles, and mood swings. It's a question of degree, in that the symptoms may be more intense and pronounced during the menopause itself.
Sleep disturbance is another common side-effect of the menopause, and it's here that a holistic approach using both conventional medicine and alternative medicine can help a woman come to terms with both the physical and emotional symptoms that she is experiencing.
It's also very important that a woman deals effectively with changes to lubrication in her vagina, since this may impact directly on her relationship. Without treatment, the lack of lubrication can cause pain and difficulty during intercourse, as well as leading to atrophy of the vaginal lining. Happily, localised treatment with oestrogen pellets nearly always reverses these changes and makes intercourse pleasurable and enjoyable once again.
It's also possible that a woman may become more susceptible to urinary tract infections such as cystitis during the perimenopause and menopause, which once again emphasises the importance of a holistic approach to health care during this period of life.
It turns out that only about 10% of women actually seek medical help as they go through the menopause -- in part, that's because many don't need any treatment, but it is also clear that there are many women who could be helped with symptoms that are actually bad enough to interfere with their daily life. Treatment options include hormone replacement therapy, vaginal lubricants, antidepressants, and drugs called tibolone and clonidine.
By the way, any woman who does not wish to get pregnant should continue to use contraception for at least a year after her final period.
Hormone replacement therapy is an effective treatment for the most common symptoms of menopause, including night sweats and hot flushes, vaginal problems and cystitis. Hormone replacement therapy replaces oestrogen and possibly progesterone, and can be taken as either a cream or gel, an implant, a skin patch, or a tablet. While there have been some false alarms about the safety of hormone replacement therapy, close analysis of these reports shows that many of them are based on false information. Indeed, hormone replacement therapy is perfectly safe for women when administered, as it now is, in much lower doses than previously. Furthermore, if it's only about replacing lubrication, and preventing atrophy of the tissues in the vagina, then there are plenty of localised treatments that are possible.
Artificial hormones called tibolone and clonidine can also be prescribed for women in certain circumstances.
Thinking ahead, it's important for women to realise that hormone replacement therapy isn't just about convenience now -- it's also about preventing osteoporosis and maintaining quality of life in later years. With effective therapy, including localised HRT and the vagina, there's essentially no reason why women's lifestyle should change just because the menopause. One of the most respected experts on the menopause is Dr. Christiane Northrup menopause writer and expert who has written extensively about empowering women through adopting a holistic approach to the mental, emotional, and spiritual challenges of the menopause produces. For any woman who wants to sail through the menopause with an experience of positivity and joy, Dr. Northrop's writings are essential reading.
Antidepressants can be useful during the menopause to prevent mood swings and irritability, although many people believe that a holistic approach using treatments such as acupuncture, reflexology, and careful nutrition can be just as effective. You can read more about Dr Northrup's menopause strategy at Roberta Phillips' website.
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