To talk about Menopause, the first thing to do is to define exactly what it is. According to the strict definition, menopause is simply the cessation of menstruation, which usually occurs around the age of 50. Climacteric, on the other hand, is the period of time, about 10 years, in which all those symptoms that people commonly call menopause occur.
Before menopause as such, there are a series of previous manifestations, the premenopause, which occurs in women between 45 and 50 years of age. Postmenopause, on the other hand, occurs between the ages of 50 and 55, that is, once menstruation has ceased.
The onset of menopause is preceded by the progressive decrease of the primordia (set of an oocyte surrounded by a layer of estrogen-producing cells), as a result of which the hypothalamus reacts by increasing its stimulus to the pituitary to produce more gonadotropins, in particular FSH, to stimulate the ovaries that do not respond adequately due to the progressive decrease of these primordia. This causes that four or five years before the onset of menopause there are alterations in the cycles more or less striking, such as shortening of the cycles or the opposite, appearance of follicles (developed primordia) of large size that cause large production of estrogen and as a result significant bleeding, etc..
Once the last menstruation or menopause arrives, an exaggerated response of the hypothalamus-pituitary gland is produced, which tries to make the ovaries work by exaggeratedly increasing the gonadotropins, that is why one way to know if a woman is already menopausal is to check that the gonadotropins – FSH and LH – are elevated. When the ovaries do not respond, they stop producing the most important hormone in a woman’s fertile age, estrogens, and it is the lack of estrogens that produces all the symptoms.
What is the Climacteric Syndrome?
There are certain signs that characterize the process of the disappearance of menstruation and that occur from premenopause. These are what are generally known as symptoms. There are four types of alterations:
- Neurovegetative alterations (hot flashes, sweating, palpitations, paresthesias, headaches).
- Psychic alterations (tiredness, irritability, aggressiveness, depression, lack of concentration and memory loss).
- Organic or systemic alterations (atrophy of the genitals, decrease in the size of the uterus, skin cracks, joint pain, cerebrovascular diseases and osteoporosis).
- Genitourinary disorders (bladder prolapse, uterine prolapse, urine leakage).
The first symptom to appear, even several years before, are hot flushes followed by skin problems and genitourinary symptoms. Once menopause arrives, osteoporosis usually appears and, some five or six years later, cerebrovascular disease may develop.
Treatment for Climacteric Syndrome
Treatment is only necessary in those women in whom the above symptoms cause serious discomfort and health problems. In these cases, they should be given what they are lacking, i.e. estrogens.
On the other hand, those women who feel well and do not have serious symptoms can get by with a series of basic recommendations:
- Do not gain too much weight
- Do not smoke
- Doing sports (at least walking)
- Eat plenty of dairy products
- Vitamin D
- A balanced diet, with special emphasis on fish, fruit and vegetables.
An exceptional case is that of women suffering from a provoked menopause, as a result of surgery, chemotherapy or radiotherapy treatment. It is then necessary to resort to hormonal treatment.
The relationship between menopause and libido
During this process, it is very characteristic that women’s libido decreases. This is due to the lack of estrogen. Occasionally, LH produces a secretion of testosterone through the connective tissue of the ovary and this allows some women to not lose libido altogether.