On World Menopause Day, Dr. Coll, specialist in Gynecology and Obstetrics at the Instituto Materno-Infantil Dr. Rafael Fraile Pérez-Cuadrado and member of Top Doctors, explains what this stage that all women suffer from the age of 50 onwards consists of. In addition to giving some useful tips to try to cope with the symptoms.
Menopause means “last menstruation or period” and it is considered the passage to this stage after a year without menstruation or period. It is accompanied by blood estrogen values below 20 pg/ml and FSH above 18 mIU/ml.
Symptoms suffered by women with menopause
The main symptoms that women suffer during the climacteric period are:
– Hot flashes – Sweating – Mood swings (irritability, depression, anxiety) – Vaginal dryness and decreased vaginal elasticity – Decreased libido – Body changes – Osteopenia or osteoporosis – Insomnia – Dry skin – Increased hair loss – Joint pain – Urine leakage
The average age of menopause is around 50 years old and the first symptoms begin in premenopause (period of 2 to 3 years prior to menopause) in which hormonal changes are already occurring.
Physical and hormonal changes
One of the fundamental changes is the loss of follicular ovarian function, which leads to hypoestrogenism and a decrease in serotonin levels. In addition, the Arcuate and Paraventricular nuclei of the hypothalamus are stimulated to produce GnRH (Gonadotrophin releasing hormone), which stimulates the release of FSH and LH in the anterior pituitary.
This hypoestrogenism in response to internal or external stressful stimuli (coffee, alcohol, tobacco, anxiety or temperature changes) leads to a serotonin discharge in the hypothalamus and hippocampus, and to the overexpression of 5-HT 2a receptors, which alters the thermoregulatory system and produces a reaction of the autonomic functions. In addition, there are increases in insulin, PTH and decreases in renin, aldosterone, DHEA, SDHEA, T3, and melatonin.
As a consequence of these hormonal changes, physical body changes occur: changes in the metabolism of cholesterol and triglycerides with an increase in these and an increase in cardiovascular risk. And weight gain with the consequent body changes and also with difficulty in losing weight. In addition to mood changes, due to frequent hot flashes, sweating, insomnia, anxiety and depression. Decreased libido, appearance of dyspareunia due to less elasticity of the vaginal wall and increased dryness. And discomfort caused by small cracks in the vaginal mucosa post coital entering a loop with consequent less sexual activity.
Finally, gradual loss of bone density with the appearance of osteopenia and osteoporosis with increased future risk of fractures and increased hair loss, weak nails and dry skin.
Treatment or palliation of symptoms
The treatment of climacteric symptomatology is aimed at improving the quality of life of women and the decrease of the increase of cardiovascular diseases, osteopenia and osteoporosis and increase of breast cancer.
Within the current treatments there are:
– Hormone replacement therapy with estrogens or tibolone (HRT) – Local hormonal treatment – Selective serotonin reuptake inhibitors – Non-hormonal treatments.
Recommendations for women entering menopause
It is advisable to have annual gynecological check-ups, with cervical cytology, pelvic and breast ultrasound, bilateral mammography, lumbar and hip bone densitometry, colon study and cardiological control.
It is also important to have healthy hygienic-dietary behaviors. It is also important to do physical exercise, avoid tobacco, alcoholic beverages and coffee.
It is also recommended to hydrate abundantly, consume fiber and fruits and avoid the consumption of gauze. In addition to avoiding stressful situations.