What is Menopause?

Our very own leading Gynecologist in Cape Town, Dr Natalia Novikova helps you understand what Menopause means.

Menopause is a stage of woman’s life when the ovaries gradually stop working. The level of female hormones produced by ovaries (oestrogen) fall and women stop having periods. Although the average age of menopause is 51 years, it can happen anytime from the thirties to sixties. Menopause usually occurs because of advanced age, but it may be caused by certain drugs (cancer medications, radiation to pelvis) or happen early in life because of some diseases and it is called premature ovarian failure. Women who smoke usually reach menopause earlier than non-smokers.

Menopause signs

Doctors call woman menopausal after she has not her periods for one year. The transitional stage between premenopause to menopause can go unnoticed for some women who have no problems related to the hormonal changes in their bodies. Other women may find this stage of their life difficult to go through due to various changes with their bodies which interfere with their regular daily activities. Menopause signs may involve hot flushes (suddenly feeling very hot for a few minutes), insomnia (difficulties falling asleep or waking up at night and inability to sleep which makes women feel very tired during the day), irregular bleeding.

What do I do if I have Menopause?

Change in a menstrual period pattern in women who are approaching menopause differs. Periods might become irregular, lighter, with a longer interval between periods or heavier with a shorter interval between them. Any change in period pattern has to be carefully assessed by a doctor to make sure these changes are not related to cancer of the uterus or other more common problems such as fibroids or polyps (benign growth in the uterus). A gynaecologist would usually examine the woman, take Pap smear and possibly a biopsy of the lining of the womb, do an ultrasound (scan) to check the uterus and ovaries and sometimes do a hysteroscopy (an assessment of the inside of the uterus with a special camera). There are various gynaecological treatments to help with bothersome bleeding during the transition to menopause. Such treatments include tablets to decrease the blood flow, hormonal

IUD (loop) inserted inside of the uterus, endometrial ablation to destroy the bleeding lining of the womb. Treatment choice depends on each woman’s particular problem.

What are the symptoms of Menopause?

Hot flushes are common during the transition to menopause and sometimes for many years during menopause. A Hot flush is a feeling of heat around the neck, head and sometimes chest, arms and back which last for several minutes (usually 30 seconds to 10 minutes) and may be associated with chills or sweating. Hot flushes may occur a few times a day or a week or only monthly. It is impossible for women to continue with their daily activities if they experience frequent hot flushes. The best treatment for hot flushes is HRT (hormone replacement therapy). Because HRT has serious side-effects its use has to be weighed against the severity of symptoms and should not be continued for more than 4-5 years. There is also a non-hormonal treatment for hot flushes, but they’re not as effective. Women who experience hot flushes should try to dress in lighter clothes (or have layers of clothes so they can easily take 1-2 layers off ), sleep under a lighter blanket, keep a bag of frozen peas under the pillow and turn the pillow around once they experience hot flush so they touch cold side. It helps to avoid spicy food and alcohol.

Does Menopause affect my sex life?

Sex problems related to menopause manifest because of vaginal dryness which leads to discomfort and pain during intercourse and loss of libido. The main reason behind vaginal dryness is low levels of oestrogen. Women with vaginal dryness can use lubricants or vaginal oestrogen cream to help with their symptoms. Loss of libido is usually the result of stress, sleep problems, irritability, medications. Exercise and lifestyle changes to reduce stress are very effective.

Low oestrogen levels are also responsible for increased risk of heart disease, osteoporosis and dementia. It is important to have regular checkups of blood pressure, cholesterol, sugar levels, mammograms.


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