During her life, a woman goes through the various phases of the reproductive journey until inevitably reaching menopause. The final menstrual period marks menopause, no more PMS, no more menstrual bleeding or cramps. The ovaries cease the production of estrogen, resulting in the manifestation of menopausal symptoms. However, menopause does not occur abruptly. Several years before the final menstrual period, a woman will experience irregular menstrual cycles.
This phase is known as Perimenopause or Climacteric Syndrome, a transitory period before the obligatory menopause. The menopausal age varies amongst individuals, but most women begin this journey between 40 and 50 years. During the menopausal transition, the hormone levels fluctuate wildly, marked by irregular heavy periods and severe PMS, imminently leading to the decline in estrogen levels.
Estrogen plays a significant role in pre and post-menopausal women. To truly understand the consequential effects of low estrogen, one must understand the physiologic functions of estrogen.
- Maintains the regularity of the menstrual cycle, making sure the reproductive organs are all set for conception
- Preserve vaginal health. Estrogen controls vaginal secretion; ascertaining adequate vaginal lubrication and keeps the vaginal lining thick.
- Maintains body temperature
- Protects bone health; estrogen promotes the deposition of minerals, such as calcium, within bones, ensuring that they are healthy, strong, and stable.
- Maintains cardiovascular health by keeping cholesterol and other lipids in check; increases the levels of good cholesterol (HDL) and decreases the levels of bad cholesterol (LDL).
- Supports mental health by regulating the production and uptake of serotonin.
- Assists in regulating sleep
- Protects skin health; increases collagen production and blood supply to the skin.
The ovaries mainly produce estrogen. And as a woman ages and her ovarian function declines, the estrogen levels start to dwindle. And soon, things begin to go awry as the estrogen levels fall, manifesting as cumbersome symptoms.
The symptoms of menopause are:
- Absence of menstrual bleeding. The intervals between the menstrual cycle start to become longer, and periods may temporarily become heavier.
- Hot flashes and night sweats (vasomotor symptoms); are glaring symptoms that often begin even before the final menstrual period.
- Vaginal dryness, itching, or burning
- Insomnia (even in the absence of the discomfort of hot flashes and night sweats); menopausal women are at an increased risk of insomnia.
- Mood changes; menopausal women are more prone to anxiety and depression.
- Weight gain or Difficulty in losing weight; due to the increase in appetite and decrease in metabolism
- Skin changes; dryness, itchiness, hair thinning, and hair loss
- Urinary incontinence and an increase in urinary frequency and urgency
Yet, the ramifications of menopause do not end at its symptoms; this fate of endogenous estrogen is permanent and increases the risk of other health conditions.
Menopause increases the risk of:
- Cardiovascular disease and stroke; due to increases in lipid levels after menopause and the deposition of cholesterol within arteries.
- Osteoporosis (thinning of bones); due to bone loss and lack of precipitation of bone-forming minerals within bones
- Type 2 Diabetes Mellitus
- Depression and Anxiety
- Thyroid issues
- Endometrial and Breast Cancer
The management of menopausal symptoms
Although the health risks of menopause will always be present, one can decide to control and manage menopausal symptoms. And it isn’t necessary to manage these symptoms as soon as menopause begins. Why not start earlier and get the upper hand in this hormonal situation.
- Stop smoking decreases the severity of vasomotor symptoms and also reduces the risk of cardiovascular disease.
- A healthy diet and regular exercise; seafood is rich in omega-3 fatty acids; these fatty acids maintain menstrual health and protect cardiovascular health. Maintaining a healthy weight and preventing obesity decreases the severity of menopausal symptoms and curbs other ailments, such as diabetes or heart disease.
- Take care of your skin. Frequently use moisturizers and sunscreen. Estrogen containing vaginal creams are beneficial for vaginal dryness and itchiness.
- Improve sleep hygiene. Maintain a regular sleep schedule, getting plentiful hours of sleep at night. Avoid caffeine at least two hours before bedtime and also avoid daytime naps. Melatonin supplements may help sustain sleep hygiene.
- Load up on vitamins and minerals! Vitamin D and calcium are essential in maintaining bone health. Vitamins B and C and zinc support skin and hair health. Vitamin E reduces stress, mood symptoms, and vasomotor symptoms.
- Natural remedies are useful in managing menopausal symptoms. Black cohosh, evening primrose oil, and ginseng are known to relieve vasomotor symptoms. Other natural supplements include chaste berry, wild yam, and red clover. Soy containing foods, such as tofu and soybeans, contain naturally derived estrogens; and the consumption of these foods will exert estrogenic effects in the body.
So far, the most popular medical treatment for menopause has been hormone replacement therapy (HRT). This exogenous source of estrogen, when started early, is known to be beneficial for women by reducing menopausal symptoms. However, the consumption of HRT increases cardiovascular disease and breast cancer risk. When the mood symptoms of menopause are disruptive and impact the quality of life, antidepressants are beneficial. Low-dose antidepressants are also known to reduce vasomotor symptoms. Another unusual drug to treat vasomotor symptoms is a seizure medication known as gabapentin.
Hormones have an intricate connection to the body’s other systems. Hormones of the reproductive system also affect other systems and organs; the decrease in estrogen levels will impact other organ systems.
Menopause is preordained. Just as young girls are educated about their imminent puberty and prospective mothers about their pregnancy, it is essential to educate ourselves about the journey and consequences of menopause. It isn’t just the end of our periods; it is more than that. The most beneficial thing we can do is to prepare ourselves before the onset of this journey. By doing so, we can avoid experiencing the unpleasant symptoms associated with the decline of estrogen. So, let us women take control of our reproductive health and improve our quality of life.