The symptoms of menopause can all be related to the decrease in oestrogen levels. Besides the preparation of the mucous membrane of the womb, oestrogen also affects one’s mood, temperature regulation, fat and bone metabolism.
Commonly known symptoms of menopause are:
Hot flushes and transpiration
All of a sudden you feel warm and are blushing. Hot flushes typically affect the face and upper chest. This flush is than followed by heavy transpiration. When the sweat evaporates, you feel suddenly cold. Flushes can last from half a minute to up to four minutes in some women.
Night time sweating
Hot flushes during your sleep can cause you to wake up, only to discover that you’re soaking wet. Falling back to sleep may be difficult. Maybe you have to change your gown or the sheets and even wake your partner, all things that disturb your sleep.
Palpitations
An unexpected increase in your hearth rhythm. Palpitations can be frightening and cause panic.
Mood disturbances
Many women are already familiar with the effects of oestrogen on their mood. Prior to menstruation some may have experienced low mood, and been more easily irritated. These mood disturbances and others are common during the menopausal period, and may result in or contribute to irritability, fatigue, memory loss and a decreased libido. However not all the psychological changes may be associated with the menopause. Some women even suffer from depression during this period, although it is not known whether it is the fall in oestrogen or other factors such as the reduction in fertility which triggers depression. Other factors include children leaving home and the visible signs of aging. Fortunately for most women, feelings of low mood tend to lessen with time. In some women, it takes only a few months for the body to adapt to the new situation, while others experience these symptoms for months or years.
The decrease in oestrogen level also has permanent consequences that do not pass with time, such as:
Changes to the vagina and urinary tract (atrophic symptoms)
Due to the decrease in oestrogen production, blood supply to the vagina and the urinary tract also decreases. Consequently, vaginal secretion diminishes, and this may result in pain during sexual intercourse.
Furthermore, thinning of the mucous membranes makes the vagina and the urinary tract more susceptible to infections. Itching is also a common problem.
The weakening of the supportive structures of uterus and vagina may cause ‘descending’ (also called a prolapse) of these organs; a situation that sometimes needs to be corrected surgically.
Urinary incontinence
Half of all women experience involuntary loss of urine after menopause, caused by insufficient closing of the urinary sphincter and worsened by the loss of supportive structures which keep the pelvic organs - including the bladder - in position.
Urine loss is related to increasing intra-abdominal pressure, as can occur during sneezing, coughing, laughing or lifting heavy loads. Some women complain about ‘urge incontinence’ or an ‘overactive bladder’: a sudden urge to urinate arises, which sometimes is so strong that there is no time to reach the bathroom.
You may find relief in ‘bladder training’, which attempts to strengthen the pelvic floor muscles. In severe cases, surgical intervention will be necessary to "lift" or otherwise modify the bladder.
Increased risk for cardiovascular diseases
Pre-menopausal women tend to have a reduced risk for the development of cardiovascular health problems compared to men of the same age. But after reaching menopause, this difference disappears. Oestrogen has a so-called cardio-protective effect, therefore, the decreased production of oestrogen will result - amongst other effects - in ‘good’ cholesterol levels falling, while ‘bad’ cholesterol levels rise.
If you have a pre-existing risk for cardiovascular diseases, (e.g. smoker, a hereditary defect or a high cholesterol level), it is important to help reduce the risks where possible. Risk and lifestyle changes, such as taking exercise, eating healthily and stopping smoking, can also help.
Osteoporosis
Osteoporosis can be thought of as the ‘decalcification’ of the bones. As the bones lose calcium, they become thinner and become more susceptible to fractures. This disorder can eventually lead to spontaneous fractures of the bones or shrinking of the spine.
Bone pain is common in patients with osteoporosis. During the first 30 years of your life, your bones become stronger and stronger, and their calcium content increases. After reaching the age of 30, the change in hormonal balance has its effect: calcium content begins to diminish rapidly. After menopause, this decline is even more substantial: with decreasing oestrogen levels, its effect as a calcium-fixating agent is gradually lost.
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