What is menopause?
Menopause is the time that marks the end of a woman’s reproductive years. It is a natural biological process that all women will go through as they age. Menopause represents the decline of fertility and the end of the menstrual cycle. It typically happens to women in their late 40s or early 50s.
The word menopause is derived from the Greek word mĕn or menos meaning month and pausis meaning to stop. This fits in very well with the medical definition of menopause. It is defined as the point when monthly periods, or menstruation, finally stops.
What is perimenopause?
Before the full onset of menopause, women go through a transition stage wherein their periods become irregular and seem to slow down. They also begin to experience varying symptoms related to hormonal changes or imbalances. The symptoms tell a woman that she has started the journey to the next stage or milestone of her life. This is called perimenopause.
Perimenopause means around menopause. This is a time during which a woman’s body makes the natural transition to menopause, marking the end of their reproductive years. It begins several years before menopause. During this period, the ovaries start to produce less estrogen.
How is menopause diagnosed?
Doctors and gynecologists can help determine if a woman is on her way to menopause. They will ask about symptoms, cycles and conduct some tests.
Menopause will be clinically diagnosed if a woman has gone through 12 consecutive months without a menstrual period.
What are the symptoms of menopause?
Just as menstruation is a different experience for every woman, so too is menopause. Some women experience virtually no symptoms, while others have a lot of difficulty with their symptoms. If the symptoms are interfering with the quality of life, it is best to go and seek medical treatment.
The hormonal roller coaster that comes with the end of a woman’s childbearing years can trigger a range of symptoms. They include:
1. Irregular periods
Irregular periods are one of the most classic signs that a woman may be on her way to menopause. Only a few women reach menopause without first encountering this symptom. For a majority of women, this is the first indication that they have entered the perimenopause or the time that a woman’s body has started its natural transition to menopause. This stage usually occurs two to ten years before menopause.
Periods that come too frequently or infrequently are the most obvious indications of irregular periods. In addition to that, the shortened or lengthened time during periods and the lightness or heaviness of flows are also considered as symptoms of irregular periods. Periods are regulated by hormones called estrogen and progesterone.
Irregular periods occur because ovulation becomes unpredictable. As women reach their late 40s or early 50s, their periods would shift from being irregular to a full stop. It is often not a steady or gradual descent but more of an erratic pattern.
2. Hot flashes and night sweats
75% of menopausal women experience hot flashes. These are another common symptom of menopause that is brought about by changing hormones, lifestyle, and diet.
Hot flashes, also known as vasomotor symptoms, are described as feelings of intense heat or warmth that are not caused by any external sources. They may appear quickly or can be slowly felt. They often last around four to ten minutes. The frequency of episodes also varies from woman to woman.
Although the root cause of hot flashes is not entirely clear, scientists believe that the fluctuating levels of estrogen cause the part of the brain that regulates body temperature (the hypothalamus) into glitching and making the body feel hot. This causes a response to cool down making blood rush to the skin and sweat glands to work.
Night sweats are hot flashes that occur during sleep and could be sometimes intense enough to wake someone from their sleep.
3. Vaginal dryness
It is also one of the most common symptoms of menopause and is perhaps one of the most uncomfortable. Vaginal dryness affects about 50% of women who are transitioning into menopause.
The changing hormone levels during menopause causes the vaginal walls to become more sensitive and irritable. Most women experience general discomfort, itching, burning, and pain or light bleeding during sexual intercourse or urinating.
The decline of the hormones estrogen and progesterone are the main cause of vaginal dryness. Estrogen keeps the walls of the vagina moist and supple with adequate mucous linings covering the vaginal walls. They are slightly acidic to help fight off any bacteria. With the drop of estrogen levels, the lubrication decreases and the walls become thin and sensitive.
4. Joint pains
The most commonly affected parts of the body are the neck, shoulders, elbows, and hands. Menopausal joint pains are described to usually hit the worst in the mornings and eases as the joints loosen due to the daily activities. The pain can be accompanied by stiffness, swelling, or even a shooting pain traveling down the back, arms, and legs. At least 50% of women at the post-menopausal stage experience joint pains.
Hormones play a very big role in a woman’s joint health. The decrease in the hormone estrogen is believed to cause these pains. Estrogen helps keeps inflammation down and with its decrease, the joints start to swell and become painful.
All the hormonal changes can drain a woman’s energy as the body tries to adapt and rebalance every day without the hormones that it is used to. Eventually, the body’s energy level will drop to a certain level that could lead to menopausal fatigue.
This ongoing lack of energy, tiredness, and weakness is not just caused by the fluctuating hormones that are all involved in regulating cellular energy in the body. When they become compromised it often leads to fatigue.
Menopausal fatigue can also be brought about by other symptoms related to menopause like night sweats. Many women find themselves suffering from a chronic lack of sleep. In turn, the fatigue further exacerbates other menopause-related conditions in a vicious and spiraling cycle.
6. Mood changes
During the transition to menopause, dropping estrogen levels creates wide-ranging changes in a woman’s body. It also has a direct link to menopausal mood swings.
Most women experience unexplained moods which are continually changing. Women experiencing menopausal mood swings exhibit reactions far stronger than a particular situation merits. Others show increased irritability and less tolerance or patience than normal.
Some of the more widespread aspects of mood swings caused by menopause include irritability, depression, crying episodes, insomnia, and anxiety.
The hormones which trigger ovulation and menstruation are also important for releasing and managing a mood-regulating chemical called serotonin. As the hormones start to decline, so does the level of serotonin. Unfortunately, the decline is not a smooth and steady descent but a bumpy road down.
In addition, night sweats and hot flashes also add to the discomfort a woman feels which aggravates the mood swings further.
7. Less interest in sex
The gradual decrease of estrogen and testosterone can lead to changes in a woman’s sexual drive. Some may experience an increase in libido and others a decrease. While not all women experience the decrease in their libido, it is still a very common occurrence experienced by women going through the transition into menopause.
Estrogen is the main female hormone that keeps the walls of the vagina healthy. When estrogen levels drop, blood supply also drops in the vagina. The lowered blood supply, in turn, negatively affects vaginal lubrication. Low estrogen can also cause vaginal atrophy or the thinning of the vaginal walls. These changes make the vagina dry and tight which often results in uncomfortable and painful intercourse.
Progesterone and testosterone also play an important role in libido levels. Testosterone is the main hormone for causing sexual desire. Progesterone stimulates the production of this hormone. However, during menopause, levels of progesterone also reduce, resulting in loss of libido.
Apart from that, other menopause symptoms like hot flashes, mood swings and other physical changes linked to menopause can also affect a woman’s sex drive.
8. Weight gain
One of the most discernible symptoms of menopause is weight gain. While it is pretty normal for people to gain weight as they grow older, women who are transitioning to menopause are more susceptible to gaining more weight because of all the hormonal and physical changes that are happening at this stage.
Many women feel that the weight gained is more noticeable because it tends to accumulate in one area of the body rather than distributed evenly throughout the body. When younger, women tend to get the extra weight around the hips and thighs. During perimenopause and after menopause, the extra weight collects around the tummy area.
Weight gain occurs because the hormonal fluctuations encountered during the transition stage means that the body deals with the consumed food in a different way. Metabolism or the rate that the body can burn off calories from food reduces which means more calories are stored rather than burned.
9. Hair Loss
While a lot of people do not automatically think that hair loss could be a symptom of menopause, it definitely can occur at this stage due to hormonal imbalance. Some women will begin to notice a change in their hair patterns. It also becomes clear that the volume and condition of the hair begin to worsen with many experiencing slow hair growth and increased hair fall during washing or brushing.
Estrogen and progesterone are hormones that help hair grow faster and stay on the head for longer periods of time. When they drop, hair grows slower and becomes much thinner. The decrease in these hormones also triggers an increase in the production of androgens or a group of male hormones. These androgens shrink hair follicles, resulting in hair loss on the head.
10. Breast changes
Breast changes like size and fullness are some of the changes in a woman’s breast that can be a symptom that she is on her way to menopause.
Estrogen keeps the connective tissue of the breasts hydrated and elastic. In the hormone’s absence, the breasts shrink because the ducts and mammary glands shrink, and the breasts become less firm and lose their shape.
Breast discomfort is also present and not all women experience breast discomfort in the same way. Sometimes it may feel like a burning sensation or soreness which can be felt in one or both breasts. Sometimes the pain may feel sharp, stabbing or throbbing. The unpredictable rise and fall of hormones affect breast tissues, therefore, making women feel discomfort or pain in their breasts.
11. Burning Mouth
Burning mouth is not as common as other symptoms but the decrease of saliva due to menopause may bring about this unusual symptom. It is described as an uncomfortable hot or burning sensation in the mouth. It is like the mouth is on fire.
Pain can be felt at the roof of the mouth, gums, lips, and sides of the mouth and the tip of the tongue. These are the most commonly affected sites.
The decrease in estrogen reduces saliva production, causes a metallic taste in the mouth and a burning sensation.
The sensations associated with burning mouth due to menopause generally occur in several different patterns that vary in intensity and consistency.
12. Urinary incontinence
Declining estrogen levels can cause thinning of the lining of the urethra. This is a short tube that passes urine from the bladder out of the body. Low estrogen levels also make the pelvic muscles weaken. The surrounding pelvic muscles also decline with aging, a process known as pelvic relaxation. These factors cause urinary incontinence in menopausal women.
Incontinence is a condition where a person unintentionally pass urine.
Estrogen is important for keeping the urethra and bladder healthy. A significant reduction in the level of this hormone may cause the pelvic floor muscles to naturally weaken. When placed under strain, such as when laughing or coughing, involuntary leakage of urine may occur.