Menopause is a normal physiologic process that every woman will experience at some point in life, usually after the age of 40 years. It is not a disease. While it marks the end of a woman’s reproductive years, it should not be viewed as a restriction in life. There are some unpleasant symptoms but it does not usually have an adverse effect on health. These symptoms should be properly managed when it does occur but even if left untreated it is not life-threatening.
How To Spot Menopause
Menstruation is the body’s way of preparing for pregnancy. It is regulated by a host of hormones that fluctuate during the course of the menstrual cycle. When menopause arises the hormonal fluctuations cease. The main hormones that regulate this process, estrogen and progesterone, decreases in the female body. Ovulation and menstruation stops and this is the main sign of menopause.
Read more on female hormones.
However, cessation of the menses can occur for a number of reasons in a woman who was previously menstruating. The main factor that needs to be considered is pregnancy. Although menopause occurs in women in their 40s or 50s, pregnancy is possible, especially in the early 40s. Drugs, hormonal disorders and even severe psychological stress can also upset the normal menstrual cycle but this is not necessarily menopause.
Am I in menopause?
Sometimes the periods can stop for a few months (secondary amenorrhea) and may restart thereafter. Once again this is not menopause. It is therefore important to understand that menopause is where there has been no period for at least 12 months in a woman of menopausal age. If it occurs in younger women then it must be investigated for other causes or a condition known as premature ovarian failure.
Although menopause is not a disease, it is advisable that a woman is assessed by a gynecologist. As mentioned, other medical conditions that may cause the periods to stop need to be excluded. Furthermore menopausal and post-menopausal women are at risk of various diseases due to the low female hormone levels, such as cardiovascular diseases and weakening of the bones (osteoporosis).
The following signs and symptoms are an indication of menopause. However, it is important to note that some women do not experience symptoms like hot flashes, night sweats and fatigue.
No More Periods
Menstruation does not stop suddenly in menopause. It occurs gradually, where there are irregular periods for months and years before it stops completely. This stage is known as perimenopause. Some months the periods may occur, then it starts again and the amount of menses (period blood) fluctuates. Once menopause sets in (12 months of no periods), any vaginal bleeding that may occur should be considered abnormal and investigated further.
Read more on amenorrhea (no periods).
A characteristic feature of menopause is hot flashes. This is where there is a sudden feeling of heat throughout the body surface. It is unclear why this occurs but it is believed to occur when the blood vessels on the skin surface suddenly widens (dilates). Hot flashes is often reported as one of the most annoying symptoms of menopause but it is not life-threatening in any way.
Many women experience night sweats even without noticing hot flashes at this time. It is believed to be due to the same reason as hot flashes. The sweat glands release sweat as a way to cool the body surface. This may be abnormally activated during menopause. However, night sweats should not be assumed to be due to menopause and other possible causes like serious infections and heart conditions must also be excluded as a possible cause.
Another commonly reported symptom of menopause is vaginal dryness. The decrease in the female hormone levels as part of menopause affects the mucus-secreting lining of the vagina which normally moisturizes and lubricates the vaginal canal. It may be most noticeable during sexual intercourse due to discomfort and pain. The dryness also increases the risk of vaginal infections caused by yeasts and bacteria.
This is another frequently seen sign of menopause. Some women may not notice it and instead it may be reported by their friends and family. There may be feelings of anxiety, sadness, grief and episodes of weeping for no known reason. These changes is also associated with the female hormone levels that decline in menopause. However, some women may feel depressed due to life situations and the physiologic changes in the body that happens at this age.
Hair Loss and Dry Skin
The female hormones play diverse roles in the body beyond the reproductive organs. In menopause there are changes that also affect the hair and skin. Thinning of the hair is one such change but menopause does not lead to balding in women. Another change that may be noticed is dryness of the skin. It is important to note that some of these changes can also occur with other hormone conditions, like hypothyroidism (underactive thyroid gland).
Many women report sleep problems during perimenopause and menopause. These sleep problems are often associated with anxiety and depression. Apart from the effect of the hormonal changes on the sleep cycle, hot flashes and night sweats can further disrupt sleep patterns. It continues till after menopause and many post-menopausal women also reported breathing problems during sleep.
Weight Gain and Low Energy
Menopause does not cause obesity. However, many women will experience slight to moderate weight gain and it is often associated with a slow down in metabolism. There are also low energy levels reported and reduced physical activity can further contribute to weight gain. Other causes of weight gain and low energy levels also need to be excluded, such as hypothyroidism, which may be more likely to affect women in this age group.
Reduced Breast Fullness
The breast tissue is highly sensitive to the female hormone levels. As these hormone levels decline, there are also changes in the breasts that may be noticed. This is often reported as the breast being less full or sagging to some extent. Changes in the breast, such as tenderness and swelling, which occur with the fluctuations in the menstrual cycle also do not occur.