Menopause
What is the menopause?
The menopause refers to that time in every woman’s life when her periods stop and her ovaries lose their reproductive function. Usually, this occurs between the ages of 45 and 55, but in a few exceptional cases women may become menopausal in their 30s, or even younger. This is then known as a premature menopause, or premature ovarian insufficiency. The menopause is influenced by hormones – or more correctly, by a change in hormone levels. During a woman’s fertile years, her ability to produce an egg each month is associated with the release of three reproductive hormones (oestradiol, oestrone and oestriol), that are referred to collectively as oestrogen. Oestrogen is mainly produced by the ovaries, though small amounts are also made by the adrenal glands and by the placenta of a pregnant woman. It is oestrogen which stimulates female characteristics at puberty and controls a woman’s reproductive cycle: the development and release of an egg each month (ovulation) for implantation in the uterus (womb), and the way in which the lining of the uterus thickens to accept a fertilized egg. The monthly period happens because no implantation has taken place – there is no pregnancy – and the lining of the uterus is shed. As women get older, their store of eggs in the ovary decreases and their ability to conceive diminishes. At this time, less oestrogen is produced, causing the body to behave differently. However the body does not stop producing oestrogen over night, and the process can even take several years, during which symptoms arise gradually. This gradual change is called the ‘peri-menopause’. At around the age of 50-55 years, the monthly cycle stops completely – so no more ovulations, no more periods and no more pregnancies. This is the menopause.
What happens and how does it feel?
For some women this loss of reproductive ability may be deeply felt, and for all women the menopause is a personal experience, not just a medical condition. However, the diminishing release of oestrogen from the ovary as women advance into their 40s is often the cause of symptoms which can be distressing and may need medical attention.
The most common symptom are hot flushes, occurring in three in every four menopausal women. Other common symptoms include night sweats, sleeplessness, vaginal dryness, irritated skin, more frequent urinary incontinence and urinary tract infections, low mood and a reduced interest in sex. Symptoms vary hugely in duration, severity and what impact they have on women.
The symptoms experienced by women at this stage are as a result of the bodies reduced production of oestrogen. Which in turn can also have its own effects such as effects on the brain causing changes in emotional well-being and thickness and elasticity of the skin.
Other long term health impacts of reduced oestrogen include the strength and density of bones with a risk of osteoporosis. Often only first being diagnosed by a bone fracture. However, you are able to self-refer for a bone scan (DEXA Scan) if you are concerned.
What can be done?
We are able to offer a number of interventions and support to women at all stages of menopause. These will be personal to you, tailored and adaptive to ensure that you are supported in the best possible way to minimise the impact of the menopause. Contact us now and speak to our women’s health specialist GP, Dr Shahnaz Schaeper who can assist you.