The word menopause means the stopping of the monthly period (menses) and is a normal stage in a woman’s life. Usually, it takes place between the ages of 45 and 55 years but it can happen as early as 35 years.
What happens during the menopause?
When a baby girl is born, she has all the eggs in her ovaries that she is going to hove. Eventually, these run out and the ovaries stop releasing eggs. During this lime, the levels of the female sex hormones, estrogen and progesterone, which are produced by the ovaries, become erratic and fall off. It is the reduction of oestrogen that causes the classical symptoms of the menopause: hot flushes, night sweats, vaginal dryness, insomnia, depression, and loss of bone density.
Many women have no symptoms during their menopausal years, but for about a third of women, there are unpleasant physical and psychological symptoms. If you bleed after your periods have stopped, see a doctor.
What treatments are there?
The conventional medical treatment for menopausal symptoms is hormone replacement therapy (HRT). Women who still hove a womb have to take a combination of a synthetic estrogen and a progestogen (progesterone-like drug) because oestrogen alone increases the risk of endometrial (womb lining) cancer, and breast and ovarian cancer. Women who have had a hysterectomy only need to take estrogen. HRT can alleviate symptoms such as hot flushes about 90 per cent of the time, although only about 20 per cent of women with symptoms choose to take it.
Estrogen and progesterone were thought to have a protective effect against heart disease (and pre-menopausal women do have a lower risk of heart disease), https://www.integratedwellnessclinic.com.au/ but HRT is no longer given to women to protect against heart disease. It is now believed that HRT can increase the risk of heart disease during the first year of taking the medication, or for those already with heart disease.
HRT is also unsuitable for some women, such as those with a history of thrombosis (blood clots] or those with abnormal vaginal bleeding. Some women stop taking HRT because of minor but unpleasant side effects, such as breast tenderness, weight gain, nausea, headaches, itchy skin rashes, and fluid retention. Other conventional drugs used in the menopause are clonidine for severe hot flushes and anti-depressants.
Complementary treatments can also help with the symptoms of menopause. There is scientific evidence for naturopathy, nutritional therapy, relaxation techniques, and herbalism. Helpful herbal medicines include St. Johns wort for mild to moderate depression, valerian for sleeplessness, vervain for stress, and black cohosh, chaste tree, sage, or wild yam for hormonal irregularity. The evidence for black cohosh is particularly strong, followed by that for chaste tree. Vitamin E or pot marigold cream may help with vaginal dryness.
Shatavari is an Ayurvedic tonic said to have a regenerative action on the female organs and to contain female hormones that help with symptoms such as dryness, excessive thirst, hot flushes, and loss of libido, although clinical studies are lacking. Therapies such as acupuncture and homeopathy might help, but the evidence is anecdotal.
Counseling or psychotherapy can help depressed women who find it hard to face children leaving home, retirement or ageing. The preventative measures discussed in the sections on heart disease and osteoporosis are also relevant. Natural progesterone creams are promoted to treat menopausal symptoms. One study suggests they might help with hot flushes but there is only limited evidence that they prevent osteoporosis.