Menopause means the cessation of a woman’s menstruation. Technically a woman has to have no menses for 12 months before she is described as menopausal.
During the reproductive years, oestrogens are produced from the ovaries, which stimulate the lining of the uterus for implantation of a fertilised egg, the beginning of pregnancy. The principle oestrogen of the menstrual cycle is estradiol.
As a woman enters her mid-thirties, her reproductive
capacity starts to decline, with a decrease of oestrogens
and progesterone production. During this time, however, she
usually continues to ovulate and her menstrual cycle generally
remains regular and normal.
When a woman reaches 40 - 45, her menstrual cycle can become
very disrupted and oestrogens levels can swing from very high
to very low. This can result in alternating sensations of
enlarged and tender breasts with bloating and irritability
when oestrogens are dominant; and hot flushes, confused thinking
or lack of concentration, memory difficulties and vaginal
dryness when the oestrogens levels plummet. There may be time
with no bleeding, followed by heavy bleeding accompanied by
severe cramps. This is referred to as peri-menopause, which
precedes the true menopause by 5 - 10 years.
Symptoms & Implications
At a woman enters the menopause, oestrogens levels have become so low that the lining of the uterus is not stimulated to build up enough to shed, and therefore periods no longer occur. These continued low levels cause:
- Increase in hot flushes
- Difficulty concentrating and memory problems
- Accelerated loss of bone at a faster rate than at any time in her life.
Other symptoms of the peri-menopause may intensify, such as:
- Vaginal dryness
- Decreased libido
- Dry skin
- Loss of skin elasticity
- Shrinking breasts
- Decreased mood and energy.
Few years after the menopause, the body will settle into a lower oestrogens state, and many women become acclimated to the symptoms. Bone loss slows down, but definitely continues. The damage to the many organ systems that need oestrogens continues insidiously, with increase in:
- Cardiovascular disease
- Osteoporosis and fracture
- Diabetes
- High blood pressure
- Strokes
- Alzheimer's disease.
The aging of a woman's reproductive system is actually a fairly continuous process that starts in the early thirties. An anti-aging approach takes this into account, and intervenes before the actual menopause to treat the symptoms and long-term consequences that result from less than optimal hormone levels.
Diagnosis
Apart from the clinical symptoms and signs that accompany the cessation of menstrual periods, blood tests can be done to measure the levels of estradiol and progesterone.
Treatments & Options
This is done through Hormones Replacement Therapy, which include estradiol, progesterone, and in cases, the male hormone testosterone too. This is discussed in the sections of Oestrogens & Progesterone, and Testosterone.