menopause

Understanding the menopause: stages, symptoms and health care

The menopause is the period in a woman's life when her monthly periods stop naturally. A woman is considered to be in the menopause when she has not menstruated for a year. This usually occurs between the ages of 45 and 55.

During the menopause, the ovaries stop releasing eggs, which makes pregnancy impossible and marks the end of a woman's fertile years. At the same time, the production of the hormones oestrogen and progesterone by the ovaries drops to very low levels.

The menopause doesn't come on suddenly; most women experience several years of changes in their menstrual cycle before their periods stop completely. Normally, they start to become irregular, usually less frequent, and vary in intensity, becoming more abundant or lighter. This phase is known as perimenopause.

The menopause is a normal stage in women's lives, but it can be associated with symptoms of varying intensity that can have an impact on their physical and mental well-being. It also represents a time of vital and social change.

What causes the menopause?

The menopause occurs naturally due to hormonal changes in a woman's body. With age, the ovaries gradually produce less oestrogen and progesterone, the hormones responsible for menstrual cycles. This progressive decrease leads to the definitive cessation of menstruation.

In some women, the menopause happens earlier. When it occurs before the age of 40, it is considered early menopause. It can be due to factors such as genetic predisposition, autoimmune diseases and poor nutrition, or it can be induced by medical intervention, for example when a woman undergoes surgery to remove her ovaries, or certain medical treatments, such as chemotherapy or radiotherapy of the pelvic area.

Can the menopause be diagnosed?

Your doctor can identify your entry into the perimenopause based on the presence of typical symptoms. The diagnosis of menopause is confirmed when a woman has not menstruated for 12 consecutive months.

In most cases, laboratory tests are not necessary to confirm the diagnosis. However, in some situations - for example, when early menopause is suspected - blood tests may be requested for hormonal evaluation.

What are the main symptoms of the menopause?

Symptoms vary from woman to woman, both in frequency and intensity. For some they can be almost unnoticeable, while for others they can be uncomfortable or even limit daily life and affect quality of life.

In addition to irregular periods, some of the most common symptoms are:

Hot flushes and night sweats. These are also known as vasomotor symptoms. Hot flashes are sudden sensations of heat in the face, neck and chest, lasting from seconds to a few minutes, which can cause redness of the skin and sweating. When they occur during sleep, they are called night sweats.
Some women feel dizzy, weak or nauseous during a hot flash. Others may feel their heart beating faster (palpitations) and sudden feelings of anxiety;
Sleep disturbances. Such as difficulty falling asleep or getting back to sleep after waking up;
Anxiety and mood swings;
Memory and concentration problems;
Skin and hair changes. The skin can become thinner, drier and less elastic, while the hair can become thinner, brittle and less dense;
Gynecological and urinary tract changes. As estrogen levels in the body decrease, the tissues of the vagina and urethra (the channel that carries urine from the bladder to the outside of the body) can become thinner and drier. This can cause urinary symptoms similar to those of an infection, such as sudden urge and burning when urinating, as well as vaginal dryness, itching, burning and pain during sexual intercourse. There is also a greater predisposition to recurrent infections. These symptoms usually appear some time after the last menstrual period and are known as genitourinary menopause syndrome;
Joint pain and tiredness;
Headaches and/or migraines that are stronger than usual;
Decreased sexual desire.

The changes that occur in women's bodies as a result of the menopause can increase the risk of certain diseases. The decrease in oestrogen levels, for example, can lead to:

Loss of bone mass, favoring the appearance of osteoporosis, a condition in which the bones become fragile and prone to fractures.
Raised cholesterol levels, increasing the risk of heart disease and stroke.

How long do the symptoms last?

The symptoms of the menopause have no fixed duration and can vary greatly from woman to woman. For some, they may only last a few months, while others may experience them for several years.

In addition, some signs can appear months or even years before your last period, during the perimenopause. The duration of the symptoms therefore depends on each woman's body and her hormonal cycle.

After the menopause, the post-menopause begins, a phase that encompasses the years following the last menstrual period. During this period, the typical symptoms of the menopause tend to diminish progressively, although some women continue to experience certain symptoms, such as vaginal dryness or bone changes.

How can I relieve the symptoms? What treatments are available?

The symptoms of the menopause tend to disappear naturally and, in many cases, are tolerable and do not require treatment. However, sometimes women experience intense or very uncomfortable symptoms. In these cases, it is important to have an assessment by a doctor, who will be able to recommend a treatment from among the various options available. These include:

Hormone replacement therapy (HRT) is the most effective treatment for controlling the symptoms of the menopause. It consists of administering substances with similar effects to the hormones produced by the ovaries - oestrogens and progestogens. HRT is available in various forms such as tablets, patches or creams. Oestrogen creams are particularly useful for relieving vaginal dryness;
Non-hormonal treatments may be recommended for women who cannot, or prefer not to, use HRT. These include drugs with effects on the central nervous system, such as antidepressants, among others.
Cognitive-behavioral therapy can be useful in treating various mental health problems during the menopause. Talking to a therapist can help reduce anxiety, improve mood and relieve sleep disturbances, providing practical strategies for dealing with emotional changes and stress at this stage of life.

What other measures can I take to control the symptoms?

There are a number of simple, practical measures that can alleviate the symptoms of the menopause, promoting greater comfort and well-being:

If you have hot flashes, dress in layers that you can easily remove when you get hot. You can also bring a fan or portable fan with you to use at those times;
Choose clothes made from natural fibers that allow your skin to breathe;
Avoid thick sweaters and scarves;
Avoid alcohol, spicy foods and caffeine as they can aggravate menopause symptoms;
If you smoke, try to quit, not only to reduce hot flushes, but also to improve your general health;
Try to maintain a healthy weight, as excess weight or obesity can intensify hot flashes;
Stay hydrated;
Use hygiene products with the right pH to avoid increasing vaginal dryness;
Using lubricant before sex can help reduce discomfort, pain or burning. The use of moisturizing products, applied regularly once or twice a week, can also help to keep the vaginal mucosa moisturized;
Adopt good sleeping habits: keep the bedroom dark, quiet and cool.

Sharing experiences with other women who are going through the same thing can be very useful, helping you to feel understood and supported.

Talking to your doctor or pharmacist is also important, as it allows you to clear up any doubts, receive reliable information about your symptoms and learn about the best treatment options available.

What can I do to stay healthy?

During the menopause, it becomes essential to adopt behaviors that promote health and contribute to overall well-being. This will help prevent conditions such as osteoporosis and cardiovascular disease, which are more common at this stage of life.

Here are some practical recommendations:

Follow a healthy diet rich in fruit, vegetables and dairy products such as milk and yogurt, which are good sources of calcium;
Expose yourself to sunlight, as this triggers the production of vitamin D, which can help keep bones strong;
Avoid excess alcohol, caffeine and tobacco;
Exercise regularly, such as walking, swimming, dancing and Pilates, which help to strengthen bones and muscles. Physical activity also helps to improve sleep and mood;
Control your weight, blood pressure and cholesterol by carrying out regular checks;
Reduce stress by using relaxation techniques such as meditation, deep breathing or muscle relaxation exercises.

When should I seek medical help?

You should seek medical help whenever symptoms are intense or persistent and begin to significantly affect your quality of life. This includes frequent hot flushes, night sweats, mood swings, insomnia, vaginal dryness or discomfort during sexual intercourse.

It is also important to see a doctor if associated health problems arise, such as bone loss, significant joint or muscle pain, increased cholesterol or blood pressure, or any new or unexpected symptoms, such as unusual vaginal bleeding or severe pain.

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