Urogynaecology
Menopause
Menopause is the time in a woman's life when she stops having monthly periods. At this time, her ovaries stop releasing eggs and stop making the hormones estrogen and progesterone. Menopause usually occurs between the ages of 45 and 55. The average age is 51.
How do I know if I am going through menopause?
Most women start to wonder about menopause when their periods start to change. If you are going through menopause, you might:
Have periods more or less often than usual (for example, every 5 to 6 weeks instead of every 4)
Have bleeding that lasts for fewer days than before
Skip one or more periods
Have symptoms of menopause, such as hot flushes (described below)
If your uterus has been removed, but you still have your ovaries, it might be difficult to know when you are going through menopause. You may go through menopause early, If your ovaries have been removed prior to the usual age of menopause.
There are no tests that can point to menopause. Blood tests do not always suggest onset of menopause and could remain abnormal for a number of years before the actual onset of menopause.
Pregnancy is still a possibility and contraceptive measures should be continued till you have stopped having periods for at least 12 months.
What are the symptoms of menopause?
Some women go through menopause without symptoms. But most have 1 or more of these symptoms:
Hot flushes – Hot flashes feel like a wave of heat that starts in your chest and face and then moves through your body. Hot flushes usually start happening before you stop having periods.
Night sweats – When hot flashes happen during sleep, they are called "night sweats." They can make it hard to get a good night's sleep.
Sleep problems – During the transition to menopause, some women have trouble falling or staying asleep. This can happen even if night sweats are not a problem.
Vaginal dryness – Menopause can cause the vagina and tissues near the vagina to become dry and thin. This usually starts a few years after menopause. It can be uncomfortable or make sex painful.
Depression – During the transition to menopause, many women start having symptoms of depression or anxiety. That's especially true for women who have been depressed before. Depression symptoms include:
Sadness
Losing interest in doing things
Sleeping too much or too little
Trouble concentrating or remembering things – This might be caused by lack of sleep that often happens at menopause, or by the lack of estrogen. Some experts suspect that estrogen is important for good brain function.
When to see your GP?
You don’t need to see your doctor just because your periods are changing and you are 45 or older. But you should see your doctor or nurse if you have symptoms that really bother you and is affecting your quality of life. (eg: poor sleep due to night sweats, feeling low etc)
You should also see your doctor or nurse if you:
Have your period more often than every 3 weeks
Have very heavy bleeding during your period
Have spotting between your periods
Have been through menopause (have gone 12 months without a period) and start bleeding again, even if it's just a spot of blood
How are menopause symptoms treated?
Treatments for hot flushes include:
Hormones (estrogen) – The hormone estrogen is the most effective treatment for menopause symptoms. Most women need to take estrogen with another hormone, called progesterone. Women who have had a hysterectomy (surgery to remove the uterus) can take estrogen by itself. Experts think these hormones are effective and safe for many women in their 40s and 50s with symptoms of menopause. If you want to take hormones, ask your doctor or nurse if it is an option for you. You should not take hormones if you have had breast cancer, a heart attack, a stroke, or a blood clot.
Antidepressants – Some types of antidepressants can ease hot flashes and depression. Even women who are not depressed can take them to help with hot flashes.
Anti-seizure medicine – One of the medicines used to prevent seizures seems to help some women with hot flashes, even if they do not have seizures.
Treatments for vaginal dryness include:
Vaginal estrogen – This is an option for women who have vaginal dryness without other symptoms of menopause. Vaginal estrogen is any form of estrogen that goes directly into the vagina. It comes in creams and vaginal pessaries. Vaginal estrogen comes in small doses that don't increase the levels of estrogen in other parts of the body very much.
Other medicines – In most cases, doctors recommend vaginal estrogen. That's because there is more evidence that it helps with vaginal dryness compared with other medicines.
Can I do anything on my own to reduce the symptoms of menopause?
Avoiding hot drinks , especially caffeinated drinks from afternoon will help prevent hot flushes get worse and may give you better sleep.
Quitting smoking as this makes flushes worse
Using lubrication before sex and using vaginal moisturisers
Stay active and exercise regularly
Have a sleep routine
Take calcium and Vit D supplements
Please check with your GP before considering any natural remedies.
https://ranzcog.edu.au/womens-health/patient-information-resources/menopause