Understanding Menopause Transition: A New Chapter for Women

Menopause is a naturally occurring biological event in a female person’s life. It occurs most frequently at ages 45-55. This event is marked by the cessation of ovulation that results from diminished ovarian function and a decline in the hormonal production of estrogen. Menopause is accompanied by a series of emotions and physical symptoms, including hot flashes, night sweats, mood swings, and vaginal dryness. It is very crucial for the women in order to know the menopause age, how the menopause stage is effectively managed, and how it is associated with health problems that may come with it.

Understanding Menopause

The definition of menopause is when periods stop permanently. Menopause is established after 12 months of an absence of a menstrual period, vaginal bleeding, or spotting. This is the normal end of menses caused by estrogen deficiency; it occurs at an age ranging from 45 to 56. This is not pathologic and is characterized by twelve-month amenorrhea (absence of periods). Natural menopause usually occurs at 51 years. Menopause has an impact on various organ systems, including the vasomotor symptoms and issues related to cardiovascular. There are hormonal and nonhormonal methods of treatment for menopause; complications can sometimes arise.
Most of the women spend around 40% of their lives in postmenopausal years. Because of the change in hormones related to menopause, women often develop uncomfortable physical and emotional symptoms. In general, menopause age differs from woman to woman based on the hormonal changes. There are treatments available to help with symptoms of menopause, including hormone therapy, medications, or lifestyle adjustments.

What is Early Menopause?

If menopause starts before the age of 40, then the occurrence is termed early menopause or premature ovarian insufficiency. Causes of early menopause are accompanied by multiple factors such as genetic predisposition, autoimmune disorders, and specific medical treatments like chemotherapy or radiation therapy, and surgical procedures, including ovarian removal. Early menopause symptoms include irregular or absent menstrual periods, hot flashes, night sweats, vaginal dryness, mood swings, and difficulty sleeping.

Stages of Menopause

Menopause is a natural biological process that marks the end of a woman’s reproductive years and occurs in three stages. The three phases of menopause are:

• Perimenopause: This is a transition stage before menopause. It starts even before one’s last menstrual flow and may begin several years before menopause. Perimenopausal women often experience fluctuating levels of hormones, as well as signs and symptoms involving low estrogen symptoms such as irregular periods (heavier, lighter, or more frequent), hot flashes, night sweats, mood swings, and sleep disturbances.
• Menopause: It is established at the end of menstruation. It is confirmed once there is no menstrual flow for 12 months in a row. Estrogen declines, so symptoms may begin or worsen; these include hot flashes, vaginal dryness, and mood swings.
• Postmenopause: This starts at the one-year postmenopause phase. It is the time after menopause when women remain under the impact of falling estrogen levels. Post menopause symptoms include vaginal dryness, sleep disturbances, mood changes, and some heart and bone-related conditions.

Menopause Symptoms

Menopause occurs when the body’s ovaries produce less estrogen and progesterone hormones, leading to various symptoms such as:

• Irregular Periods: Periods may shorten, prolong, lighten, or become heavier and more frequent until eventually they stop.
• Missed Periods: A series of missed periods may develop, which eventually stop as well.
• Hot Flashes: A feeling of intense heat that advances to the chest and face, accompanied by sweating, flushing, and palpitations.
• Night Sweats: Sweating during sleep disrupts sleep patterns.
• Vaginal Dryness: Menopause induces reduced lubrication in the vagina because of a lack of estrogen. This can cause pain during sexual intercourse.
• Urinary Incontinence: Increased frequency, urgency, or even involuntary urine leakage.
• Mood Swings: Increased irritability, anxiety, and depression are quite common.
• Sleep Disturbances: Various manifestations such as difficulty falling asleep, restlessness, and insomnia.
• Cognitive Changes: Concentration, memory failures, and “brain fog.”
• Weight Gain: Changes in metabolism and reduced physical activity due to reduced estrogen production and changes in body composition lead to weight gain.
• Skin and Hair Changes: Dry skin, hair thinning or loss, and changes in skin texture and elasticity.
• Joint and Muscle Aches: Joint and muscle pains occur for more women than previously anticipated.

Note: Irregular periods, hot flashes, night sweats, and mood swings are the common signs of menopause at 40.

Causes of Menopause

Menopause can occur naturally, surgically, or due to health-related issues like premature ovarian insufficiency, as detailed below:

• Natural decline in ovarian function: This is the most common cause of menopause. In the course of time, the ovaries lose the ability to produce fewer and fewer eggs. This natural reduction in eggs finally results in estrogen production, resulting in the absence of menstrual cycles and the eventual appearance of menopause. This is normal aging.
• Surgical menopause: Removal of both ovaries, called bilateral oophorectomy, which often occurs at the time of hysterectomy, removal of the uterus, will lead to an instant menopause as the ovaries are the biggest source of estrogen in the human body.
• Premature ovarian insufficiency (Early Menopause): There are some individuals who are predisposed to have early menopause before 40 due to some genetic tendencies and conditions; the conditions are:
• Autoimmune diseases: For instance, conditions such as lupus and rheumatoid arthritis might affect the immune system, thus attacking the ovaries unintentionally, leading to premature ovarian failure.
• Chemotherapy and radiation: These treatments are often used to fight cancer and could damage the ovaries significantly and therefore reduce their functions, potentially resulting in premature menopause.
• Pelvic surgery: Some surgeries involving the pelvis, like surgeries for endometriosis or ovarian cysts, can cause damage to ovarian tissue and hence lead to premature ovarian failure.
• Smoking: Early menopause was found to have a positive relation with smoking, as smoking may expedite the decline in ovarian function.

Menopause Complications

There might be chances of developing some complications during or after menopause due to certain medical conditions and specific health-related issues. Some of the possible complications of menopause include:

• Osteoporosis: The estrogen hormone plays a crucial role in bone health. The decrease in estrogen levels following menopause results in a great increase in the person’s likelihood of developing this bone-weakening disease.
• Cardiovascular diseases: Estrogen also benefits the heart, which means that after menopause, women will have higher risks of developing heart diseases.
• Urinary incontinence: This is more common when the pelvic floor muscles become weakened as a result of decreased estrogen (involuntary loss of urine).
• Atrophic vagina: A decrease in estrogen level leads to dryness and thinning of vaginal walls and causes more issues along with discomfort and bleeding during intercourse.
• Cognitive changes: Some women experience cognitive changes, like forgetfulness or difficulty concentrating.

Menopause Diagnosis

Doctors or gynecologists diagnose menopause by discussing the menstrual cycle and the symptoms over the last year. This menopause condition is unique and is diagnosed after it occurs. If a person has gone a year without a period, they are considered postmenopausal. Apart from this, there are few hormone-related tests for the diagnosis of menopause or to check the hormone levels, such as:

• Follicle-stimulating hormone (FSH) and estrogen (estradiol): FSH rises and estrogen levels fall during menopause. These hormones fluctuate during perimenopause; it can be difficult to solely determine from these tests whether one is in menopause.
• Thyroid-stimulating hormone (TSH): Overfunctioning of the thyroid, known as hyperthyroidism, also causes symptoms resembling menopause.

Menopause Treatment

Menopause is a natural process in women’s lives and needs no treatment. However, treatments aim to alleviate symptoms and manage ongoing health conditions associated with early menopause or aging. Treatments for menopausal hot flashes, cognitive changes, and vaginal dryness include hormone therapy, vaginal estrogen, progestin with estrogen, low-dose antidepressants, and oral estrogen receptor modulators. Hormone therapy is best for younger individuals and those within 10 years of menopause onset. Long-term use may have risks, but starting with hormone therapy around menopause can provide benefits.

When to seek an appointment?

While menopause is a natural biological process, the fact remains that everyone experiences it differently. Visit your doctor or gynecologist if:

• Symptoms are severe or interfering: If hot flashes, night sweats, mood swings, or other symptoms interfere significantly with your daily life, work, or relationships.
• Early onset of menopausal symptoms: If you’re experiencing menopausal symptoms before the age of 40.
• Vaginal bleeding after menopause: Any vaginal bleeding after 12 months of no menstrual periods requires immediate medical attention.
• Concerns about long-term health: Discuss with your doctor strategies to manage long-term health risks associated with menopause, such as osteoporosis and heart disease.

Conclusion

Menopause is a very natural part of life for any woman, though it does provoke a series of physical and psychological changes. Educating oneself regarding these changes and also seeking appropriate care can significantly alter the quality of life. Indeed, many women have menopause without significant complications; still, awareness regarding potential long-term health concerns—such as osteoporosis or heart disease—could help with prevention and effective management.
Yashoda Hospitals offers comprehensive women’s healthcare services, including expert gynecological care for women experiencing menopause. Our team of experienced gynecologists provides treatment options for varied menstrual health problems and other abnormalities particular to women’s health. Yashoda Hospitals supports women in achieving confidence to better handle the problem of menopause and to attain optimal health and well-being through this important phase of life.
Have any questions or concerns about your health? We’re here to help! Call us at  +918929967127 for expert advice and support.

REFERENCES

• https://www.ncbi.nlm.nih.gov/books/NBK507826/
• https://www.mayoclinic.org/diseases-conditions/menopause/diagnosis-treatment/drc-20353401
• https://www.hopkinsmedicine.org/health/conditions-and-diseases/introduction-to-menopause