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Women’s Health: Understanding Common Illnesses and How to Prevent Them, Part 3: Menopause

Introduction

Menopause is a significant and inevitable stage in a woman’s life. It marks the end of her reproductive years and brings about a series of physical and hormonal changes. While menopause is a natural process, it can be accompanied by a range of symptoms that vary in intensity from person to person.

Advances in healthcare, nutrition, and lifestyle have contributed to a significant increase in the average human lifespan over the past century. This trend is a testament to our ability to combat diseases, improve overall health, and enhance the quality of life for individuals worldwide. However, amidst this remarkable progress, the biological clock governing menopause remains relatively unchanged. Menopause typically occurs around the age of 50, marking the end of a woman’s reproductive years. This unyielding biological reality means that women are now spending a larger proportion of their lives in the post-menopausal stage, which brings with it a unique set of health challenges.

In light of these considerations, menopausal treatments have come to the forefront of medical research and practice. They aim not only to alleviate the discomfort associated with menopause but also to address the potential health risks that can arise during this phase. Women now experience menopause at a later age and live longer, resulting in a prolonged period of post-menopausal life. This extended menopausal phase can have adverse effects on women’s health and significantly impact their overall quality of life. It underscores the pressing need for effective menopausal treatments to help women navigate this extended stage of life with improved well-being and health.

This article will primarily focus on defining menopause, exploring its effects, and discussing various treatment options.

As we delve into the details of menopause, its effects, and the available treatment options, GSS Health and Consultation is here to empower women with the knowledge and support they need to make informed decisions about their health. Our commitment is to assist women in embracing this life transition with confidence and optimal well-being, leveraging the opportunities offered by the global healthcare landscape.

In the context of menopausal treatments and healthcare, GSS Health and Consultation stands as a dedicated partner. As a prominent health tourism consultancy firm, we specialize in providing comprehensive support to women seeking menopausal treatments, along with a wide array of healthcare solutions. Our expertise lies in facilitating access to world-class medical facilities, renowned specialists, and cutting-edge treatments. We assist in coordinating every aspect of their medical journey, from arranging consultations and appointments with leading experts to organizing travel logistics and accommodations. Our goal is to ensure that women receive the highest standard of care and a personalized approach to address their specific menopausal needs.

In today’s world, where healthcare has become increasingly globalized, women have the opportunity to explore a wide range of options when it comes to managing menopause and its associated challenges. This is where GSS Health and Consultation, a leading healthcare tourism advisory firm, steps in. GSS Health and Consultation specializes in providing tailored support and guidance for women looking to navigate the journey through menopause with confidence and ease, leveraging the advantages of health tourism.

What is Menopause?

Menopause is a natural biological process that marks the end of a woman’s reproductive years. It is defined as the point in time when a woman has not had a menstrual period for 12 consecutive months and is no longer able to conceive naturally. Menopause typically occurs in women between the ages of 45 and 55, with the average age being around 51.

During menopause, a woman’s ovaries gradually reduce their production of two key hormones: estrogen and progesterone. These hormones play essential roles in regulating the menstrual cycle, fertility, and various bodily functions. As their levels decline, it leads to a range of physical and hormonal changes in a woman’s body.

While menopause is a natural part of aging, the physical and emotional symptoms it brings can be challenging for some women. Fortunately, there are various treatments and lifestyle adjustments available to help manage these symptoms and support a woman’s overall well-being during this life transition.

Menopause is influenced by several key factors. Firstly, ovarian aging is a fundamental contributor, where a woman’s ovaries gradually reduce their production of crucial hormones, primarily estrogen and progesterone. These hormones are integral in governing the menstrual cycle and fertility, and as their levels decrease, menstrual irregularities occur, eventually leading to the cessation of menstruation. Additionally, genetic factors play a significant role; a woman’s family history can influence the timing of her menopause, with those having a family history of early or late menopause often experiencing it at a similar age. Furthermore, hormonal changes, apart from the natural aging process, can be induced by medical interventions such as hysterectomy (the removal of the uterus) or oophorectomy (the removal of one or both ovaries), leading to menopause. Lastly, lifestyle and environmental factors can also impact menopause timing, with smoking and exposure to toxins potentially causing menopause to occur earlier than expected.

The Effects of Menopause on Women

Menopause is a significant life transition for women, bringing about a multitude of physical and emotional changes. It is crucial to recognize that the specific effects and their severity can vary significantly among individuals, making each woman’s menopausal journey unique.

Menopausal symptoms encompass a broad spectrum, affecting women cognitively, physically, and psychologically. These symptoms can manifest as hot flushes, often followed by chills, heart palpitations, persistent fatigue, disrupted sleep patterns, dry eyes, muscular aches, headaches, night sweats, skin irritations, and mood disturbances such as irritability and anxiety. Poor concentration and an increased need for bathroom breaks may also be part of the menopausal experience. Even for those who do not exhibit overt symptoms, menopause ushers in physiological changes that can impact overall health, including increased risks of heart disease, decreased bone density, and the potential development of osteoporosis. Thus, menopause represents a multifaceted phase in a woman’s life, necessitating individualized care and attention to both visible and underlying changes.

On the physical front, menopause can manifest as hot flashes, night sweats and disturbed sleep patterns. Hot flashes are one of the hallmark symptoms of menopause. These sudden, intense sensations of heat can engulf the upper body, face, and neck, often causing flushing of the skin. Also called hot flushes, about 75 percent of all women experience brief, sudden increases in body temperature. Heart palpitations or dizziness may accompany the feeling of being hot. Hot flashes may be accompanied by sweating, a rapid heartbeat, and an acute sense of discomfort. Hot flushes, often followed by chills, are a common and distinctive symptom of menopause. What makes hot flushes particularly challenging is the subsequent sensation of chills that may follow, as the body attempts to regulate its temperature. These fluctuations can be uncomfortable and disruptive, impacting a woman’s daily life and overall comfort during the menopausal transition. They can occur at any time of day, even during sleep, leading to night sweats. These episodes can be disruptive, leading to disturbed sleep patterns and daytime fatigue. During menopause a woman’s hormones are in flux, including a hormone called progesterone, which is known to help regulate sleep patterns. Women might get less REM sleep, and if they are sleep-deprived, that can make a big difference in their well-being.

Another effect of menopause on women is that menstrual cycles become irregular before ceasing altogether. Periods may become heavier or lighter, and the time between them may vary.

Moreover, vaginal dryness, and potential urinary issues can also occur. Decreased estrogen levels can cause vaginal dryness, itching, discomfort, and pain during sexual intercourse. The tissues of the vagina and urethra may become thin and dry. This can lead to pain during intercourse and in some cases, more serious problems such as vaginitis (an inflammation of the vagina that can cause discharge, itching and pain) and cystitis (urinary tract infection). Additionally, sexual health can be affected, with vaginal dryness and pain during intercourse impacting both comfort and intimacy.

As estrogen levels decrease, the stimulation of the skin’s natural collagens and oils diminishes. This can result in dry, itchy skin. Additionally, as another effect, some women may experience increased facial hair growth, while scalp hair may become thinner.

Furthermore, menopause’s impact on bone health is noteworthy, with the decline in estrogen levels increasing the risk of osteoporosis and bone fractures. Osteoporosis is a condition that causes bones to become weak and brittle, making them more prone to fractures.  It is often referred to as the “silent disease” because it typically progresses without any noticeable symptoms until a fracture occurs. Bones are dynamic structures that constantly undergo a process of renewal, with old bone tissue being replaced by new bone tissue. In osteoporosis, this balance is disrupted, leading to a reduction in bone density and quality. As a result, bones become fragile and porous, making them susceptible to fractures from even minor falls or everyday activities. The most common fractures associated with osteoporosis occur in the hip, spine, and wrist. Hip fractures, in particular, can have severe consequences, often leading to reduced mobility and independence in affected individuals.

Cardiovascular changes post-menopause result in a decreased advantage in terms of heart health, potentially elevating the risk of heart disease. The hormonal shift, particularly the decline in estrogen levels, plays a role in altering the cardiovascular landscape. Estrogen is known to have a protective effect on the inner lining of blood vessels, helping to maintain their flexibility and preventing the buildup of plaque. However, with lower estrogen levels during and after menopause, the risk of atherosclerosis (hardening and narrowing of arteries) increases. This can lead to conditions such as high blood pressure, elevated cholesterol levels, and an overall higher risk of heart disease.

Weight changes, including weight gain or shifts in body composition, may also be part of the menopausal experience. During menopause, many women notice changes in the distribution of body fat, often with an increased tendency to accumulate fat around the abdomen. This change in body composition can be influenced by hormonal fluctuations, metabolic changes, and lifestyle factors.

While some weight gain can be a normal part of aging, it’s important to note that excessive weight gain, especially around the waistline, can contribute to an increased risk of chronic conditions such as type 2 diabetes, heart disease, and certain cancers.

Simultaneously, hormonal fluctuations can result in mood swings, anxiety, and even depression. These emotional changes can manifest as sudden shifts in mood, increased irritability, feelings of sadness, or heightened anger. Alongside these emotional fluctuations, menopausal women may also encounter cognitive effects often referred to as “brain fog.” This includes difficulties with memory, concentration, and mental clarity, leading to forgetfulness, word recall challenges, and a pervasive sense of mental haziness. Some women might experience moments of confusion or disorientation, which can affect daily life and work. It’s important to note that the intensity and duration of these symptoms can vary widely among individuals, with some experiencing them more acutely than others.

Survey Studies on Menopause

The results of the surveys below demonstrate how women are affected during menopause and that the majority do not receive any treatment for it.

According to a survey report from the Fawcett Society published in May 2022, based on data from the largest-ever survey of menopausal and peri-menopausal women in the UK, it reveals that women often experience significant difficulties during the menopausal period, especially due to the lack of support from healthcare providers.

  • 77% find at least one menopause symptom ‘very difficult’
  • 84% experience trouble sleeping
  • 73% experience brain fog
  • 69% of women experience difficulties with anxiety and depression due to menopause
  • 54% of women said they found loss of interest in sex to be difficult during the menopause.
  • Almost half (45%) of women haven’t spoken to their GP surgery about their symptoms.
  • 44% of women experienced three or more severe symptoms
  • 41% say they have seen menopause or menopause symptoms treated as a joke by people at work.
  • Among women who had taken time off due to menopause, 39% had cited anxiety or depression as the main reason on their sick note, rather than share their menopause status.
  • Official guidance says that hormone replacement therapy (HRT) should be offered to women who are struggling with menopause symptoms, but just 39% of women say their GP or nurse offered HRT as soon as they knew they were experiencing menopause, and only 14% of menopausal women said that they are currently taking HRT.

According to another survey, The State of Menopause Study, conducted with 1,039 women ages 40 to 65 across the United States, women are facing similar significant issues as women in the UK related to menopause.

  • 73% of women are experiencing, yet not currently treating such symptoms of menopause
  • Vaginal atrophy, which causes symptoms like vaginal dryness and painful sex, is treatable with vaginal moisturizer, yet 68% of menopausal women have never used OTC vaginal treatments
  • 65% of women will not consider using HRTs to treat their menopause symptoms
  • 61% of menopausal women report vaginal dryness contributes to painful sex, yet 41% of them never use lubricants or sex aids during sex with a partner
  • 57% of women always feel understood and supported by their doctor / OBGYN
  • 53% of women are engaging in sexual activity with a partner(s) less often due to their menopause symptoms, while only 4% report engaging in more sexual activity
  • 50% of women experience physically painful sex with a partner since the onset of menopause symptoms, and 55% of those women report dryness contributed to this pain
  • 45% of women didn’t know the difference between perimenopause and menopause prior to experiencing symptoms
  • 34% of women with menopause symptoms are currently undiagnosed and 20% went 12+ months with menopause symptoms before being formally diagnosed by their healthcare provider
  • 32% of women feel there was not enough perimenopause and menopause information available before they started experiencing symptoms
  • 27% of women do not have sexual intercourse with their partner
  • 15% of menopausal women are reporting experiences of weight gain,14% are reporting hot flashes and 14% are reporting difficulty sleeping, followed by 12% reporting night sweats, 11% reporting bladder control issues (i.e. sudden urges or waking up often to go and frequent bathroom trips), and 10% reporting brain fog.

Menopausal Treatments

1- Hormonal Therapy

Hormonal treatment, also known as hormone therapy or hormone replacement therapy (HRT), is a medical approach used to manage the symptoms of menopause by supplementing the body with hormones that naturally decline during this life stage. These hormones primarily include estrogen and, if a woman has not had a hysterectomy, progesterone or a synthetic form called progestin. The goal of hormonal treatment is to alleviate the discomfort and health risks associated with menopausal symptoms. There are different types of hormonal treatment options available, and they can be tailored to an individual’s specific needs and medical history.

– Estrogen Therapy: Estrogen therapy involves the use of synthetic or naturally derived estrogen hormones to supplement the declining levels of estrogen in a woman’s body during menopause. This form of HRT involves the administration of estrogen alone. It is typically recommended for women who have had a hysterectomy, as there is no need for progesterone in this case to protect the uterine lining. Estrogen therapy comes in various forms, including oral pills, skin patches, creams, gels, and vaginal rings.

– Combined Hormone Therapy (Estrogen and Progestin): Combined Hormone Therapy, often referred to as estrogen-progestin therapy or simply HRT (Hormone Replacement Therapy), is a medical treatment used primarily in menopausal and postmenopausal women. This therapy involves the administration of two hormones, estrogen and progestin, to replace the declining levels of these hormones in the body. Estrogen helps alleviate menopausal symptoms like hot flashes and vaginal dryness while also aiding in the maintenance of bone density. Progestin is added to the treatment for women who have not undergone a hysterectomy to reduce the risk of endometrial cancer, as estrogen alone can increase this risk. Combined Hormone Therapy can be delivered in various forms, such as pills, patches, creams, or vaginal rings, and the specific regimen and duration of treatment are often tailored to an individual’s unique needs and health considerations.

– Low-Dose Hormone Therapy: Combined Hormone Therapy, often referred to as estrogen-progestin therapy or simply HRT (Hormone Replacement Therapy), is a medical treatment used primarily in menopausal and postmenopausal women. This therapy involves the administration of two hormones, estrogen and progestin, to replace the declining levels of these hormones in the body. Combined Hormone Therapy can be delivered in various forms, such as pills, patches, creams, or vaginal rings, and the specific regimen and duration of treatment are often tailored to an individual’s unique needs and health considerations.

– Bioidentical Hormone Therapy: Bioidentical hormone therapy (BHT) is a form of hormone replacement therapy (HRT) that involves the use of hormones that are structurally identical to those naturally produced by the human body. These hormones, including estrogen, progesterone, and sometimes testosterone, are typically derived from plant sources and are synthesized to match the molecular structure of the body’s own hormones.

The key principle of bioidentical hormone therapy is to provide individuals, often women going through menopause, with hormones that closely mimic the ones their bodies once produced. This is believed to reduce the risk of adverse effects associated with some synthetic hormones. Bioidentical hormones can be administered in various forms, including creams, gels, patches, pills, and pellets, and the treatment is often customized to an individual’s specific needs.

– Selective Estrogen Receptor Modulators (SERMs): SERMs are medications that can mimic the effects of estrogen in certain parts of the body while blocking it in others. They are a class of compounds designed to interact with estrogen receptors in the body in a selective manner. These versatile pharmaceutical agents can act as either agonists or antagonists, depending on the specific tissue or target organ. SERMs are commonly employed in the field of medicine to modulate estrogen’s effects, particularly in hormone-related conditions. They are often used to treat and prevent various medical conditions such as breast cancer, osteoporosis, and postmenopausal symptoms, by either blocking or stimulating estrogen receptor activity. Notable examples of SERMs include tamoxifen and raloxifene, each with distinct applications and therapeutic benefits. SERMs have proven invaluable in providing targeted therapies while minimizing the potential side effects associated with estrogen-based treatments, making them an essential component of modern medical practice.

– Vaginal Hormone Therapy: Vaginal hormone therapy is a medical treatment that involves the localized application of hormones to the vaginal area. It is primarily used to alleviate symptoms of vaginal atrophy and dryness, which can occur during menopause or as a result of hormonal changes. Vaginal hormone therapy typically utilizes estrogen in the form of creams, rings, or tablets, which are applied directly to the vaginal tissues. This therapy helps to restore the thickness and elasticity of the vaginal walls, reduce discomfort during sexual intercourse, and alleviate symptoms like itching and burning.

2- Non-hormonal Treatment

Non-hormonal treatments for menopause are often sought by individuals who either cannot or prefer not to use hormone replacement therapy (HRT) to manage their menopausal symptoms. These types of treatments often involve the use of medications that do not contain estrogen. Anti-depressants might help with hot flashes. Certain prescription medications, such as selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs), can help manage mood swings and hot flashes.

Cognitive Behavioral Therapy (CBT) is a valuable talk therapy option for managing mood swings, anxiety, and depression associated with menopause. Herbal remedies like evening primrose oil and dong quai, acupuncture, and hypnotherapy have also been explored for symptom relief. Over-the-counter (OTC) products, including vaginal lubricants and moisturizers, can ease vaginal dryness and discomfort during intercourse, while prescription medications like SSRIs and SNRIs may be prescribed off-label to address mood swings and hot flashes.

Making lifestyle changes can also help manage menopause symptoms. Eating a healthy diet, getting regular exercise, practicing stress-reducing techniques, and getting enough sleep can all help alleviate menopause symptoms. Some women find relief through acupuncture, yoga, or dietary supplements like black cohosh and soy.

Conclusion

In conclusion, menopause can be a significant turning point in women’s lives, and to manage this phase effectively, the right information, experience, and expertise are essential. Treatment options should be personalized, taking into account an individual’s specific needs and preferences to cope with the menopausal transition. Unfortunately, due to insufficient knowledge and insufficient attention among women and healthcare providers, the adverse effects of menopause are often overlooked, with menopause being perceived as a natural consequence.

Collaborating with healthcare professionals consciously can assist women in addressing the challenges of menopause and maintaining their physical and emotional well-being during this natural life stage. However, with proper management, these symptoms can be reduced or eliminated, allowing women to live healthy and fulfilling lives. GSS Health and Consultation has become a trusted partner for women seeking guidance and assistance during the menopausal transition.We work closely with a network of renowned healthcare professionals who specialize in menopause management, ensuring that women receive the best possible care and treatment options.

At GSS Health and Consultation, our mission is to empower women to take control of their health and well-being during this crucial phase of life. Our goal is to make menopause a manageable and even empowering experience, allowing women to continue living life to the fullest. In collaboration with our team of experts and healthcare professionals, GSS Health and Consultation is dedicated to helping women navigate the challenges of menopause with confidence and grace. We believe that with the right guidance and support, menopause can be a transformative and positive journey, setting the stage for a healthy and vibrant future.