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THE MENOPAUSE

 

I did a little research on the menopause in case you are interested in reading it. I still have some more to add...... but ....I have to write it first!!!

Introduction  |  The Menopause  |  Reproductive Changes  |  How does the menopause occur?  | 
Surgical Menopause  |  What to expect  |  Hot Flushes  |  What Causes a Hot Flush |

Introduction


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More than one third of the World's female population (about 36 million in the US alone) have reached or been through the menopause. Today, life-expectancy is approximately 75 years and so a 50 year old woman can expect to live about one third of her life after the menopause. That's a long time, and science is only just starting to understand the biology of the menopause and that's why we, as women, should also try to understand the changes that our bodies are undergoing.


 

The menopause

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The menopause is that point in a woman's life when she permanently stops menstruating and signifies the end of her ability to have children. This is often referred to as the 'change of life.'  In actual fact it is the final stage of a gradual process in which the ovaries reduce their production of Oestrogen (or Estrogen) which is the female sex hormone. This process starts between 3 and 5 years before the final menstrual period and is known as a transitional phase called the climacteric or peri-menopause.

The entire process of the menopause can take several years and is considered complete when a woman has had no menstrual periods for about 1 year.  Generally this occurs at about 50 years of age; although each person is individual and the timing will vary from person to person. It is a well known fact that smokers usually reach menopause earlier than non-smokers!


 

Reproductive changes

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Normally, each newborn female has approximately 2 million egg cells at birth. This number depletes with age and at around puberty there are only approximately 300,000 remaining egg cells. Of these, only about 400 to 600 will mature and be released during menstruation. Those that do not mature degenerate over the years.

During a woman's reproductive years (from around age 13 to 48 years old) the pituitary gland (in the brain) produces hormones that stimulate a new egg to be released from its follicle each month (approximately every 28 days). The follicle also increases production of oestrogen (estrogen) and progesterone to thicken the uterus lining. This lining is considered to be enriched and is prepared to receive and nourish a fertilized egg following conception (impregnation by a male sperm cell). If fertilization does not occur then the levels of circulating hormones (oestrogen and progesterone) decrease and the lining of the uterus breaks down resulting in menstruation.

When a woman has reached menopause her levels of the female sex hormone Oestrogen (or Estrogen) and progesterone are decreased and this leads to shrinkage of the internal sex organs (such as the fallopian tubes, vagina, uterus and ovaries).

 


 

How Does The Menopause Occur?

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The ovaries reduce their hormone production (normally between the ages of 30 and 40), although the exact process for this is currently unknown. Then this process(es) accelerate(s) (normally during the ages of 40 and 50) and the levels of Oestrogen (or Estrogen) in the circulating blood system begin to fluctuate, thus causing irregular menstrual cycles. These irregular menstrual cycles can lead to unpredictable episodes of heavy bleeding. Although the ovaries significantly reduce in their hormone output they still produce low levels which leads to continued menstrual periods. Oestrogen (Estrogen) is also produced from the fatty tissues and levels produced are increased depending on the amount of fatty tissue in your body.

The other female hormone, Progesterone, works during the second half of the menstrual cycle and creates a lining in the uterus. This lining provides a viable home for an egg to implant. Progesterone also works by ensuring that the uterine lining is shed if an egg is not fertilised and implanted. When you miss a period (menstrual period) then this may mean that your body is not producing enough progesterone in order to break down the uterine lining, and your oestrogen (Estrogen) levels may stay high even though you are not menstruating.

basically, when you reach the menopause your hormone levels will not always decline uniformly but may alternately rise and fall again. Changes in your ovarian hormone levels will affect other glands in your body. TOgether these make up the endocrine system. The endocrine system controls growth, metabolism and reproduction and must constantly readjust itself to work effectively. Ovarian hormones also affect other tissues, including the breasts, vagina, bones, blood vessels, gastrointestinal tract, urinary tract and the skin.

 

Surgical Menopause

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Surgical menopause occurs when premenopausal women have both their ovaries removed surgically. They experience an abrupt menopause and may experience greater menopausal symptoms than women who go through the menopause naturally. Hot flushes may be more severe, more frequent and last longer and there may be a greater risk of heart disease and/or osteoporosis. If one ovary is removed only, then menopause normally occurs naturally. If the uterus is removed (hysterectomy) and the ovaries are left  intact then the menstrual periods will cease but other menopausal symptoms will normally occur at the age when menopause is reached naturally. However, women who have had a hysterectomy may experience menopausal symptoms at a younger age.


 

What To Expect

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Every woman is an individual and therefore the menopause is an individual experience. Some women will notice little difference in their moods or their bodies; however, others may find the change quite disruptive to their general health and well being.


 

Hot Flushes

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The most common symptom of the menopause is the Hot Flush which affects more than 60% of menopausal women. A hot flush is a sudden and intense feeling of heat in the upper part or all of the body. The neck and face may appear flushed and reddened as the blood vessels dilate and red blotches may appear on the chest, back and arms. Normally a hot flush is followed by intense and profuse sweating and then a cold shivering as the body adjusts its temperature. Hot flushes may last a few moments and be rather fleeting for some women, or they may be more prolonged for up to 30 minutes or more.

Hot flushes will normally occur sporadically for several years before other signs of the menopause manifest. The good news is that they will normally decline in frequency and intensity as you get older and closer to the end of the menopause. Around 80% of women will experience hot flushes for 2 years or less, although a small percentage may experience them for more than 5 years. A hot flush can occur at any time and may be as mild as a light blush or severe enough to wake you from a deep sleep.

Hot flushes can be triggered by caffeine, alcohol, hot drinks, spicy foods and stressful or frightening situations. Avoidance of these triggers does not necessarily mean that you will not experience a hot flush!


 

What Causes a Hot Flush

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Hot flushes are generally considered to be a direct result of decreasing oestrogen (estrogen) levels. In response to falling oestrogen levels, the bodies glands release higher amounts of other hormones that affect the brain's thermostat, causing body temperatures to fluctuate. Hormone therapy relieves the discomfort of hot flushes in most cases. Vitamin E may also provide minor relief for hot flushes, although there has never been a study to confirm this.

Some suggestions for helping you to cope with hot flushes are given below :

  • Dress in layers so you can remove them at the first sign of a flash.
  • Drink a glass of cold water or juice at the onset of a flash.
  • At night keep a thermos of ice water or an ice pack by your bed.
  • Use cotton sheets, lingerie and clothing to let your skin "breathe."

     


Images courtesy of Mark J Thomas 

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