Firstly, let’s start with the good news …. Yours is a great age to be a woman.
Today, thanks in part to improved healthcare and better medicines, your life expectancy is much longer than previous generations.
This graph shows the increase in female life expectancy at birth between 1850 – 2000. Notice that the average age of menopause remains relatively constant.
Menopause is defined by the absence of periods for more than one year, no regular or even artificial menses, and loss of estrogen that starts declining at the peri-menopausal level. The menopause marks the end of menstruation, but as with the menache in relation to puberty, it reflects only one manifestation of a series of changes.
The age of the physiological menopause varies with race and socio-economic conditions, but in Western Europe and the USA, the average age of onset is between 49 and 50 years. Spontaneous cessation of the periods before the age of 40 years is defined as premature menopause.
The menopause may be physiological or artificial, when it is associated with the removal of the Ovaries or the Uterus.
HOW DO WE FEEL THE APPROACH OF THE MENOPAUSE?
In the short term, the first signal of menopause is hot flushes. The woman will begin to experience night sweats, insomnia and frequent mood swings. The duration of this phase is quite short, and varies independently from one woman to another.
The onset of menopause can also mean many mental and physical changes for women. What may also annoy the woman is the irritability. Postmenopausal women become very irritable with fatigue sensitivity. She might experience facial hair growth, sometimes acne appears or even thinning of the hair on the scalp.
Some women may find these symptoms merely annoying and decide to just “tough it out. Others however may suffer severely from these feelings and experience detrimental consequences, both mental and physical
The commonest symptom of the menopause is the development of hot flushes. These episodes, which consist of flushes and perspiration, occur in about 80% of the female population and may persist for up to 5 years after the menopause.
Changes in the organs that are under the influence of hormones:
The most obvious response is the cessation of menstruation. Periods generally exhibit a gradual reduction in both amount and duration with occasional delays in menstruation.
The vaginal walls lose their rigosity (spongy and elastic quality) and become smooth and atrophic. In severe cases, this may also be associated with chronic infection and atrophic Vaginitis.
The cervix diminishes in size and there is a reduction in cervical mucus production.
The uterus also shrinks in size and the endometrium, which is the internal membrane of the uterus, becomes atrophic.
The breasts exhibit parallel changes in structure and the cyclical breast changes disappear which may bring considerable relief to some women.
The Bladder becomes atrophic as well, which causes frequent bouts of cystitis.
Epidermal appendage: The skin tends to become thinner and wrinkled after the menopause as a result of estrogen deprivation. There is loss of scalp hair and of pubic and auxiliary hair. There is an androgen-based – or male hormone based – increase in the growth of coarse facial hair so that a slight moustache may develop, and loss of scalp hair sometimes results in partial or complete baldness, but this is uncommon.
Physiological and emotional symptoms: Many women experience severe emotional disorders at the time of the menopause, with depression and anxiety states.
There are many other symptoms ascribed to the menopause, including anorexia, excessive fatigue, nausea, and vomiting and bowel disorders.
There is evidence of an increase in Coronary Heart Disease following the menopause which is not simply an age-related phenomenon.
Serum Cholesterol levels rise at the time of the menopause. There is an increase in all Tryglicerides which can lead to cardiovascular problems.
There is no specific association between the menopause and Hypertension.