What does the term ‘Menopause’ actually mean?

Menopause is a term that often brings a mix of curiosity and concern for many women, especially those in their 40s. So, what does it really mean? Simply put, menopause marks the end of a woman’s menstrual cycles and fertility. But it’s not just a single event; it’s a process that can take years to unfold. Many women wonder if a delay in their periods means they’ve hit menopause. The answer is a bit more complex. A woman is considered to have reached menopause only after she has gone 12 consecutive months without a menstrual period. On average, this occurs around the age of 51, but symptoms can start much earlier, sometimes up to a decade before.

Understanding Menopause

The definition of Menopause

Menopause is defined as the time in a woman’s life when her ovaries stop producing eggs, leading to a significant drop in hormone levels, particularly oestrogen and progesterone. This transition can lead to various physical and emotional changes.

When Does Menopause Occur?

While the average age for menopause is 51, it can vary widely. Some women may experience it in their 40s, while others may not reach it until their late 50s. The key takeaway? It’s a unique journey for every woman.

What is the ‘Perimenopause’?

Before menopause, many women enter a phase known as peri-menopause. This period can last several years and is characterized by irregular menstrual cycles and fluctuating hormone levels. Symptoms of Peri-Menopause may include those similar to menopause, including hot flashes, mood swings, and sleep disturbances. It’s a time of change and understanding these symptoms can help women navigate this transition more smoothly.

Common symptoms of the Menopause?

A woman’s reproductive hormones do not only affect her reproduction but affect every organ in her body.

Hot Flushes and Night Sweats

One of the most notorious symptoms of menopause is hot flushes, which can leave women feeling suddenly warm and sweaty. Night sweats can disrupt sleep, making it hard to get a good night’s rest.

Mood Changes and Cognitive Effects

Mood swings, anxiety, and even memory lapses can occur during menopause.

Hair and Skin Changes

These become drier and thinner, this includes the skin around the genital area, giving rise to urogenital problems for some women.

In addition to the above, we now recognise multiple symptoms associated with menopause including joint stiffness and pain, palpitations, tinnitus, loss in sex drive, worsening of migraines and PMS symptoms, burning mouth syndrome and the list goes on.

What causes the menopause? 

The role of ovaries and hormones

Women are born with a finite number of eggs in their ovaries. As they age, this supply diminishes, leading to decreased hormone production (oestrogen, progesterone and some testosterone). Eventually, this results in menopause. It’s a natural part of aging, but it can come with its own set of challenges.

Are there long-term health problems related to the menopause?

With the onset of menopause we begin to see other health related problems. These include osteoporosis (thinning of the bones) resulting in a higher risk of hip and vertebral fractures. There is an increased risk of high cholesterol levels and cardiovascular disease putting women at higher risk of developing a stroke or heart attack after menopause. In addition, there is increased weight gain, together with an increased risk of developing diabetes.

What is HRT? What are the benefits of taking any medication?

Hormone Replacement Therapy (HRT) involves replacing hormones that the body no longer produces. Depending on a women’s condition either one or two of the female hormones (oestrogen and progesterone) can be replaced in a continuous or cyclical method to treat the symptoms of menopause. Some women will also benefit from having testosterone replaced. In recent years HRT has received ‘bad press’ due to the WHI study published in 2001, highlighting an increased risk of breast cancer, heart disease and stroke with HRT use. A re-evaluation of this study has enhanced our understanding of the optimal age to start HRT and the safest form of HRT to use, allowing women to alleviate their symptoms with minimal risk.

When a woman presents to me requesting HRT, I want to understand which disruptive symptoms she is experiencing as well as her risk factors for chronic diseases, commonly associated with menopause. After ruling out other possible causes for her symptoms, we discuss the different HRT options, as well as alternatives to HRT that can alleviate her symptoms, In addition, we address lifestyle measures that will have a positive impact on both her symptoms as well as her general health. Regular reviews including mammograms and pap smears are arranged, and for some women a bone densitometry may be advised.

Menopause in conclusion

Menopause is a natural event that every woman will experience, understanding perimenopause and menopause can empower women to seek help and manage their symptoms effectively. Whether through HRT or lifestyle changes, there are numerous options available to ensure a smoother transition.

If HRT is thought to be the best option, then women should discuss the benefits and risks of HRT with their doctor to make an informed choice. In addition, lifestyle measures should be part of any comprehensive perimenopause and menopause management plan, both to alleviate the symptoms of menopause as well as prevent chronic disease.

Remember, menopause doesn’t mean the end of vitality; with the right support, women can continue to lead fulfilling lives

This article is written by Dr Sundus Hussain-Morgan and she aims to provide a comprehensive understanding of menopause, its symptoms, causes, and treatment options, ensuring that women feel informed and empowered during this natural transition. Dr Sundus is a UK trained doctor based in IMC Camden and IMC Holland Village, she is additionally trained in Lifestyle Medicine.

To consult with Dr Sundus, book online or call +65 6733 4440.