Menopause In Women: Symptoms, Complications and Management 

Menopause is defined as having no menstruation occurring for 12 consecutive months after the last menstrual period. Menopause can occur from 40 years of age onward, and there have been cases where patients have gone into menopause in their late 30's, but the average age of occurrence is around 52 years of age worldwide.

Menopause is a physiological and biological process that occurs due to the ovaries not functioning anymore. Oestrogen levels decrease which means that the individual won't ovulate anymore and therefore can't become pregnant and won't menstruate either.

Menopause only means that one can't become pregnant anymore and that shouldn't interfere with ones ability to stay healthy and still be sexual. Even though this is the case, the menopausal state can cause some unwanted and undesired effects due to the decreased oestrogen levels in the body.

Symptoms of menopause

The following symptoms can occur around the time leading up to menopause, called the peri-menopausal stage:

• Hot flashes
• Slowed metabolism
• Weight gain
• Vaginal dryness
• Sleep disturbances
• Night sweats
• Mood changes, such as increased depression
• Dry skin
• Thinning hair
• Loss of breast fullness
• Irregular periods, usually every 2-3 months. It's important to take note that one can still become pregnant during this time.

Complications and management of menopause

Osteoporosis

In the first few years after menopause, women lose bone density at a fast rate, thereby increasing the risk of developing osteoporosis. Osteoporosis is the condition where bone resorption occurs faster than bone production therefore causing bones to become brittle and weak, which can increase the chances of fractures of the hips, wrists or spinal vertebrae.

Calcium and vitamin D supplements are available for patients who have a family history of osteoporosis and who are in the peri-menopausal phase. Patients who are diagnosed as osteoporotic will be prescribed medications such as the bisphosphonates that help to prevent the loss of bone mass.

Cardiovascular disease

When oestrogen levels decrease, then one's risk of developing cardiovascular diseases increases. It is therefore suggested that post-menopausal women eat a healthy diet, get regular exercise and maintain a normal weight. Physicians will also discuss managing issues such as high cholesterol levels, diabetes and hypertension in patients already diagnosed with these chronic conditions.

READ Eat to Beat the Menopause

Urinary incontinence

The muscles and ligaments of the urethra and vagina lose elasticity in the post-menopausal state and this may cause the individual to experience frequent and strong urges to urinate. This can be followed by urge incontinence (involuntary loss of urine) or stress incontinence (loss of urine when coughing, sneezing, laughing or lifting). This situation can also result in frequent urinary tract infections.

Urinary incontinence can be managed by strengthening the pelvic floor muscles with Kegel exercises. Using a topical vaginal oestrogen cream can also help relieve the symptoms of incontinence.

Sexual function

Decreased oestrogen levels can result in decreased moisture production and loss of elasticity of the vagina. These issues can result in slight bleeding and discomfort during sexual intercourse. An individual's libido can also be negatively affected due to decreased vaginal sensation.

Using a good quality water-based (not glycerin-based as this can cause irritation or burning) vaginal lubricant or moisturizer may help with menopause induced vaginal dryness. If a moisturizer or lubricant isn't having the desired affect, then one could benefit from the use of vaginal oestrogen treatments, which are available as a cream, ring or tablet.

Weight gain

During the menopausal transition, a woman's metabolism rate decreases and this can result in increased weight gain. Ways to manage this is by trying to restrict calorie intake and increasing physical activities.