When does menopause typically begin. What factors influence the onset of menopause. How can you recognize the signs that menopause has started. What is the difference between perimenopause and menopause. How long does the transition to menopause usually last. What are the common symptoms associated with menopause.

What is Menopause and How is it Defined?

Menopause is a natural biological process marking the end of a woman’s reproductive years. It is officially defined as the point when a woman has not had a menstrual period for 12 consecutive months. During this time, the ovaries gradually produce less estrogen and progesterone, leading to the cessation of menstruation and fertility.

The transition to menopause, known as perimenopause, can last several years. During this phase, hormone levels fluctuate, causing various symptoms and changes in menstrual patterns. Once menopause is reached, the ovaries no longer release eggs, and pregnancy is no longer possible naturally.

Key Stages of the Menopausal Transition

• Perimenopause: The transitional phase leading up to menopause
• Menopause: The point at which 12 months have passed since the last menstrual period
• Postmenopause: The years following menopause

The Average Age of Menopause Onset: What to Expect

The average age of menopause onset varies among women, but typically occurs between the ages of 45 and 55. According to medical research, the median age for menopause in the United States is 51 years old. However, it’s important to note that this is just an average, and individual experiences can differ significantly.

Some women may experience menopause earlier or later than the average age range. Early menopause, occurring before age 45, affects approximately 5% of women. On the other hand, late menopause, happening after age 55, is less common but still possible.

Factors Influencing the Timing of Menopause

Several factors can influence when a woman experiences menopause:

1. Genetics: Family history plays a significant role in determining the age of menopause onset
2. Ethnicity: Studies have shown slight variations in average menopause age among different ethnic groups
3. Lifestyle factors: Smoking, for example, has been associated with earlier menopause
4. Medical conditions: Certain autoimmune disorders or cancer treatments can affect the timing of menopause
5. Body mass index (BMI): Some research suggests a correlation between BMI and menopause timing

Recognizing the Signs: How to Know if Menopause Has Started

Identifying the onset of menopause can be challenging, as symptoms can vary widely among women. However, there are several common signs and symptoms that may indicate the beginning of the menopausal transition:

• Irregular periods: Menstrual cycles may become longer, shorter, or more unpredictable
• Hot flashes and night sweats: Sudden feelings of heat, often accompanied by sweating and flushing
• Mood changes: Increased irritability, anxiety, or mood swings
• Vaginal dryness: Discomfort or pain during intercourse due to decreased vaginal lubrication
• Sleep disturbances: Difficulty falling asleep or staying asleep throughout the night
• Changes in libido: Decreased sex drive or changes in sexual response
• Weight gain and slowed metabolism: Changes in body composition and energy levels
• Thinning hair and dry skin: Hormonal changes can affect hair and skin quality

It’s important to note that these symptoms can also be associated with other health conditions. Consulting with a healthcare provider is crucial for an accurate diagnosis and appropriate management of menopausal symptoms.

Perimenopause vs. Menopause: Understanding the Distinction

While often used interchangeably, perimenopause and menopause are distinct stages in a woman’s reproductive life. Understanding the differences between these two phases is essential for proper management and expectations.

Perimenopause: The Transitional Phase

Perimenopause is the transitional period leading up to menopause. It typically begins in a woman’s 40s but can start as early as the mid-30s. During this time, the ovaries gradually produce less estrogen, leading to hormonal fluctuations and various symptoms. Key characteristics of perimenopause include:

• Irregular menstrual cycles
• Varying cycle lengths
• Changes in menstrual flow
• Onset of menopausal symptoms
• Potential for pregnancy, although fertility is reduced

Perimenopause can last anywhere from a few months to several years, with the average duration being about four years.

Menopause: The Definitive End of Menstruation

Menopause is officially diagnosed when a woman has gone 12 consecutive months without a menstrual period. At this point, the ovaries have essentially stopped producing eggs and significant amounts of estrogen. Key aspects of menopause include:

• Complete cessation of menstrual periods
• End of fertility
• Continuation or intensification of menopausal symptoms
• Increased risk of certain health conditions due to lowered estrogen levels

Once menopause is reached, a woman enters the postmenopausal stage, which lasts for the rest of her life.

Early Menopause: Causes and Implications

Early menopause, also known as premature menopause, occurs when a woman experiences menopause before the age of 40. This condition affects approximately 1% of women and can have significant implications for long-term health and quality of life.

Causes of Early Menopause

Several factors can contribute to the onset of early menopause:

1. Genetic predisposition: Family history of early menopause
2. Autoimmune disorders: Conditions like thyroid disease or rheumatoid arthritis
3. Chromosomal abnormalities: Such as Turner syndrome or fragile X syndrome
4. Surgical interventions: Removal of ovaries (oophorectomy)
5. Cancer treatments: Chemotherapy or radiation therapy to the pelvic area
6. Infections: Certain viral infections that affect the ovaries
7. Lifestyle factors: Smoking, extreme stress, or very low body weight

Health Implications of Early Menopause

Women who experience early menopause may face increased risks for certain health conditions due to prolonged estrogen deficiency. These include:

• Osteoporosis and increased fracture risk
• Cardiovascular disease
• Cognitive decline and potential increased risk of dementia
• Mood disorders, such as depression and anxiety
• Sexual dysfunction and vaginal health issues

Early diagnosis and appropriate management, including hormone therapy when suitable, can help mitigate these risks and improve quality of life for women experiencing early menopause.

Managing Menopausal Symptoms: Treatment Options and Lifestyle Changes

While menopause is a natural process, the symptoms associated with it can be disruptive and uncomfortable. Fortunately, there are various treatment options and lifestyle modifications that can help manage these symptoms effectively.

Medical Treatments for Menopausal Symptoms

1. Hormone Therapy (HT): Estrogen and progesterone supplementation to alleviate symptoms like hot flashes and vaginal dryness
2. Low-dose antidepressants: Can help with mood swings and hot flashes
3. Vaginal estrogen: Topical treatments to address vaginal dryness and discomfort
4. Gabapentin: May help reduce hot flashes and improve sleep
5. Ospemifene: For treating painful intercourse associated with vaginal changes

Lifestyle Changes to Manage Menopause Symptoms

• Regular exercise: Helps maintain bone density, manage weight, and improve mood
• Balanced diet: Rich in calcium and vitamin D to support bone health
• Stress reduction techniques: Such as meditation, yoga, or deep breathing exercises
• Avoiding triggers: Identifying and avoiding hot flash triggers like spicy foods or alcohol
• Maintaining a healthy weight: Can help reduce the frequency and severity of hot flashes
• Quitting smoking: Improves overall health and may reduce menopausal symptoms
• Pelvic floor exercises: To strengthen muscles and improve bladder control

It’s crucial to consult with a healthcare provider to determine the most appropriate treatment plan based on individual symptoms, medical history, and personal preferences.

Long-term Health Considerations for Postmenopausal Women

As women transition through menopause and enter the postmenopausal phase, they face new health considerations due to the long-term effects of decreased estrogen levels. Understanding these risks and taking proactive measures can help maintain overall health and well-being in the years following menopause.

Key Health Concerns for Postmenopausal Women

1. Cardiovascular Health: Increased risk of heart disease and stroke
2. Bone Health: Greater susceptibility to osteoporosis and fractures
3. Urogenital Health: Continued issues with vaginal dryness and urinary incontinence
4. Cognitive Function: Potential increased risk of cognitive decline and dementia
5. Metabolic Changes: Altered fat distribution and increased risk of metabolic syndrome

Preventive Measures and Health Maintenance

• Regular health screenings: Including mammograms, bone density scans, and cardiovascular assessments
• Balanced diet: Emphasizing calcium, vitamin D, and heart-healthy foods
• Weight-bearing exercises: To maintain bone density and overall fitness
• Hormone therapy: When appropriate, to address specific symptoms and health risks
• Cognitive stimulation: Engaging in mentally stimulating activities to support brain health
• Stress management: Practicing relaxation techniques and maintaining social connections
• Regular check-ups: Monitoring overall health and addressing any emerging concerns promptly

By understanding the long-term implications of menopause and adopting a proactive approach to health management, postmenopausal women can maintain their quality of life and reduce the risk of age-related health issues.

When Does Menopause Start? – Forbes Health

Table of Contents

• What Is Menopause?

• What Age Does Menopause Start?

• How to Know if Menopause Has Started

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If you’re wondering at what age you may start experiencing menopause, you’re not alone. Many have this question in the back of their minds, especially as they move toward and beyond middle age. While menopause is a completely normal part of the aging process, all of the changes it can bring may feel intimidating. Having an idea of when to expect it can offer some relief.

While there is an average age for menopause to begin, everyone’s experiences are unique to them. There are some factors that can determine the onset of menopause, and not everyone will have the same symptoms.

Read on to get a better idea of when you can expect menopause to start.

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What Is Menopause?

Menopause officially occurs when there is a cessation of ovarian hormonal production, typically resulting in the absence of a menstrual period for one full calendar year. Once an individual has officially entered menopause, they will no longer get their menstrual period and will no longer be able to get pregnant.

As hormones like estrogen, progesterone and testosterone start to decrease, a lot of physiologic, behavioral and psychosocial changes can take place, explains Emily Anderson, a gerontology clinical nurse specialist based in Minnesota. This transition period, known as perimenopause, typically results in “urogenital changes like vaginal dryness and urinary incontinence, reduced bone density, vasomotor changes like hot flashes and night sweats, cognitive decline and increased risk of ischemic heart disease,” says Andereson.

Perimenopause and Menopause: What’s the Difference?

Think of the years before menopause as a transition period, where a person may experience some changes in their body. This is the perimenopause period, and it can last anywhere between four to eight years ^{tippy-popover-container-bg-white’ }”>[1]}Menopause 101. The North American Menopause Society. Accessed 1/24/2023. . Perimenopause generally begins with changes in the length of a person’s menstrual period and ends after 12 months of a person not getting their period, signaling the start of menopause.

“During this period of time, the ovaries begin producing fewer hormones, which may result in irregular menstrual cycles and symptoms of lower estrogen,” explains Anderson.

While perimenopause and menopause may cause similar symptoms, the presence of a menstrual period, even one that is late, during perimenopause is the main difference between them. “During perimenopause, fertility and conception are still possible, as the potential for ovulation still remains,” says Anderson. “However, after a woman’s final menses occurs (signaling menopause) natural fertility and conception are no longer achievable.”

Perimenopause vs Early Menopause: What’s the Difference?

Early menopause is menopause that happens between the ages of 40 and 45. About 5% of people naturally go through early menopause, and there are some factors that can cause this to happen, such as smoking or certain medicines or treatments, like the removal of the ovaries.

In the case of early menopause, “menstrual cycles end prematurely due to ovarian or follicular dysfunction,” says Anderson. She notes that perimenopause might happen before early menopause, but it might not. Some factors that may cause early menopause include:

• Certain autoimmune diseases, such as thyroid disease or rheumatoid arthritis
• Certain genetic disorders, such as Turner’s syndrome
• Chronic fatigue syndrome
• Surgery to remove the ovaries
• Chemotherapy or pelvic radiation
• Smoking
• A family history of early menopause

While perimenopause can be the body’s way of preparing for menopause, early menopause is when menopause begins before the average starting age.

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Partner Offers feature brands who paid Forbes Health to appear at the top of our list. While this may influence where their products or services appear on our site, it in no way affects our ratings, which are based on thorough research, solid methodologies and expert advice. Our partners cannot pay us to guarantee favorable reviews of their products or services

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What Age Does Menopause Start?

The average age that menopause begins is 51, and most will experience menopause between the ages of 40 and 58^[1]Menopause 101. The North American Menopause Society. Accessed 1/24/2023. . As Anderson notes, there is no way to predict exactly what age menopause will start since there are so many different contributing factors.

“Genetics play a strong role,” she says, and a person may be able to get a general idea of when menopause will begin by noting what age their mother experienced it.

A 2021 research letter in the Journal of the American Medical Association exemplifies just how many factors can play into the age that menopause. The letter highlights a study analyzing 60-year trends in age for natural menopause and reproductive life span. Researchers found that Black women or women of Hispanic ethnicity had an earlier age of natural menopause. Lower socioeconomic status, current and former smoking status and hormone therapy use were also associated with an earlier age of natural menopause. Researchers also found that more education and oral contraceptive use were associated with a later age of natural menopause ^{tippy-popover-container-bg-white’ }”>[2]}Appiah D, Nwabuo C, Ebony I, et al. Trends in Age at Natural Menopause and Reproductive Life Span Among US Women, 1959-2018. JAMA. 2021;325(13):1328-1330. .

Diet may also play a role in menopause onset. A 2018 U.K. study in the Journal of Epidemiology and Community Health linked an earlier onset of menopause with a diet that included a higher amount of refined pasta and rice, while later onset of menopause occurred with a diet of higher amounts of oily fish and fresh legumes^[3]Dunneram Y, Greenwood DC, Burley VJ, et al. Dietary intake and age at natural menopause: results from the UK Women’s Cohort Study. J Epidemiol Community Health 2018;72:733-740. .

Because the age a person reaches menopause is dependent on so many factors, it’s important to reach out to your doctor if you believe you may be dealing with perimenopause, early menopause or menopause itself.

How to Know if Menopause Has Started

The definitive way of knowing menopause has begun is if your menstrual period is absent for 12 consecutive months. “I recommend that women track their menstrual cycles each month, which will serve as an alert to irregular or absent menstrual cycles,” explains Anderson.

Even though menopause is a completely normal part of life,it may still feel overwhelming to some. Thankfully, there are ways to make the transition easier. “Both hormonal and non-hormonal therapies can be utilized to help alleviate the symptoms of menopause,” says Anderson.

For those transitioning into menopause, Anderson recommends 150 minutes of exercise each week, using a combination of walking and strength training. “This may improve blood sugar stabilization, enhance sleep, reduce risk of cardiovascular disease, aid in bone health and improve mood,” she says. She also recommends non-hormonal therapies such as herbs like maca, chaste tree, schisandra and red clover to reduce symptoms including hot flashes, night sweats and insomnia. “Vitamins and minerals like magnesium, vitamins B6, C and D can offer mood support as well as protection against loss of bone density,” adds Anderson.

Hormonal treatments are available as well, and usually involve the use of bio-identical hormones including estrogen, progesterone and testosterone. “During perimenopause, often the only hormone needed is progesterone to help balance estrogen and enhance the brain’s ability to cope with stress,” says Anderson. “Progesterone converts to a neurosteroid called allopregnanolone which can cross the blood-brain-barrier and act on GABA receptors to help calm the brain. This can help to reduce symptoms of anxiety and poor sleep.”

Those interested in trying either a non-hormonal or hormonal treatment during menopause or during the transition into menopause should speak with their doctor to come up with a plan that works for them.

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Menopause | NHS inform

Menopause is when a woman stops having periods. Menopause means ‘the last menstrual period’. It’s not only those who identify as women who will experience menopause. Some transgender men, non-binary people and intersex people or people with variations in sex characteristics may also experience menopause.

Menopause is a natural event and transition that women experience, however, the timing and symptoms are different for everyone. You can look at your family history to get an idea of when you might go through it. It’s likely to be a similar age to when your mother or older sisters started theirs.

Menopause can also occur due to certain surgeries or cancer treatments. This can sometimes cause symptoms to be more sudden and in some cases more severe.

Perimenopause is the time from the start of menopausal symptoms until after a woman has experienced her last period. Periods will usually start to become less frequent over a few months or years before they stop altogether. They might be more irregular and become heavier or lighter. For some women, they can stop suddenly.

Postmenopause is the time after a woman experiences her last period. A woman is said to be postmenopausal when she has not had a period for 12 months.

Perimenopause and menopause are a natural part of a woman’s life course and usually occur between the ages 45 and 55 years of age, as a woman’s oestrogen levels drop (although it can start earlier). In the UK, the average age for a woman to reach menopause is 51.

Life doesn’t have to be put on hold because of menopause. There’s a lot that can be done to help manage symptoms, including making healthy lifestyle choices, trying different treatments and seeking support from healthcare professionals.

Menopause myths
(https://www.youtube.com/watch?v=uol9wrUZwHM)

Symptoms of menopause

Most women will experience menopausal symptoms. Some women will experience few, or no, symptoms. But for some, they can be quite severe and have a significant impact on everyday life.

The first sign of menopause is usually a change in the normal pattern of your periods. You may start having either unusually light or heavy periods.

The frequency of periods may also be affected. They may occur every two or three weeks, or they might not occur for months at a time. Eventually, periods will stop altogether, although for some women other menopause symptoms may continue.

Some women can start experiencing symptoms such as migraines, irritability and low mood especially around the period time, without seeing irregularity in periods.

There are many menopausal symptoms and symptoms can differ between individuals. Some of the most common symptoms include:

• ‘brain fog’ and memory issues
• difficulty sleeping
• fatigue
• hot flushes
• joint aches
• loss of sex drive (libido)
• low mood or anxiety
• migraine
• night sweats
• vaginal dryness or pain

Further information about the symptoms of menopause

Causes of menopause

Menopause is caused by a change in the balance of the body’s hormones, which occurs as you get older. Premature or early menopause can occur at any age and, in many cases, there’s no clear cause.

Menopause happens when the ovaries stop producing as much of the hormone oestrogen and no longer release an egg each month.

Menopause can also occur when a woman’s ovaries are affected by certain treatments such as chemotherapy or radiotherapy, or when the ovaries are removed, often at the time of a hysterectomy.

Further information about early and premature menopause

Treatments for menopausal symptoms

It’s important to get healthcare advice around menopause treatments so that you can make the decisions that are best for you.

If you or someone you know does need help to manage symptoms, support can be accessed through your GP practice.

Your healthcare professional can talk to you about treatments and work with you to explore lifestyle changes if you have menopausal symptoms that you feel are interfering with your day-to-day life. These include:

• hormone replacement therapy (HRT)
• vaginal oestrogen preparations, lubricants or moisturisers for vaginal dryness
• cognitive behavioural therapy (CBT)
• eating a healthy, balanced diet and exercising regularly
• taking supplements such as vitamin B6 and vitamin D

Further information about treating the symptoms of menopause

Menopause is nothing to fear
(https://www.

youtube.com/watch?v=wXxdbWEjX68)

Menopause and day-to-day life

Menopausal symptoms can sometimes be severe and they could impact day-to-day life. There is help available if you need it.

Living with the menopause
(https://www.youtube.com/watch?v=BbP8Eel5Uu0)

Mental wellbeing

Menopause can have an effect on your mental health and wellbeing. Some of the symptoms might include irritability, depression and anxiety. Lack of sleep caused by menopause can also have an impact on a person’s mood and how they feel.

If you or someone you know is suffering from any of these symptoms and it’s having an impact on day-to-day life, discuss it with someone from your local GP practice and they can help you get the support you need.

Further information about mental wellbeing during the menopause

Workplace

Some people find it hard to manage menopause symptoms at work. It’s important to remember that the menopause is a normal time in women’s lives and that support should be available to help you feel comfortable at work.

Further information about menopause in the workplace

Sex and relationships

Menopause symptoms such as vaginal dryness or pain, reduced sex drive or discomfort during penetrative sex might have an impact on your sex life and relationships.

There are treatment options available that might help ease or manage some of these symptoms. It might also be helpful to discuss how menopause is affecting you with your partner. By helping them have an understanding of what you’re experiencing, they’ll be more aware of how they can support you.

Further information about sex and intimacy during menopause

Supporting someone through menopause

If you know someone around you is going through menopause, you can let them know that you’re there to support them. Ask them what you can do to help, or just ask them how they’re feeling. People might not always feel comfortable discussing all of their symptoms, but it’s still important to let them know you’re there for them. 

Further information about how to support someone through menopause

Source:
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29 November 2022

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Climax. What is important to know? | Blog

Climacteric syndrome (aka menopause) is a period in a woman’s life during which the work of the ovaries decreases and the amount of hormones they produce decreases. The main result of these physiological processes is the cessation of female reproductive function.

The period of menopause in most women occurs after 48-52 years. Its symptoms include hot flashes or sweating, as well as risks of developing serious illnesses. That is why menopause must be kept under control, visit a doctor regularly, and perform prescribed diagnostic procedures.

Stages and types of menopause

Menopause in women does not occur immediately. The climacteric period includes three main stages:

premenopause or premenopause. Menstruation does not stop, but ovarian function decreases. The stage lasts up to 2 years;

menopause. Caused by the cessation of menstruation. The beginning of the period is the absence of menstruation for 12 months. Usually occurs at 50-52 years;

postmenopausal. This stage is characterized by a further decrease in female sex hormones until the complete cessation of the functioning of the ovaries.

The duration and timing of these stages are individual and depend on various factors, including the lifestyle and health of the woman.

Menopause is also distinguished by the severity of manifestations:

first or mild degree. It is characterized by infrequent (up to 10 times a day) hot flashes, which are the main manifestation of menopausal syndrome;

second degree or medium. Symptoms are more pronounced, and hot flashes are not the only manifestation of this condition;

severe or third degree. Signs of menopause are strongly pronounced, not limited to hot flashes, the number and frequency of which is quite large (more than 20 times a day). Working capacity decreases, the general state of health worsens significantly.

Symptoms of menopause

The preliminary stage (before menopause) often occurs without obvious signs. But it also happens vice versa, when a woman is worried about not one, but several symptoms at once. In addition, manifestations can differ significantly in different periods of time.

Early signs of climacteric syndrome include:

hot flashes, goosebumps, sweating;

rapid pulse;

headaches;

pressure surges;

sudden changes in mood;

sleep problems;

memory impairment;

decreased sexual desire.

When menopause occurs, menstruation stops in women. Other signs during this period of development of the syndrome include the following:

dry skin and mucous membranes of the genital and urinary tract;

pain during sex;

urinary incontinence;

muscle and joint pain;

hair loss.

In the future, after menopause, various complications of menopause are possible:

hypertension;

atherosclerosis;

osteoporosis.

Also increases the risk of developing diabetes, hearing, vision and mental abilities are reduced.

In order to prevent these diseases and problems, during menopause, women are advised to regularly visit their doctor in Kyiv, monitor their health and adhere to the prescribed treatment.

Diagnostics of menopause

Diagnostic examinations of menopausal syndrome are carried out by gynecologists of our clinic. They examine and interview the patient, establish the relationship between menopause and various manifestations of menopause. An important diagnostic task is also the identification of concomitant diseases, such as hypertension, diabetes mellitus, etc.

During menopause, women may be prescribed various tests, including:

laboratory tests for hormones, lipid spectrum, coagulation;

cytological and microscopic: their purpose is to exclude the presence of atypical cells in the cervix.

To exclude the development of complications of menopause, such types of studies as ultrasound of the pelvic organs, mammography, radiography of bone tissues, ECG are used.

Menopause treatment

Menopause is a physiological process that occurs with age in any woman. Therefore, the therapeutic effect, as a rule, is aimed at minimizing negative manifestations, that is, facilitating the course of menopause. So with a mild degree of the syndrome, special treatment may not be required at all. If there are minor complaints about the general state of health, the following is prescribed:

hormone replacement therapy;

vitamins, especially A, C and group B;

physiotherapy, including massage, exercise therapy, etc.

A balanced diet is also recommended during menopause.

With a large number of unpleasant manifestations (moderate severity of menopause), antidepressants and medications that allow normalization of blood pressure may be indicated.

If you are concerned about menopausal syndrome, please contact our clinic in Kyiv. Specialists will help women reduce symptoms during menopause, prescribe the necessary tests and offer preventive measures that will reduce the risk of various complications.

Receptionist

symptoms, diagnosis and treatment at the NCC of Russian Railways, with a branch of the Central Clinical Hospital No. 1

What is menopause? Translated from Greek – a rung of a ladder. Indeed, menopause is just the beginning of another stage in a woman’s life, when a third of her life is still ahead. The entire transitional period before menopause, when cycle disorders begin (from delays to shortening of the cycle), the first menopausal complaints occur, and several years after menopause, when there is a serious restructuring of the body, is called menopause. And I want to live this stage of life in a quality, healthy way, without being distracted by sores and feeling unwell. Is climax a staircase up or down? The solution to this issue is in your hands.

What is menopause?

This is the last menstruation of a woman’s life. Menopause is set retrospectively one year after the last menstruation.

The average age of menopause is 51 years: by this age, the supply of eggs in the ovaries is completely depleted, and the synthesis of female sex hormones, estrogen, stops. Normally, the phenomena of the beginning of the transition period begin after 45 years, this is considered timely. If menopause occurs at 40-45 years old, they talk about early menopause. If at 37-40 years old – this is premature menopause. If the function of the ovaries is turned off before the age of 37, they speak of premature ovarian failure.

Age of menopause is genetically programmed. If the mother and female relatives had an early menopause, their daughter will almost certainly share their fate. It is impossible to stop or slow down the internal biological clock. To date, no means have been found that can prevent inherited insufficient ovarian activity. Gynecological operations, severe and prolonged stress, infectious diseases during puberty can bring the onset of menopause closer. Menopause can begin earlier with severe illness, exhaustion. The onset of menopause is caused by the removal of the ovaries or their dysfunction due to radiation or chemotherapy. It is believed that menopause occurs 1-3 years faster in women who smoke a lot. The number of pregnancies and childbirth does not affect the age at which menopause occurs.

Also, the onset of menopause means a pronounced decrease in the ability to conceive. But since spontaneous bursts of ovarian hormonal activity are still possible, pregnancy is still possible. Therefore, contraception can be canceled only two years after the last menstruation. Unexpected pregnancies in women 45-50 years old are not uncommon. A hormonal blood test can most likely tell about a woman’s ability to conceive. The main indicator that the doctor evaluates is the level of anti-Müllerian hormone, which reflects the supply of eggs.

Estrogen receptors are found not only in the reproductive organs (uterus, ovaries, cervix, vaginal mucosa), but also in the heart and blood vessels, bones, nervous system, skin, bladder and urethra, and many others. That is why the symptoms of menopause, that is, the symptoms of estrogen deficiency, are not limited to hot flashes and sweating, mood swings and sleep disturbance. And only with these complaints the patients address.

Climacteric symptoms :

For some reason it is believed that these are just unbearably annoying vegetative and emotional complaints (hot flashes, sweating, tearfulness, mood swings, sleep disturbances). Attacks of sudden sweating are associated with dysregulation of vascular tone and body temperature due to changes in the hormonal balance in a woman. They often occur at night (night sweats) and can lead to sleep disturbances. In the daytime, a number of factors can provoke the development of hot flashes and sweating: drinking coffee and, in general, drinking hot foods and drinks, drinking alcohol, situations of mental stress, and much more.

Since there is not enough estrogen during menopause, the most effective protection against hot flashes and sweating during menopause is to restore hormonal balance in the body through menopausal hormone therapy (MHT). You need to give the body what it lacks. You can, of course, use both herbal preparations and dietary supplements, but only the effectiveness of MHT reaches 90-95%, alternative means – no more than 40-50%, and herbal preparations – 20-30%, less than placebo. But is menopause only scary with hot flashes?

Deficiency of estrogen in the central nervous system causes depression, so characteristic of this age. Also, depression is aggravated by a change in social role – children have grown up and do not require constant care, etc. Characteristically, memory loss, difficulty concentrating and concentrating. After menopause, the risk of Alzheimer’s disease increases dramatically.

A decrease in the amount of estrogens during menopause gives rise to the development of atherosclerosis, since the female hormone estrogen prevents the deposition of cholesterol on the walls of blood vessels. According to statistics, myocardial infarction in women under 40 is 10 times less common than in men, and at 60 these figures are already the same. Estrogens have an anti-atherosclerotic effect, protect against cardiovascular pathology

Bone density and bone strength begin to decline, postmenopausal osteoporosis develops, fractures occur with minimal trauma (see Postmenopausal Osteoporosis – link).

Estrogen deficiency causes a decrease in the trophism of the vaginal mucosa: dryness in the vagina, itching and burning due to an imbalance in the vaginal flora, the impossibility of sexual intercourse due to severe soreness and vulnerability of the mucous membranes.

Atrophy of the urethra and decreased tone of the pelvic muscles is the cause of urinary disorders (urinary incontinence with stress or urgency), frequent cystitis occurs (see section Urinary incontinence in women – link).

Appearance is also a problem. Due to the lack of estrogen, the skin becomes thinner and dryer. As a result, the face “acquires” new wrinkles, an unhealthy color. The skin loses elasticity, acquiring the appearance of a shriveled apple, the chest sags, hair thins, psychological balance is disturbed, despondency and depression are increasingly coming. The body loses silkiness, elasticity. In general, the metabolism slows down, so women after menopause begin to gain weight dramatically. Of course, they do not follow a diet, they do not move much – although not one of them admits this, first of all to herself. The important thing is that the redistribution of fat begins, it begins to accumulate not on the buttocks, as in youth, but on the stomach. The so-called abdominal obesity is formed. In addition to a cosmetic defect, this type of obesity is a serious health risk (see section Obesity. For abdominal fat is the most active endocrine organ in our body! Not only sex hormones are synthesized in it, which is why unwanted hair grows on the face, along the white line of the abdomen, on the thighs and other hormone-dependent areas, uterine bleeding occurs due to uncontrolled growth of the mucosa, the risk of mammary gland pathology increases.A huge amount of pro-inflammatory factors, cytokines, growth factors, etc. are also produced there, which increases the risk of cardiovascular diseases and serves as the basis for a serious violation metabolism up to diabetes.What the body forgave at 20 years old – irregular, unbalanced diet, sleepless nights, lack of physical activity, frivolous attitude to preventive examinations – becomes categorically unacceptable after forty years!0003

Diagnosis and treatment:

All of the above is a consequence of the shutdown of ovarian function, the cessation of estrogen synthesis. Therefore, it is absolutely logical to prescribe hormone replacement therapy with preparations of natural sex hormones in low doses. The treatment is to replace your own hormones with identical ones that your ovaries produce. In fact, these drugs “deceive” the body. He receives the hormones he lacks in just the amount so as not to be “outraged”, but in much less than what was produced by the ovaries. Therefore, the process of restructuring does not slow down, but goes smoothly and almost painlessly.

Unfortunately, hormone therapy causes absolutely unreasonable fear and horror in our compatriots. The history of hormone therapy began in 1940. As you can see, the world did not choke on fat and bearded women, and cancers did not cause the extinction of the beautiful half of humanity.

To date, the safety of taking MHT for 5-7 years has been absolutely proven when MHT is first administered to a woman under 60 years of age who has not gone through menopause for more than 10 years. During this period, all age-related processes still continue, only they are not noticeable to a woman, do not violate her quality of life. And thanks to the protective preventive effect, the health of a woman improves in comparison with her peers who do not take MHT. And they look better – slender, without wrinkles, and feel younger – sleep well, enjoy life, are not chronic patients of a huge number of doctors.

If menopause is early and premature, then for the prevention of diseases of old age, MHT is prescribed immediately and at least up to 50 years. In this case, the benefits far outweigh the risks. Otherwise, if menopause occurs, for example, at the age of 38, by the age of 50 a woman may face sores of patients over 70 …

But we must remember that this is not an elixir of youth, not a panacea. MHT has indications and contraindications, it is not prescribed for everyone.

In addition, MHT is prescribed only by a doctor after a mandatory preliminary examination, taking into account indications and contraindications. Self-activity in the appointment of the drug MHT is fraught with serious consequences.

So, it is absolutely proven that MHT is unsurpassed in the relief of hot flashes and other vegetative complaints, is an effective prevention of osteoporosis, urinary incontinence problems and sexual disorders, Alzheimer’s disease and dementia, obesity and diabetes mellitus, cardiovascular diseases, helps to reduce the severity of arterial hypertension and the number of drugs to normalize blood pressure.

Before prescribing MHT, it is necessary to undergo an examination to clarify the indications and exclude contraindications:

• Pelvic ultrasound with vaginal probe
• Ultrasound of the thyroid gland and abdominal organs according to indications
• Mammography
• Pap smears from the cervix
• Blood chemistry plus lipid profile as indicated
• Hemostasiogram or coagulogram according to indications
• Densitometry according to indications
• Hormonal profile (FSH, estradiol, prolactin, TSH, free T4, AT-TPO, testosterone) according to indications
• Blood pressure measurement
• Physician consultation according to indications

It is obligatory to take into account concomitant and past diseases, data from extracts from previous hospitalizations.

While taking MHT, the patient should visit a gynecologist-endocrinologist at least once a year for a consultation and undergo an annual examination to clarify the state of health and re-assess the risks.

Many people think that after menopause there is no need to visit a gynecologist. It is not right. It is women of the 5th-6th decades who have an increased risk of such diseases as osteoporosis, atherosclerosis, various tumor diseases, which at first are asymptomatic and are detected only during a special examination. So, hormone replacement therapy before and after the onset of menopause minimizes such risks. And this means that a woman does not turn into a regular patient of the local clinic, but for many years she retains physical strength, mental alertness, and natural beauty.

You can stop MHT and turn to alternative methods. Phytopreparations relieve such unpleasant symptoms of menopause as hot flashes, sleep disturbance, headaches, frequent mood swings, excessive sweating, but are not able to protect against age-related changes in the cardiovascular system, bones, lower urinary tract, skin and nervous system.