Wellbutrin menopause. Wellbutrin for Menopause: Evaluating Bupropion’s Effectiveness in Hot Flash Treatment
Can Wellbutrin (bupropion) effectively treat menopausal hot flashes. How does bupropion compare to other antidepressants for managing hot flash symptoms. What are the potential benefits and limitations of using Wellbutrin for menopause-related hot flashes.
Understanding Bupropion’s Potential in Managing Menopausal Hot Flashes
Bupropion, commonly known by its brand name Wellbutrin, has been a subject of interest in the treatment of menopausal hot flashes. This antidepressant, primarily used for nicotine dependence and depression, has garnered attention due to its unique side effect profile and anecdotal reports of hot flash relief in some patients.
A pilot study conducted between January 1999 and October 2004 sought to evaluate bupropion’s efficacy in treating hot flashes. The study enrolled 21 patients, comprising 7 men and 14 women, to assess the drug’s potential in alleviating this common menopausal symptom.
Study Design and Methodology
The research utilized self-completed daily hot flash diaries to document the frequency and severity of hot flashes. Participants recorded their experiences during a baseline week (week 1) and throughout the treatment period (weeks 2 through 5). The treatment protocol involved administering bupropion 150 mg every morning for the first three days, followed by 150 mg twice daily for a total of four weeks.
Challenges and Limitations
Several challenges emerged during the study:
- One woman did not provide any hot flash information and was excluded from the analysis.
- Five women were unable to complete the study due to side effects.
- The sample size was relatively small, potentially limiting the generalizability of the results.
Analyzing Bupropion’s Efficacy in Hot Flash Management
The results of the pilot study did not demonstrate a significant reduction in hot flash frequency or severity compared to what would be expected with a placebo. This outcome aligns with bupropion’s mechanism of action and current hypotheses about hot flash pathophysiology.
Mechanism of Action and Hot Flash Pathophysiology
Bupropion functions primarily as a norepinephrine reuptake inhibitor without significant serotonergic effects. Current understanding of hot flash pathophysiology suggests that these symptoms are associated with increased noradrenergic activity and decreased serotonergic activity. This mismatch between bupropion’s action and the underlying mechanisms of hot flashes may explain its lack of efficacy in this context.
Comparing Bupropion to Other Antidepressants for Hot Flash Treatment
While bupropion did not show promising results in this pilot study, other antidepressants have demonstrated efficacy in managing hot flashes. How do these medications compare to bupropion?
Venlafaxine for Hot Flash Management
Venlafaxine, a serotonin-norepinephrine reuptake inhibitor (SNRI), has shown more promising results in treating hot flashes. A randomized controlled trial published in The Lancet demonstrated that venlafaxine effectively reduced hot flashes in breast cancer survivors. This suggests that medications with both serotonergic and noradrenergic effects may be more suitable for hot flash management.
Other Centrally Active Nonhormonal Therapies
Research has explored various centrally active nonhormonal therapies for hot flash treatment. These include other antidepressants, anticonvulsants, and alpha-adrenergic agonists. The efficacy of these treatments varies, highlighting the complex nature of hot flash management and the need for individualized approaches.
Implications for Future Research and Clinical Practice
The results of this pilot study suggest that bupropion may not be a promising candidate for further investigation as a hot flash remedy. What are the implications of these findings for future research and clinical practice?
Redirecting Research Efforts
Researchers may need to focus on other medications or interventions that better align with the current understanding of hot flash pathophysiology. This could include exploring compounds with combined serotonergic and noradrenergic effects or investigating novel therapeutic targets.
Personalized Treatment Approaches
Given the variability in individual responses to hot flash treatments, healthcare providers may need to consider a more personalized approach. This could involve assessing each patient’s specific symptoms, medical history, and preferences to determine the most appropriate intervention.
Understanding the Limitations of the Pilot Study
While the pilot study provides valuable insights, it’s important to recognize its limitations. What factors should be considered when interpreting these results?
Sample Size and Diversity
The small sample size of 21 participants limits the study’s statistical power and generalizability. Future research may benefit from larger, more diverse cohorts to better represent the population affected by hot flashes.
Duration of Treatment
The four-week treatment period may not have been sufficient to fully assess bupropion’s long-term effects on hot flashes. Extended studies could provide more comprehensive data on the medication’s efficacy and safety profile in this context.
Exploring Alternative Approaches to Hot Flash Management
Given the limited efficacy of bupropion in treating hot flashes, what alternative approaches should be considered for managing this menopausal symptom?
Hormonal Therapies
Hormone replacement therapy remains an effective option for many women experiencing menopausal hot flashes. However, its use must be carefully considered in light of potential risks and contraindications.
Lifestyle Modifications
Non-pharmacological interventions, such as dietary changes, stress reduction techniques, and regular exercise, may help alleviate hot flash symptoms for some individuals.
Complementary and Alternative Medicine
Some women find relief from hot flashes through complementary therapies like acupuncture, herbal supplements, or mindfulness practices. While evidence for these approaches varies, they may offer additional options for symptom management.
The Future of Hot Flash Treatment Research
As our understanding of hot flash pathophysiology evolves, what directions might future research take in developing more effective treatments?
Targeting Neurotransmitter Systems
Research may focus on developing medications that more precisely target the neurotransmitter systems involved in hot flash regulation, potentially offering more effective and targeted relief.
Personalized Medicine Approaches
Advances in genomics and personalized medicine may lead to more tailored treatment strategies, allowing healthcare providers to predict which interventions are most likely to benefit individual patients based on their genetic profile and other factors.
Novel Delivery Methods
Exploring innovative drug delivery systems or non-invasive neuromodulation techniques could potentially enhance the efficacy of hot flash treatments while minimizing side effects.
In conclusion, while the pilot study of bupropion for hot flash treatment did not yield promising results, it contributes valuable knowledge to the field of menopausal symptom management. By understanding the limitations of certain approaches, researchers and clinicians can refine their focus on more promising avenues for hot flash relief, ultimately working towards more effective and personalized solutions for individuals experiencing this challenging menopausal symptom.
Pilot evaluation of bupropion for the treatment of hot flashes
. 2006 Jun;9(3):631-7.
doi: 10.1089/jpm.2006.9.631.
Domingo G Pérez
1
, Charles L Loprinzi, Jeff Sloan, Paul Novotny, Debra Barton, Lisa Carpenter, Deanne Smith, Brad Christensen, Teresa Rummans
Affiliations
Affiliation
- 1 Mayo Clinic College of Medicine, Rochester, Minnesota 55905, USA.
PMID:
16752968
DOI:
10.1089/jpm.2006.9.631
Domingo G Pérez et al.
J Palliat Med.
2006 Jun.
. 2006 Jun;9(3):631-7.
doi: 10.1089/jpm.2006.9.631.
Authors
Domingo G Pérez
1
, Charles L Loprinzi, Jeff Sloan, Paul Novotny, Debra Barton, Lisa Carpenter, Deanne Smith, Brad Christensen, Teresa Rummans
Affiliation
- 1 Mayo Clinic College of Medicine, Rochester, Minnesota 55905, USA.
PMID:
16752968
DOI:
10.1089/jpm.2006.9.631
Abstract
Bupropion is commonly used in the treatment of nicotine dependence and depression, and in most people, does not cause sexual dysfunction, weight gain, or sedation. Given its attractive side effect profile, the efficacy of other newer antidepressants against hot flashes and anecdotal observations of resolution of hot flashes in some patients taking bupropion for nicotine dependence, it was decided to explore its clinical activity as a hot flash remedy in a pilot study. Between January 1999 and October 2004, 21 patients (7 men and 14 women) were enrolled in the study. Self-completed daily hot flash diaries were used to document the frequency and severity of hot flashes at baseline (week 1) and during the treatment period (weeks 2 through 5). Participants received bupropion 150 mg every morning for the first 3 days and then 150 mg twice per day for a total of 4 weeks. One woman did not provide any hot flash information and was excluded from the analysis. Five women could not complete the study because of side effects. The study did not show a reduction in hot flash frequency and/or severity significantly higher than what would be expected with a placebo.
Even though the sample size was small, these results are consistent with bupropion’s mechanism of action (norepinephrine reuptake inhibition without serotonergic effects) and what it is now hypothesized about the pathophysiology of hot flashes (increased noradrenergic activity and decreased serotonergic activity). These data suggest that bupropion should not be further investigated as a remedy for hot flashes.
Similar articles
Bupropion for control of hot flashes in breast cancer survivors: a prospective, double-blind, randomized, crossover, pilot phase II trial.
Nuñez GR, Pinczowski H, Zanellato R, Tateyama L, Schindler F, Fonseca F, Del Giglio A.
Nuñez GR, et al.
J Pain Symptom Manage. 2013 Jun;45(6):969-79. doi: 10.1016/j.jpainsymman.2012.06.011. Epub 2012 Sep 25.
J Pain Symptom Manage. 2013.PMID: 23017618
Clinical Trial.
Pilot evaluation of venlafaxine for the treatment of hot flashes in men undergoing androgen ablation therapy for prostate cancer.
Quella SK, Loprinzi CL, Sloan J, Novotny P, Perez EA, Burch PA, Antolak SJ Jr, Pisansky TM.
Quella SK, et al.
J Urol. 1999 Jul;162(1):98-102. doi: 10.1097/00005392-199907000-00024.
J Urol. 1999.PMID: 10379749
Clinical Trial.
Venlafaxine in management of hot flashes in survivors of breast cancer: a randomised controlled trial.
Loprinzi CL, Kugler JW, Sloan JA, Mailliard JA, LaVasseur BI, Barton DL, Novotny PJ, Dakhil SR, Rodger K, Rummans TA, Christensen BJ.
Loprinzi CL, et al.
Lancet. 2000 Dec 16;356(9247):2059-63. doi: 10.1016/S0140-6736(00)03403-6.
Lancet. 2000.PMID: 11145492
Clinical Trial.
Centrally active nonhormonal hot flash therapies.
Loprinzi CL, Stearns V, Barton D.
Loprinzi CL, et al.
Am J Med. 2005 Dec 19;118 Suppl 12B:118-23. doi: 10.1016/j.amjmed.2005.09.045.
Am J Med. 2005.PMID: 16414336
Newer antidepressants and gabapentin for hot flashes: a discussion of trial duration.
Loprinzi CL, Diekmann B, Novotny PJ, Stearns V, Sloan JA.
Loprinzi CL, et al.
Menopause. 2009 Sep-Oct;16(5):883-7. doi: 10.1097/gme.0b013e31819c46c7.
Menopause. 2009.PMID: 19295449
Review.
See all similar articles
Cited by
A systematic review of non-hormonal treatments of vasomotor symptoms in climacteric and cancer patients.
Drewe J, Bucher KA, Zahner C.
Drewe J, et al.
Springerplus. 2015 Feb 10;4:65. doi: 10.1186/s40064-015-0808-y. eCollection 2015.
Springerplus. 2015.PMID: 25713759
Free PMC article.Efficacy of nonestrogenic hot flash therapies among women stratified by breast cancer history and tamoxifen use: a pooled analysis.
Bardia A, Novotny P, Sloan J, Barton D, Loprinzi C.
Bardia A, et al.
Menopause. 2009 May-Jun;16(3):477-83. doi: 10.1097/gme.0b013e31818c91ca.
Menopause. 2009.PMID: 19188850
Free PMC article.
MeSH terms
Substances
Treating Sexual Difficulties in Menopause
CAROLINE WELLBERY, MD
Am Fam Physician. 2007;76(11):1717
Background: Women often experience changes in sexual function after menopause. Although changes in desire are not inevitable, postmenopausal women consistently experience a decrease in arousal, manifested by decreases in genital perfusion, engorgement, vaginal lubrication, and response to touch and vibration. Many also experience a decrease in the intensity of orgasm.
In addition to the physiologic changes that occur during menopause (most likely because of a drop in estrogen), psychological factors and expectations may also play a role in sexual satisfaction. Iatrogenically, surgical treatment of stress incontinence and hysterectomy have variable effects on sexual function, depending on preoperative factors and surgical technique. Atherosclerosis and hyperglycemia can impair sexual function in women, as can certain medications, such as selective serotonin reuptake inhibitors and dopamine receptor blockers.
Recommendations: Evaluation should include a comprehensive medical, sexual, and psychosocial history. A genital examination should include evaluation of resting pelvic floor muscle tone and voluntary vaginal and anal sphincter tone. Laboratory testing such as testosterone measurement is not indicated. However, targeted testing is appropriate for suspected disorders.
Treatment addressing sexual complaints should take into account the importance of sex to the patient. Other treatment recommendations include addressing unrealistic expectations, using lubricants, and creating romantic environments. Sex therapy can be helpful for psychological problems.
Estrogen improves vaginal lubrication and may improve orgasm. Although high doses of estrogen can achieve central effects that are more broadly beneficial to sexual function, the progesterone required for endometrial protection negates many of these benefits. If estrogens are used in patients who have an intact uterus and no risk factors, transdermal formulations should be prescribed, because oral estrogens increase sex-hormone binding globulin and decrease desire. Vaginal estrogen increases lubrication, may increase vasocongestion, and is safer than systemic estrogen, but long-term use should be avoided. Combination estrogen/testosterone increases sexual desire and responsiveness but lowers high-density lipoprotein cholesterol levels. Using a testosterone patch may avoid this adverse effect and, in combination with systemic estrogen, may improve the number of satisfying sexual episodes.
Other medications that may be helpful include bupropion (Wellbutrin) and phosphodiesterase inhibitors. Bupropion may increase arousal and orgasm completion. Phosphodiesterase inhibitors increase genital perfusion but have no significant effect on arousal. A subgroup of women taking phosphodiesterase inhibitors had improved overall satisfaction with changes in vaginal lubrication, genital sensation, and ability to achieve orgasm. The same cautions that apply to men in the use of these agents are relevant to women.
Several mechanical devices are available. Vibrators supply high-intensity, direct clitoral stimulation. A hand-held vacuum pump also increases clitoral blood flow and has been shown to increase sexual satisfaction. Some data suggest that pelvic floor exercises can be beneficial and can decrease sexual incontinence. New products to improve desire—including androgen delivery systems and dopamine agonists—as well as agents targeting genital arousal are currently in development.
Menopause
Menopause
- Health Issues »
- A
- B
- C
- D
- D
- E
- Y
- C
- T
- U
- F
- X
- C
- H
- W
- W 9000 5
- b
- S
- B
- E
- S
- I
R
- Popular Topics
- Air pollution
- Coronavirus disease (COVID-19)
- Hepatitis
- Data and statistics »
- News bulletin
- The facts are clear
- Publications
- Find country »
- A
- B
- C
- D
- L
- E
- Y
- W
- W
- Y
- Y
- K
- M
- H
- O
- R
- R
- S
- T
- U
- F 9 0005
- X
- C
- H
- W
- W
- B
- S
- L
- Yu
- I
90 004 L
900 04 E
- WHO in countries »
- Reporting
- Regions »
- Africa
- America
- Southeast Asia
- Europe
- Eastern Mediterranean
- Western Pacific
- Media Center
- Press releases
- Statements
- Media messages
- Comments
- Reporting
- Online Q&A
- Events
- Photo reports
- Case Studies
- Questions and answers
- Speeches
- Update
- Emergencies ”
- News ”
- Disease Outbreak News
- WHO data »
- Dashboards »
- COVID-19 Monitoring Dashboard
- Basic moments ”
- About WHO »
- CEO
- About WHO
- WHO activities
- Where does WHO work?
- Governing Bodies »
- World Health Assembly
- Executive committee
- Main page/
- Media Center /
- Newsletters/
- Read more/
- Menopause
[ii] United Nations, Department of Economic and Social Affairs, Population Division (2019). World Population Aging 2019: Highlights (ST/ESA/SER.A/430). https://www.un.org/en/development/desa/population/publications/pdf/ageing/WorldPopulationAgeing2019-Highlights.pdf
[iii] UNAIDS. The Gap Report 2014: People aged 50 years and older. Geneva, Switzerland. (2014). UNAIDS. https://www.unaids.org/sites/default/files/media_asset/12_Peopleaged50yearsandolder.pdf
“,”datePublished”:”2022-10-17T13:00:00.0000000+00:00″,”image”:”https://cdn.who.int/media/images/default-source/health-topics/physical-activity/woman_running.jpg?sfvrsn=f48f6faa_13″,”publisher”: {“@type”:”Organization”,”name”:”World Health Organization: WHO”,”logo”:{“@type”:”ImageObject”,”url”:”https://www.who.int/Images/SchemaOrg/schemaOrgLogo.jpg”,”width”:250,”height”:60}},”dateModified”:”2022-10-17T13:00:00.0000000 +00:00″,”mainEntityOfPage”:”https://www.who.int/en/news-room/fact-sheets/detail/menopause”,”@context”:”http://schema.org”,”@type”:”Article”};
Key Facts
- Menopause is one of the stages in a woman’s life cycle that marks the end of reproductive age.
After menopause, a woman cannot become pregnant except in rare cases when special fertility treatments are used.
- Most women experience menopause between the ages of 45 and 55 as a natural part of biological aging.
- Menopause occurs as a result of the decline in ovarian follicular function and a decrease in circulating estrogen levels.
- The menopausal transition can be gradual. It usually starts with changes in the menstrual cycle. “Perimenopause” means the period that begins with the onset of the first signs and ends one year after the last menstrual period.
- Perimenopause can last for several years, affecting physical, emotional, mental and social well-being.
- Symptoms of perimenopause can be alleviated with various non-hormonal and hormonal agents .
- Menopause may result from surgical or medical procedures.
How does menopause proceed?
For most women, menopause is associated with the cessation of monthly periods (also known as “periods”) due to the decline of ovarian follicular function. This means that the ovaries stop releasing eggs for fertilization.
The regularity and length of the menstrual cycle varies during a woman’s reproductive life, but the age of natural menopause for women worldwide is typically between 45 and 55 years of age.
Natural menopause is considered to occur after the absence of menses for 12 consecutive months without any other obvious physiological or pathological causes and in the absence of clinical intervention.
Some women experience menopause earlier (before age 40). This “premature menopause” may be due to certain chromosomal abnormalities, autoimmune disorders, or other unknown causes.
It is impossible to predict when a woman will go through menopause, although there are links between the age of menopause and several demographic, medical and genetic factors.
Menopause may also occur as a result of surgery to remove both ovaries or medical interventions that suppress ovarian function (eg, radiation therapy or chemotherapy).
Many women stop menstruating before menopause, such as those who have undergone certain surgeries (hysterectomy or surgical removal of the lining of the uterus) and those who take certain hormonal
contraceptives and other medicines that lead to infrequent or no periods. However, they may experience other changes associated with the menopausal transition.
Changes associated with menopause
Hormonal changes associated with menopause can affect physical, emotional, mental and social well-being. The symptoms experienced during and after the menopausal transition vary significantly from woman to woman. Some have symptoms
practically absent. Others may experience severe symptoms that can affect daily activities and quality of life. Some may experience symptoms for several years.
Symptoms associated with menopause include the following:
- hot flashes and night sweats. Hot flashes are sudden sensations of heat in the face, neck, and chest, often accompanied by reddening of the skin, sweating (sweating), rapid heart rate, and intense physical discomfort.
which may last several minutes; - changes in the regularity and course of the menstrual cycle, ending in the cessation of menstruation;
- vaginal dryness, pain during intercourse and urinary incontinence;
- difficulty sleeping/insomnia; and
- mood changes, depression and/or anxiety.
These changes may also affect the composition of body tissues and increase the risk of cardiovascular disease. The advantage of women over men in terms of the risk of developing cardiovascular diseases is gradually decreasing.
not with a significant drop in estrogen levels after menopause. Menopause can also lead to weakening of the pelvic floor structures, which increases the risk of pelvic organ prolapse. Loss of bone density during menopause is significant
a factor contributing to an increase in the incidence of osteoporosis and fractures.
There are a number of non-hormonal and hormonal agents that can help relieve menopausal symptoms. Symptoms that affect health and well-being should be discussed with a healthcare professional to determine available options
their relief, taking into account medical history, values and preferences.
Pregnancy is still possible during perimenopause. To avoid unwanted pregnancy, it is recommended to use contraceptives for 12 consecutive months after the last menstrual period. Pregnancy after menopause without fertility treatment,
involving the use of donor eggs or previously frozen embryos is unlikely.
During perimenopause and after menopause, sexually transmitted infections (STIs), including HIV, can still be contracted through unprotected sex, including oral, anal, and vaginal sex. Thinning of the walls of the vagina after
menopause increases the chance of damage and ruptures, which increases the risk of HIV transmission through vaginal sex.
The importance of understanding menopause
It is very important to consider menopause as one of the life cycle stages. The state of health of a woman entering the perimenopausal period is largely determined by the previous state of health, reproductive history, lifestyle and factors
environment. Perimenopausal and postmenopausal symptoms can be devastating to personal and professional life, and the changes brought about by menopause impact a woman’s health as she ages. Therefore rendering
Perimenopausal health care plays an important role in promoting healthy aging and improving quality of life.
Menopause can be an important transitional period, both socially and biologically. Socially, how a woman experiences menopause can be influenced by gender norms, family and sociocultural factors, including how aging
women and the menopausal transition are accepted in her culture.
The global population of postmenopausal women is growing. In 2021, women aged 50 and over made up 26% of all women and girls in the world. This figure has increased from 22% 10 years earlier[i]. In addition, the life expectancy of women is longer
than in men. In 2019d. women aged 60 worldwide could expect to live an average of 21 more years[ii].
Menopause can be an important opportunity to reassess your health, lifestyle, and goals.
Menopause-related public health issues
Perimenopausal women need access to quality health care and to communities and systems that can support them. Unfortunately, awareness of and access to menopause services remains serious.
problem in most countries. Often, menopause-related issues are not discussed in families, communities, workplaces, and health care settings.
Women may not be aware that the symptoms they experience are associated with menopause and that there are counseling and treatment options available to help relieve discomfort. Women experiencing menopausal symptoms may feel uncomfortable
or shame that prevents them from drawing attention to their experiences and asking for support.
Health care providers may not be trained to recognize perimenopausal and postmenopausal symptoms and counsel patients about treatment options and health care after the menopausal transition. Currently in programs
The training of many medical professionals has given limited attention to the problem of menopause.
In many countries, the sexual well-being of menopausal women is neglected. This means that common gynecological effects of menopause, including vaginal dryness and pain during intercourse, may remain.
without attention. Similarly, older women may not consider themselves at risk of contracting sexually transmitted infections, including HIV[iii], and may not receive safe sex or testing advice from their doctors.
Many governments do not have the health policy and funding to include diagnostic, counseling and treatment services for menopause as part of routine services. Menopause services are
presents a particular challenge in the presence of other urgent and competing health financing priorities.
WHO activities
WHO believes that social, psychological and physical health support during the menopausal transition and after menopause should be an integral part of health care. WHO aims to improve understanding of menopause through
following events:
- raising awareness of menopause and its impact on women at the individual and community levels, as well as on the health and socioeconomic development of countries;
- advocacy for the inclusion of diagnostic, treatment and counseling services for menopausal symptoms in the universal health coverage package;
- Promoting the inclusion of menopause education and treatment options in pre-service training programs for health workers; and
- promoting a lifelong approach to health and well-being (including sexual health and well-being) by ensuring that women have access to relevant health information and services to promote healthy
aging and a high quality of life before, during and after menopause.
Notes:
and self-identify as women), transgender men and some individuals who do not identify as either male or female are also going through menopause.
In this fact sheet, “women” are referred to according to available data, which usually does not specify gender identity. There is little data available on the experience of menopause among transsexuals and individuals with
gender identity. Transgender people and individuals with different gender identities have their own age-related health needs that clinicians should consider, including referral to specialized
services.
2) Although menopause is not a disease, in this fact sheet what women experience during perimenopause and postmenopause is
called symptoms because it can cause discomfort that affects quality of life.
[i] United Nations, Department of Economic and Social Affairs. (2021) World Prospects 2021. https://population.un.org/wpp/Download/Standard/Population/
[ii] United Nations, Department of Economic and Social Affairs, Population Division (2019). World Population Aging 2019: Highlights (ST/ESA/SER.A/430). https://www.un.org/en/development/desa/population/publications/pdf/ageing/WorldPopulationAgeing2019-Highlights.pdf
[iii] UNAIDS. The Gap Report 2014: People aged 50 years and older. Geneva, Switzerland. (2014). UNAIDS. https://www.unaids.org/sites/default/files/media_asset/12_Peopleaged50yearsandolder.pdf
Women’s Health
Sexual and Reproductive Health and Research (English)
Aging
Sexual health
What is menopause – menopause, symptoms of menopause.
Menopause or menopause is a natural period in a woman’s life, when the hormonal balance in the body changes, decreases, and then completely disappears the possibility of becoming pregnant, menstruation stops. The ovaries produce less sex hormones as a result of the aging process.
Menopause (menopause) is not a disease, but a physiological restructuring of the body. For some menopause goes unnoticed, while others have a number of complaints. It can last several years and consists of three stages.
Stages of menopause (menopause)
- Perimenopause is a transitional period that begins, on average, 4 years before menopause (ages 45-47) and continues for 12 months after the cessation of menstruation. The first sign of perimenopause is changes in the menstrual cycle, both in duration and in the amount of blood loss. In the last one to two years of perimenopause, the fall in estrogen accelerates. At this stage, symptoms of menopause are observed. Women still have menstrual cycles and can become pregnant.
- Menopause is the time of the last natural bleeding (menses). Begins either 12 months after the last menstrual period, or after the cessation of menstruation for a clinical reason.
- Postmenopause – the period when a woman has not had bleeding within a year after menopause, which continues until 65-69 years, gradually passing into the period of reproductive aging.
Why does menopause occur?
Natural menopause occurs at the beginning of the age of 50, when it is not caused by surgery or other disease. But there are reasons that can provoke an artificial menopause.
- Natural reduction of reproductive hormones .
As a woman approaches her 40s, the ovaries begin to produce less estrogen and progesterone, the hormones that regulate menstruation, and fertility declines. Menstrual periods become longer or shorter, heavier or lighter, and more or less frequent. On average, by the age of 51, they stop.
- Primary ovarian failure.
About 1% of women experience menopause before the age of 40 (premature menopause). It may be the result of an inability of the ovaries to produce normal levels of reproductive hormones, which is due to genetic factors or autoimmune diseases (decreased immune defenses). Often, the cause of premature menopause cannot be found. Hormone therapy is usually recommended for these women, at least until the natural age of menopause, to protect the brain, heart, and bones.
- Surgery to remove the ovaries (oophorectomy).
Surgery causes immediate menopause. Periods stop and menopausal symptoms begin to appear. They can be serious because hormonal changes happen suddenly rather than gradually over several years.
- Surgery to remove the uterus (hysterectomy) ,
usually does not cause immediate menopause. Although menstruation has stopped, the ovaries still produce estrogen and progesterone.
- Chemotherapy and radiotherapy.
These cancer treatments may induce menopause and its symptoms during or shortly after treatment. The cessation of menstruation and fertility do not always occur. Radiation therapy affects the function of the ovaries only if the radiation is directed at them. Therapy of other parts of the body will not affect menopause.
Symptoms of menopause
According to statistics, approximately 30% of women experience menopausal disorders, another 30% – in an aggravated form. During menopause, various physical and mental changes occur.
Changes associated with perimenopause and menopause include:
- Lower fertility
As a woman approaches the end of the reproductive stage, but before the onset of menopause, estrogen levels begin to drop. This reduces the chances of getting pregnant.
- Irregular menses
The first sign of approaching menopause is less regular periods. They may come less often or more often, they may be heavier or lighter.
- Vaginal dryness and discomfort
Vaginal dryness, itching and discomfort may begin during perimenopause and continue into menopause. A woman with any of these symptoms may experience irritation and discomfort during intercourse. Various moisturizers, lubricants, and medications reduce vaginal dryness and related problems.
- Tides
Hot flashes often occur during menopause. They cause a sudden sensation of warmth in the upper body. The flush may start in the face, neck, or chest and progress up or down. The duration of each is up to 1-2 minutes. Various factors can provoke – climate change, stress.
- Psycho-emotional changes
Depression, anxiety and low mood are common during menopause. Often there are bouts of irritability and crying.
- Sleep disorders
During menopause, sleep disorders, constant feelings of weakness, decreased performance, memory and concentration may begin.
- Physical changes
Physical changes may develop during menopause, such as:
- weight gain;
- changes in color, texture and volume of hair;
- skin problems;
- reduction and pain in the chest;
- Urinary incontinence.
Complications
After menopause, the risk of certain diseases increases. Examples include:
Heart and vascular disease (cardiovascular) . When estrogen levels decrease, the risk of cardiovascular disease increases. Heart disease is the leading cause of death for both women and men. Therefore, it is important to exercise regularly, eat a healthy diet and maintain a normal weight. Ask your doctor for advice on how to protect your heart, such as how to lower your cholesterol or blood pressure if it’s too high.
Osteoporosis. This condition causes bones to become brittle and weak, which increases the risk of fractures. During the first few years after menopause, bone density can be lost rapidly, increasing the risk of osteoporosis. Postmenopausal women with osteoporosis are particularly susceptible to fractures of the spine, hips, and wrists.
Urinary incontinence. The tissues of the vagina and urethra lose their elasticity, resulting in a sudden and intense urge to urinate, which can develop into incontinence. Strengthening the pelvic floor muscles, with Kegel exercises and topical vaginal estrogen, can help relieve these symptoms. Hormone therapy is also an effective treatment option.
Sexual function. Vaginal dryness due to decreased moisture production and loss of elasticity may cause discomfort and slight bleeding during intercourse. In addition, decreased sensitivity affects sexual activity (libido). Vaginal moisturizers and water-based lubricants may help. If this is not enough, estrogen treatment available as a vaginal cream, tablet, or ring can be used.
Weight gain. Many women gain weight during and after menopause due to slow metabolism. In this case, you have to change your eating habits and exercise more to maintain your current weight.
How is menopause (menopause) diagnosed?
A gynecologist can diagnose menopause in several ways:
The first is a discussion of the menstrual cycle over the past year.
Another way is the FSH blood test, which checks the level of follicle stimulating hormone. FSH analysis is a regulator of the development of ovarian follicles in the female body. However, this test can be misleading at the onset of menopause when the body is in transition and hormone levels fluctuate up and down.
A hormone test should always be interpreted in the context of what is happening with the menstrual cycle.
Prevention of menopausal disorders
- Eat a healthy diet. Proper nutrition contributes greatly to the overall health of a person. During menopause, the diet should contain a variety of fruits, vegetables, and grains. Eliminate fatty, spicy, salty foods from your diet. Reduce the consumption of meat, sausages, smoked meats. Take supplements with calcium, vitamin D, supplements with Omega 3 polyunsaturated fatty acids every day (dosage will help you choose a doctor). Drink alcohol and caffeine in moderation. Do not smoke.
- It is important for menopausal women to drink plenty of water : experts recommend drinking about 1.
5-2 liters per day. Water replenishes the fluid lost after excessive sweating during hot flashes and reduces their frequency.
- Exercise (at least half an hour a day), try to stay active, this will help reduce hot flashes and prevent osteoporosis.
- Do not wear synthetic fabrics . Synthetic fabrics impair heat transfer and impair ventilation, which contributes to overheating and an increase in the frequency of hot flashes. In addition, synthetic clothing absorbs moisture worse and accelerates the appearance of an unpleasant sweat odor. It is better to give preference to clothes made of cotton, linen or viscose. These recommendations also apply to bed linen.
- Don’t overstress . Tension, stress, fatigue provoke the appearance of hot flashes, so a woman during menopause should not take on too many responsibilities. Do not try to do everything at once, alternate work with rest, pay attention to your health.
A good night’s sleep is important, it significantly reduces stress levels and reduces the frequency of hot flashes.
Treatment of menopause (menopause)
Menopause is a natural process. Many symptoms disappear over time. But if they’re causing problems, treatment can help you feel better.
- Hormone replacement therapy (HRT). Taking hormone replacement drugs that are no longer produced in the body. Certain menopausal medications or combinations of them can help with hot flashes and vaginal symptoms, as well as strengthen bones. But they can also put you at risk for health problems like heart disease or breast cancer, so you should take the lowest dose that works for the shortest amount of time.
- Local hormonal therapy. This is an estrogen cream or gel that is inserted into the vagina to relieve dryness.
- Non-hormonal preparations. Includes drugs for depression, insomnia, blood pressure, and others.