Menopause

Menopause is the last menstrual (monthly) period in a woman’s life. It is a natural occurrence and marks the end of the reproductive years, just as the first menstrual period during puberty marked the start. You know that the menopause has taken place if you have not had any bleeding for 12 months.

Most women reach menopause between the ages of 45 and 55, the average being around 50. Menopause before the age of 40 is called ‘premature menopause’.

Hormone levels fluctuate as menopause approaches

As you approach menopause, the production of hormones (for example oestrogen) by the ovaries starts to slow down. However, hormone levels fluctuate up and down and you may notice changes in your menstrual cycle:

* Cycles may become longer, shorter or totally irregular

* Bleeding may become lighter

* Bleeding may become unpredictable and heavy (seek advice from your doctor).

Eventually your hormone levels will fall to a point where menstruation (periods) will cease altogether and the menopause is reached.

Although fertility after the age of 45 is low, contraception is needed (even if only barrier contraception) until you have had one year without a natural period.

Other signs and symptoms

The most common symptom of menopause is the hot flush. However, women sometimes experience other symptoms, which may include:

* Aches and pains

* Crawling or itching sensations under the skin

* Forgetfulness

* Headaches

* Irritability

* Lack of self-esteem

* Reduced sex drive (libido)

* Sleeping difficulty

* Tiredness

* Urinary frequency

* Vaginal dryness.

Long-term risks

A decrease in female hormones after menopause may lead to:

* Thinning of the bones (osteoporosis) and an increased risk of fractures

* An increase in the risk of heart attack.

Manage the menopause with a healthy lifestyle

Unpleasant symptoms of the menopause can often be greatly reduced by improving your lifestyle habits. Here are some suggestions for what to try first.

Healthy diet

* Choose a wide variety of foods, including plenty of fresh vegetables, fruits, cereals, whole grains and small portions of lean meat, fish or chicken several times a week.

* Increase fluids and eat low fat dairy foods with high calcium content.

* Decrease caffeine and limit alcohol (aim for 1–2 standard glasses or less per day).

Exercise

Regular exercise is important. At least 30–45 minutes on most days of the week will:

* Maintain your heart health and improve your general health

* Keep your bones healthy and prevent bone loss through osteoporosis

* Help maintain good balance and reduce the risk of injury from falls

* Provide a feeling of relaxation and wellbeing

* Help improve hot flushes.

Education

It is important to understand the changes your body is going through. There are many different sources of information available. Make sure you seek out credible websites and brochures that provide up-to-date, non-biased information from organisations that specialise in women’s health.

Avoid smoking

It’s important to avoid smoking because of the associated risk of osteoporosis, coronary heart disease and lung cancer (which may soon exceed breast cancer as the leading cause of death in women). For help to quit smoking, call the Quitline on 131 848.

Think positive

Some women experience mood changes such as mild depression and irritability. These symptoms are often related to physical changes such as hot flushes, night sweats and poor sleeping. It’s important to keep a positive outlook.

Regular Pap smears and breast checks

You should have:

* Two-yearly Pap smears (see your doctor)

* A two-yearly mammogram (this is a free service if you are over 40).

Hormone replacement therapy

Hormone replacement effectively reduces many of the unpleasant effects of symptoms of the menopause and may be appropriate for short-term use in women with moderate to severe menopausal symptoms. Discuss the advantages and disadvantages of hormone replacement with your doctor.

Natural therapies

These can be of benefit to some women. It is important to remember that ‘natural’ herb and plant medications can have unpleasant side effects in some women, as can prescribed ‘Western’ medications. A registered naturopath may provide long-term guidance and balance through the menopausal years.

Natural therapies can often be taken in conjunction with hormone replacement. It is important to let both your doctor and naturopath know exactly what each has prescribed.

Where to get help

* The Jean Hailes Medical Centre for Women Tel. (03) 9562 7555

* Your doctor

* Your local community health service

* Specialised Women’s Health Clinic

* BreastScreen Australia Tel. 132 050

Things to remember

* Menopause means the end of monthly periods.

* You may experience a range of symptoms.

* A healthy lifestyle will help to manage symptoms.

* You should have regular breast checks and Pap smears.

* Mammogram screening is free if you are over 40.