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Menopause: A challenging time for women – Adeyemi Maxwell

Menopause is not only the cessation of monthly menstrual cycles characterised by “hot flushes” in women, but it is a condition that can affect many body physiologies of women. For some women, they are only affected by the occasional hot flushes, while for others, they can suffer debilitating psychological and physical symptoms. The experience can even be so disturbing that many may not realize their problems are menopausal.

This developmental milestone in women often present between 45-55 years of age, but in some women, it may come as early as 38 years while some may come later than 55 years.

Divers manifestations of menopause

Menopause can affect so many functions and systems of the female body in ways you may not expect:

Nervous system: Oestrogen helps raise levels of the brain chemicals serotonin and dopamine, which are responsible for mood regulation. Low oestrogen that occurs in menopause can lead to low mood, depression and anxiety. This affects a woman’s ability to cope with stressful situations, triggering agitation, dry mouth, hyperventilation, rapid heartbeat and shortness of breath.

Dizziness may be caused by the effect hormones have on blood vessels, making blood pressure fluctuate.

Sleep problems can be triggered by night sweats, but are also directly linked to oestrogen, which regulates our magnesium levels. Magnesium helps muscles relax, allowing us to fall asleep.

Memory lapses, poor concentration and inability to find the right words can all be linked to the drop in oestrogen. Not only does the brain need oestrogen to help it function, but it also encourages blood flow in the brain.

Physical fatigue: Hormones help regulate how our cells use energy, so when levels drop, so too do energy levels. Many menopausal women experience persistent feelings of weakness, tiredness and apathy, even after a good night’s sleep.

Thinning hair: The loss of oestrogen leads to a drop in collagen, a natural protein in hair, so hair becomes more brittle. The natural rate of hair loss can also speed up as the follicles need oestrogen to sustain hair growth.

Oral health: Oestrogen is important for the lubrication of mucous membranes, such as those in the mouth. Lower levels mean the mouth becomes drier, allowing bacteria to flourish, causing tooth decay and making gums bleed. This can damage the taste buds on your tongue, setting off the pain nerve cells, causing bad breath, a bad taste or a burning sensation on the tongue.

Palpitations: Oestrogen deficiency can effectively over-stimulate the nervous and circulatory systems, causing a pounding, rapid and irregular heartbeat. Some may even mistake this for a heart disease.

Allergies: Hormones and the immune system are linked, and menopausal changes can lead to allergies becoming worse, or can develop for the first time, particularly asthma, hay fever and dermatitis.

Breast tenderness: Fluctuating hormones can lead to an imbalance where progesterone temporarily dominates; this can trigger fluid retention, causing tenderness.

Hot flushes: As levels of oestrogen drop, the hypothalamus gland — the body’s thermostat — can be fooled into thinking you’re overheating; you sweat and flush to cool down.

Weight gain: You may struggle to keep the weight off, as the body strives to retain fat cells, especially on the abdomen, as fat produces oestrogen.

As your testosterone levels drop, your metabolic rate slows, the stress linked to menopause also raises levels of cortisol, which encourages fat deposits around the abdomen.

Bloating: Oestrogen is important for maintaining the correct amount of water and bile in your body. As levels begin to change, you tend to store more water, making you feel bloated.

Muscle pain and weakness: Oestrogen has a calming effect on the body; as levels drop, the stress hormone cortisol can dominate, causing the muscles to tighten and tire. All muscles have oestrogen receptors, so falling levels can trigger pain and affect muscle tone. Oestrogen also has an effect on your joints — low levels during menopause can lead to increased joint pain or trigger it for the first time, known as menopausal arthritis.

Heavy bleeding: The hormonal imbalance can lead to changes in flow periods may be heavier or lighter than before, and there may be clots and frequency with longer, shorter, or irregular cycles.

Oestrogen normally thickens the womb lining, and the egg that’s released produces progesterone, which reduces that thickening effect. However, if no egg is produced, the thicker lining is shed as a heavy period.

Incontinence: The loss of collagen linked to lower oestrogen levels can mean the tissues around the bladder become thinner and less elastic.

The surrounding pelvic muscles may weaken, too, causing urine to leak when you cough, laugh or sneeze, or trigger a sensitive bladder characterised by a constant need to urinate or frequent bladder infections.

Low libido: Reduced oestrogen levels can affect the sense of sensation and the ability to have orgasm. Falling progesterone levels lead to lower libido — progesterone stimulates testosterone production, and testosterone is key to sex drive.

Vaginal dryness: The mucous membranes of the vaginal walls can become dry, triggering itching, stinging or burning, and possibly pain during intercourse.

Mental health: Because of the physical and psychological stress at the time, women can experience mental health issues, and behavioural changes that can negatively impact their relationships with their spouse and children. If this is not properly handled with understanding it may lead to breakdown in relationships and even family life.

Migraine: Headaches affect more than 90 per cent of women going through the menopause, and some start suffering from migraines for the first time.

The main reason for this is the fluctuation of oestrogen, falling oestrogen levels can trigger chemical changes in the brain, causing a migraine.

If you are In the menopausal age range or you are experiencing symptoms of menopause, it is advisable to consult with your physicians so that an accurate diagnosis can be made and tests carried out to rule out other medical conditions that may mimic or have similar symptoms. Then appropriate treatments can be given.

In addition to the treatments that can be instituted, physical exercise is very helpful in the management of menopause.

Being active really can help menopausal symptoms, women who exercise have fewer and milder flushes, night sweats and sleep disturbances. Endorphins — feel-good chemicals — released during exercise can lift menopausal low moods and ease depression.

Women who exercise were less likely to report anxiety, depression, memory and concentration problems and hot flushes. Exercise will also help you control your weight at a time when hormones are conspiring to pile the fat around your middle.

Exercise also has significant long-term benefits, reducing your risk of heart disease, diabetes and osteoporosis which rises significantly once the protective effect of oestrogen is lost.

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