Menopause refers to the transitional period in which ovarian activity gradually subsides and a woman ceases to be reproductively fertile. As menopause approaches, the body produces smaller amounts of the female hormone estrogen. This reduction in estrogen production does not occur uniformly, but in “swings”. These sudden swings can cause symptoms such as hot flashes, night sweats, mood swings, and depression. This transition period will last, on average, about 5 years.
Because every woman is unique, it’s impossible to say exactly when you should expect menopause. Most women begin to notice their periods becoming less frequent in their late 40s to early 50s, while for some this may not occur until well into their 60s. Menopause before the age of 40, although not extremely uncommon, is still rare enough to be considered premature. Whatever age you are, if you suspect you may be experiencing the initial symptoms of the change, a visit to your doctor will help clear up any uncertainty.
Different factors (including medical conditions) can affect when you begin menopause. However, just like the age at which you started puberty, the timing of your menopause is partially predetermined by your genes – so finding out about your mother or other female relatives can sometimes offer an indication of when to prepare.
The first symptom of menopause is usually an increase in the length of time between your periods. For some women, this will be the only noticeable difference, with periods gradually becoming less regular until they cease altogether. Others, however, may demonstrate a host of different symptoms, including mood swings, headaches, a faster heartbeat and increased temperature, sweats, and spontaneous hot flashes. These issues can cause discomfort and inconvenience when they’re happening, but (thankfully!) are ultimately only temporary.
Another common problem for women is vaginal dryness. Up to 55% of women undergoing menopause experience vaginal dryness at some point (Menopause and breast cancer: Symptoms, late effects, and their management. Patricia A Ganz. Seminars in Oncology. 2001;28(3):274-283). This is a result of the reduction in estrogen levels. Estrogen keeps the vaginal lining thick and healthy, but during and after menopause, as estrogen levels reduce, the lining of the vagina becomes thinner, drier, and more prone to damage. It also becomes more easily irritated by sexual activity.
Other long-term effects can include continence issues, a decrease in sex drive, and (over time) osteoporosis (loss of bone density). Fortunately, there are many options for treating these symptoms – so the changes in your body needn’t mean a drastic change in your habits.
Although menopause cannot be prevented, there are tips to help ease the symptoms. These include the following:
- Avoiding caffeine and alcohol
- Not smoking
- Staying away from spicy foods
- Eating a low fat diet with plenty of vitamin D and calcium
- Including soy foods in your diet
- Exercising daily (including your pelvic floor muscles with Kegel exercises)
- Practicing breathing techniques
- Doing yoga, tai chi, or meditation to help relax
- Remaining sexually active
- Using lubricant gels during intercourse
- Treating vaginal dryness with a moisturizing feminine wash
It’s important to talk to your doctor about your concerns regarding menopause. If you experience discomfort, pain, or emotional stress related to menopause, your doctor can help you to develop a plan and prescribe any necessary medication or treatment. Although natural solutions may be enough for some, if you are suffering from severe symptoms you should seek clinical treatment. Your doctor may prescribe some form of hormone replacement therapy (HRT) to boost your depleted hormone levels, primarily of estrogen. The result is relief of the immediate symptoms, as well as a reduction in long-term risks such as osteoporosis.
Often, the first line of treatment recommended by doctors to improve pelvic floor muscle strength is Kegel exercises. One of the best things about Kegel exercises is that you can do them discreetly, almost wherever and whenever you want. To do a Kegel, tighten your pelvic floor muscles and lift your anus, urethra, and vagina just like you would to stop urine flow. Hold the contraction for 2–10 seconds and then relax for an equal amount of time.
Developing an exercise routine is a great way to regain strength. Try doing this exercise in sets of 4 or 5 repetitions a few times each day.