April 18, 2017 General Health

Hello Everyone!

I hope you had a marvellous Easter weekend. A couple of weeks ago we discussed the very basics of menstruation, otherwise known as your period. Then we took a quick break to talk about UV light (I do hope you are enjoying the fantastic weather, I know I am). Now we are back with another primary women’s care article about menopause, which literally means the ceasing of your menstruation.

This should happen after a point in every woman’s life. It is the sign that your body is no longer releasing eggs for fertilisation and thus, no longer preparing to have children. The average age for menopause to begin is 51 years old. It can be slightly earlier or slightly later depending on the woman in question but should start no sooner than 40 and no later than 60. The cause of menopause is that your oestrogen levels decrease as your body stops producing it, due to the expectation that you will no longer be bearing children. The thing to remember is that this process is completely natural and is meant to occur.

You can expect a number of things during menopause but some of the most common symptoms are hot flashes, sleep problems, and vaginal and urinary tract changes. These are normal and very commonly occur when women go through this process. So lets talk about what can be considered ‘normal’.

Hot flashes can last from a couple of seconds to several minutes or possibly longer and they can occur frequently or infrequently. It all depends on who is experiencing them. Hot flashes can even happen at night while you are sleeping. They can cause you to wake up for the briefest of seconds or longer causing you restlessness, making you feel groggy and tired the next day.

Sleeping problems can occur through any number of causes but the main ones are linked to hot flashes while sleeping, insomnia, and waking up before your usual time.

Vaginal and urinary changes occur throughout life but you can expect them in your menopause years. As your oestrogen levels decrease, the lining of the vagina may become thinner, dryer, and less elastic. Dryness can cause pain during sex and you may also find that you have more vaginal infections. You may also find that your periods become less regular. The urethra may also become inflamed, dry, or irritated. This can cause you to need to urniate more often and can cause increased urinary tract infections.

Some less well known side effects are increased risk of heart disease and stroke due to the lowered estrogen production. Oestrogen helps prevent these circulatory problems. As you age, the chance of having problems with your heart increase for a number of reasons which include lack of activity, high blood pressure, and high cholesterol. Once menopause begins, women are at an increased risk and should take precautionary measures to avoid developing such conditions.

You may also find that your bones are more brittle as you age. A small amount of bone loss is to be expected in anyone over the age of 35. This amount raises in women who are 4-8 years past the start of menopause due to the decreased oestrogen production. If you lose too much bone density, you will be at an increased risk of osteoporosis. The spine, wrists, and hips are the areas that are typically more affected than other areas of the body.

So what can be done to counteract these problems? Hormone therapy is often considered the best way to alleviate the symptoms of menopause. The particulars are best left for another article or a consultation with your doctor as hormones can be quite complicated on their own but, in essence, what hormone therapy will be doing is regulating your oestrogen and/or progesterone levels. You can take oestrogen by itself but this singular therapy is often only advised to women who have had a hysterectomy (the removal of the uterus). Without progesterone, women who still retain their uterus can be at an increased risk of uterine cancer, and therefore, women who have not had a hysterectomy will often be prescribed both oestrogen and progesterone.

Hormone therapies of this nature can be administered in two ways. Systemic treatment is where either through a pill, gel, patch or spray, oestrogen and/or progesterone are released into the blood stream after having been applied to the skin or ingested as the case may be. Local treatment is where hormones are released directly into the vaginal wall via tablet, vaginal ring, or cream.

These therapies may help with hot flashes, vaginal dryness, and night sweats. It may also help slow the development of osteoporosis if treated systemically. When combined in therapy, oestrogen and progesterone can aid with preventing colon cancer. Combined therapies can also slightly increase the risk of stroke and deep vein thrombosis but this increased risk is generally very small.

All in all it is best to consult your doctor for a full run-down of what is available to assist you with the symptoms of menopause and find what will work best for you. As always, if you are in the Nashville area Dr. Paschall would be thrilled to see you and answer any questions.

See you next time!