Answers for eight commonly asked questions about menopause

Menopause, also known as "the change of life," is an inevitable but normal part of a woman's life. In this article, the author mainly answers some frequently asked questions on this transitional phase in a woman's reproductive life.


1. What is menopause? What causes this condition?


The ability to conceive is one of the things that define a woman, thanks to our ovaries which are the main source of female hormones. These hormones are primarily responsible for the development of the female characteristics and regulation of the menstrual cycle and pregnancy. However, as a woman ages, the stored eggs in the ovaries deplete gradually, menses then become irregular and eventually stop, and physical changes may become evident.


The absence of menstrual period for 12 months is defined as menopause. Women who underwent surgical removal of the uterus (hysterectomy) without undergoing removal of both ovaries cannot menstruate anymore, but the remaining ovaries are still capable of producing the female hormones until there is natural depletion of ovarian eggs. The same is true for those with only one remaining healthy ovary. On the other hand, removal of both ovaries will cause abrupt onset of menopause.


2. At which age do women usually experience menopause?


Menopause occurs at an earlier age among Filipinas compared to western women, on average 47 to 48 years old and 51 years old, respectively. The variance in menopausal age is thought to be correlated to a woman's general health status, socioeconomic status, parity, ethnicity, genetics and probably physical activity. As a general rule, women may undergo menopause at an age similar to their mothers.


Hormone levels fluctuate and may differ daily and individually, hence the diagnosis of menopause is made on the lack of menstrual period for 12 continous months in the expected age range, mostly between 45 to 55 years. Onset of menopause during the thirties may occur in cases of premature ovarian failure.


3. What are the signs and symptoms of menopause? How long do they last?
Symptoms of menopause vary from none, few to severe. The extent and severity may vary individually. The length of time from perimenopause to menopause in a woman is undetermined. The depleting hormonal level during this transition phase may cause irregular vaginal bleeding from more frequent to longer intervals. Occurrence of abnormal vaginal bleeding in a woman warrants evaluation of a physician to rule out other medical causes of bleeding.

4. What are hot flushes?

Hot flushes are prevalent during the late peri-menopausal transition and often occur before the onset of menstrual irregularities. It is the excessive feeling of warmth which is most remarkable in the face, neck and chest which then spreads over the body. Sometimes they are accompanied with night sweats, which causes interrupted sleep and subsequent day ime tiredness. For most women, hot flush is transient, improving from few months to approximately five years and ceases eventually, while some continue to experience hot flushes years after they have reached the menopausal phase.

5. Is sexual contact prohibited during menopause?

The thinning of the vaginal lining, decrease in vaginal lubrication, and decrease in the elasticity of the vagina cause pain during sexual activity. Sexual activity during menopause is not contraindicated, however it is limited by the pain and discomfort experienced by women.

6.What are the other complications of menopause?

Complications of menopause include osteoporosis and heart disease. Osteoporosis may be present silently until a woman suffers a painful fracture. Lifestyle changes such as cigarette smoking cessation, regular exercise and dietary supplements of vitamin D and calcium are recommended. Medications to slow down bone loss and increase bone strength that are available locally. On the other hand, the increased risk for cardiovascular disease also warrants lifestyle modification and perhaps maintenance medication.

7. What are the do's and don'ts for women who are suffering from menopause?

Menopause is not a disease. It is an inevitable phase of life brought about by age and changes in hormonal level. With complications mentioned above and the symptoms noted, regular exercise, healthy lifestyle and regular consultation and follow up with a physician is recommended.

8. Where should a menopausal woman seek advice for her condition?Taking into account the inherent risks and benefits of each treatment and the patient's medical history, management should be individualized. Hence it is best to consult with the physician, to know which mode of therapy would best suit the patient.Obstetrician and gynecologists can address the concerns of women experiencing menopausal symptoms.