Menopause, pronounced as ‘men-no-pause’, is ironically a woman’s phenomenon. Indeed, it would be better understood if it is called ‘womenpause’, however linguistic evolution has its way of selecting for the word that somehow appears descriptive of the wrong sex. ‘Menos’ means month and ‘pausis’ means cessation or a pause in Greek. Thus, menopause means the cessation of the women’s monthly menstrual cycle.
A woman is diagnosed of having menopause if she had gone through 12 months without a menstrual period. Most women reach menopause between the ages of 45 and 55, but menopause may occur much earlier, or may not occur until a woman reaches her 60s.
Menopause is a natural biological process. As a woman approaches her late 40s, her ovaries start making lesser estrogen and progesterone – the hormones that regulate menstruation. Her menstrual periods may become longer or shorter, heavier or lighter, or, more or less frequent, until eventually, on average, by age 51, her ovaries shut down completely, and her monthly menstrual period comes to an end.
Estrogen is a wonderful hormone in a female. Besides the regulation of menstruation, it has many other beneficial effects on a woman. It is what makes a woman feminine and young. Thus, it is not surprising for women to experience many changes or disorders with their dwindling estrogen as she approaches her menopause. All these changes are collectively known as climacteric changes.
The word climacteric is often confused with its look alike word – climatic. Both words do have something in common, anyway. The climacteric changes of women is somewhat like the recent more drastic climatic changes of our earth in this era of global warming. Incidentally, the Eastern concept of disease is largely explained based on the four basic elements of nature, namely earth, water, wind and fire.
Palpitation or the racing heart is like the tumultuous earthquakes. It is a disorder of the earth element. Excessive night sweating is comparable to the unusual heavy rainfall or flash flood. They are the manifestation of the disorder of water element. The mood swing or emotional instability is the tornadoes of the mind, or simply the wind element turning violent. The sudden surge of heat waves up to the neck and head known as hot flushes is a disorder of the fire element comparable to eruption of volcanoes on the earth surface. Other changes include chills, weight gain, dry skin, backache, bone demineralisation, loss of breast fullness and libido, vaginal dryness, etc.
In some women, the triple whammy of palpitation, hot flushes, and mood swing are too much for them to cope. Often their sleep, energy level, emotional stability, and performance of their work are adversely affected. Consequently, their general health and quality of life may take a drastic turn for the worse.
Fortunately, for all these problems there are solutions. All these adverse symptoms can be effectively ameliorated by replacing the hormones that are lost and making the necessary lifestyle adjustment. In spite of these, many women continue to suffer in silence for one reason or other.
The inappropriate adverse publicity of hormone therapy by the mass media that over-sensationalizes certain related issues creates much unnecessary fear and anxiety towards it. Thus, it is essential for the affected woman to consult her family doctor before starting any treatment to address all the important issues related to their symptoms and treatment. It is necessary to correct their misinformation and neutralise whatever unwarranted fear before starting the treatment. Certain health screening tests may also need to be done from time to time.
It is important to know that after menopause, the risk of certain medical conditions increase significantly with the depletion of the protective estrogen. This includes heart disease, blood vessel disease, decreased bone density, incontinence of urine, sexual dysfunction and weight gain. Thus, it is important to adopt a healthy lifestyle of getting regular exercise, eating a healthy diet and maintaining a normal weight.
Upon reaching menopause, many women develop high blood pressure and high bad cholesterol. These contribute significant risk to their heart and blood vessels. Thus, they need to be corrected.
During the first few years after menopause, women loses their bone density rapidly. Their bones become porous and brittle, thus easily fracture following relatively minor trauma or fall. The common sites of bone fractures are the spine, hips and wrists.
The loss of elasticity of the tissue in the urethral together with the weakening of pelvic muscles often lead to problems such as frequent strong urge to urinate or involuntary leakage of urine with coughing, laughing or lifting (stress incontinence). Urinary tract infections are also more common in menopausal women. Often the doctor may advise on specific exercises to help strengthen certain group of muscles to overcome stress incontinence. Hormonal cream may be helpful.
The loss of tissue elasticity of the vulva and vagina together with dryness due to decreased secretion may cause discomfort and slight bleeding during sexual intercourse. In addition, decreased sensation of the sexual organs may reduce desire for sexual activity (libido). Water-based vaginal moisturisers or lubricants may be helpful. Sometimes it may be necessary for the doctor to prescribe a hormonal cream.
Many women gain weight after menopause following a slowdown in their rate of metabolism. The best solution to this, is to eat less and exercise more.
My next column will be on ‘The karma of meat-eating’.
Dr. Victor Ti, MD, MFAM (Malaysia), FRACGP (Australia), Dip P Dermatology (UK), Dip STDs/AIDS (Thailand), Dip. AARAM (USA), LCP of Aesthetic Med.(Malaysia) is an experienced expat specialist generalist (Family Physician) of BH Clinic, Phnom Penh. As a specialist generalist, he is skillful at diagnosing all general diseases and excluding the sinister ones. Apart from the general diseases, Dr. Victor is also known for his skill in skin diseases, sexually transmitted diseases, minor surgery and aesthetic medicine. He can be contacted via email [email protected]
Tel: 023900446 or Whatsapp: +60164122977