Menopause is a phase in a woman’s life when her reproductive organs undergo a series of changes which make ovulation cease and, as a consequence, menstruation stops altogether. All women go through menopause, with the majority experiencing this phase around the ages of 45 to 52 years of age.
Menopause is a normal and perfectly natural process and nothing to become overtly concerned about. However, it presents women with a series of side effects and symptoms, some of which can be challenging to adapt to.
There are three main phases that characterize this transitional period in a woman’s life:
Perimenopause: Can last anywhere from 4 to 10 years.
Menopause: Symptoms last on average 2 to 4 years.
Postmenopause: Some syptoms ease up during the postmenopausal years; however, new clinically significant symptoms arise.
The exact length and symptomatology of each of these periods can vary from one woman to the next. However, there are symptoms which affect all menopausal women.
In the transition from perimenopause to menopause and beyond the signs and symptoms that are most commonly observed are:
1. Shorter Menstrual Cycles
One of the first symptoms associated with menopausal changes in the body is a noticeable shortening of the menstrual cycle. During the initial stages of menopause, the body’s reproductive hormone levels undergo a rapid change. For example, production of Follicle-stimulating hormone, also known as FSH, increases while the production of Progesterone decreases.
Consequently, the ovaries and the endometrium become overstimulated, which shortens the length of the menstrual cycle.
2. Longer Menstrual Cycles
In the later stages of the menopausal transition, the ovaries become more resistant to a hormonal stimulus which, in conjunction with the rising FSH levels as well as a drop in Estradiol, results in menstrual delays and missed periods.
Curiously enough, women experiencing a lengthening of their menstrual cycles often report having significantly heavier flow when menstruation does occur.
Menstrual periods will eventually cease altogether. Once a full 12 months have passed since a woman’s last period, menopause will have concluded.
3. Hot flashes
The marked decrease in estrogen production that occurs during menopause causes significant changes in the body’s Temperature-Regulating Center of the brain. These changes generate imbalances in the control of body temperature, which often results in women experiencing sudden episodes of intense heat and profuse sweating. These episodes are colloquially known as hot flashes, can last anywhere from 2 to 12 minutes each, and are perhaps the most common sign of menopause.
It is estimated that close to one-quarter of all menopausal women experience moderate to severe hot flashes fairly regularly. The exact impact that this annoying side effect will have on a woman’s quality of life will depend on their intensity and frequency, but they are regularly ranked as one of the most disruptive changes of menopause.
4. Night sweats
Night sweating is another common side effect of menopause in women. Just like daytime hot flashes, episodes of night time sudation are caused by changes in estrogen levels which impair the brain’s thermoregulation capacity.
Night sweats are considered significantly more impactful than their daytime counterparts because they often interrupt sleep and impede women’s ability to rest. Furthermore, night sweats have been linked with the appearance of various cognitive and psychological side effects such as fatigue, difficulty concentrating, irritability, etc.
5. Sleep disorders
As a consequence of menopausal changes, women are twice as likely to suffer from sleep disorders as men. One of the most common and harmful sleep disorders that can arise from menopausal changes is Insomnia.
In fact, while other common menopausal symptoms are highly variable, Insomnia is the notable exception, remaining a near-constant in women of a certain age regardless of when they had their last menstrual period.
Menopausal women often report having difficulty falling asleep. Additionally, it is common that once sleep is attained, it cannot be maintained for any period of time, with frequent awakenings interrupting sleep throughout the night. Furthermore, some menopausal women who are able to fall asleep report poor quality sleep that is rarely restful.
6. Vaginal Dryness
With the onset of menopause, many women report experiencing vaginal dryness. This symptom, which is part of a greater condition known as a genitourinary syndrome or vulvovaginal atrophy, appears because the levels of serum estrogen produced by the ovaries drop dramatically.
When the vaginal tissue no longer receives the hormonal stimulus of estrogenic action, the production of vaginal secretions and vaginal discharge decreases significantly, which leads to dryness. Vaginal dryness often results in pain, or an itching or burning sensation.
Women affected by this condition can make a series of lifestyle changes that can help reduce dryness. Most at risk of suffering from vaginal dryness are obese women, smokers, those who practice strenuous physical activity, and those who suffer from dryness in other organs, such as the mouth or eyes. Furthermore, vaginal dryness can also be treated with a vaginal moisturizer that is introduced directly into the vaginal cavity to moisten the area and provide relief.
7. Painful Intercourse
When sexual intercourse results in pain, a condition known as dyspareunia might be present. The appearance of this condition is closely related to genitourinary syndrome and vaginal dryness.
While a large number of women report feeling occasional discomfort during sexual relations, menopausal women often experience chronic pain along the outer and inner genital organs as well as in the upper pelvic region and abdomen.
Dyspareunia occurs due to a thinning and weakening of the vaginal tissues caused by a drop in estrogen levels in the blood.
8. Incontinence
With the onset of menopause, women become increasingly susceptible to incontinence. Estrogenic action is heavily involved in the integrity of the tissues that surround the bladder, so when estrogen levels drop an immediate weakening of the muscles along the pelvic floor occurs.
Urinary incontinence is an extremely distressing condition and can be cause for significant embarrassment and shame since it has the potential to hinder work, social, and sexual life.
9. Mood Changes
When hormone levels drop during menopause, a series of mood-altering changes occur. As it turns out, the synthesis of important mood-regulating neurotransmitters is deeply intertwined with hormonal balance. So much so, that menopausal women often report dramatic alterations in their psychological state such as sudden mood swings, irritability, melancholy, depression, etc.
Further complicating matters is the fact that these changes often occur in conjunction with other changes in a woman’s life, such as when children leave home during this period, which may intensify these symptoms.
10. Arthralgia
More than 50% of women of menopausal age report experiencing a condition known as arthralgia. This condition can be best characterized by severe non-inflammatory joint pain.
The exact causes of joint pain in women during menopause have not yet been determined; especially because various chronic rheumatic diseases tend to develop around the same age group as menopause. However, there is evidence to suggest that there are clear cut interactions between the various sex hormones and specific pain processing pathways in the brain.
11. Osteoporosis
Osteoporosis is a disease whose primary characteristic is the deterioration of the bones. There is a direct relationship between drops in estrogen production during and after menopause and the development of osteoporosis. When sex hormone levels are low, women tend to lose significant bone mass and become more prone to fractures.
12. Dry skin
Menopause and dry skin almost always go hand and hand. In fact, this affectation of the skin is one of the most common external signs caused by the hormonal changes of menopause.
This is due to the fact that when a decrease in estrogenic hormones occurs, dermal tissue repair decreases significantly. Dryness of the skin is further compounded by the fact that women of menopausal age have much lower concentrations of collagen, which makes their skin much less elastic and prone to sagging and wrinkling.
13. Hair Loss
The hormonal fluctuations that accompany menopause also affect the health of the body’s millions of hair follicles. As a result, hair becomes brittle, dry, and more fragile. These changes cause an abnormal number of hair fibers to fall off prematurely.
In contrast to men, who experience outright balding, most menopausal women tend to experience a more generalized and diffuse thinning, especially on the top of the head. It is very common for copious clumps to fall off during brushing.
14. Conclusion
Every woman will experience menopause differently. Some have very little discomfort, while others experience severe emotional and physical distress. However, all women will experience significant changes in the way their bodies function. It is important to be vigilant during this period and pay close attention to any changes or alterations that occur.
Estrogenic hormones are not only important for keeping the reproductive organs in good health, they are also necessary for the function of a wide variety of systems and body processes. As such, menopause has the potential to exert far-reaching changes that can dramatically affect a woman’s quality of life.
Thankfully, there are a variety of viable treatments to treat this wide range of symptoms. These include but are not limited to: Systemic Hormone Replacement Therapy, Vaginal Estrogen Creams, Lubricants, Antidepressant medication, Antihypertensive drugs, and nutritional supplementation.