Menopause is a natural part of a woman’s life. Yet, it can be challenging for some women.

It is the end of menstruation and the beginning of changes in a woman’s life. These changes include the physical, emotional and sexual changes resulting from decreasing oestrogen levels.

Menopause occurs at different ages for different women. The average age of menopause is 51, but it can occur between 45 and 55.

The average woman has about 450 periods during her reproductive life. After she has reached her mid-40s, she will start to notice an increase in length between periods and an eventual decrease in frequency to once every three months or less. This usually signals that there is an end to fertility and that menopause is approaching.

Menopause is not a disease

Menopause is a natural process that happens in all women at a certain age, and it’s a normal part of ageing. However, it is not something that can be prevented or cured.

However, coping with these changes can be difficult for some women. If you’re experiencing menopause symptoms, talk to your doctor about treatment options that may help reduce your discomfort.

Perimenopausal period

The perimenopausal period is the time before the cessation of menopause.

Perimenopause is a transition period that starts with the beginning of menstrual irregularities and ends with menopause. It can last several years and be quite difficult for some women.

The hormonal changes that occur during perimenopause can cause various symptoms, including hot flashes, mood swings, vaginal dryness and more.

The exact length of the perimenopause period varies from woman to woman. However, the average length of the perimenopausal period is four years.

Menopausal symptoms

Women experience menopause differently. Some women have few or no symptoms, while others may have debilitating symptoms that disrupt their daily lives at the onset of menopause.

Some common symptoms include:

• Hot flashes (flushing and sweating)
• Vaginal dryness
• Sleep problems such as insomnia, night sweats or restless sleep
• Mood swings or irritability
• Loss of interest in sex
• Irregular periods
• Weight gain

Treatments for menopause

1. Lifestyle changes

A woman’s body undergoes many changes during menopause, including hot flashes and vaginal dryness. Many women find these symptoms manageable with lifestyle changes, such as staying hydrated and exercising regularly. However, other women may need treatment to help them cope with hot flashes, sleep problems and vaginal dryness.

2. Hormone Replacement Therapy (HRT)

Hormone Replacement Therapy (HRT) is a treatment used to help relieve the symptoms of menopause.

The most common hormone used in HRT is oestrogen, which comes in two forms:

• Oestrogen-only HRT is used by women who have had their wombs removed (hysterectomy). Oestrogen helps reduce symptoms such as hot flashes, night sweats, vaginal dryness, and painful sex. Oestrogen-only HRT can also reduce the risk of osteoporosis.
• Combined HRT contains both oestrogen and progestogen. It’s usually prescribed for women who still have wombs (uterus) but sometimes for those who have had a hysterectomy.

Management of hot flushes and night sweats

Hot flushes and night sweats are common symptoms of menopause. They can be very uncomfortable and distressing, but there are things you can do to help manage them.

The primary treatment for hot flashes is hormone replacement therapy (HRT). This contains oestrogen, which can help reduce the frequency and severity of hot flushes.

Other options to try are,

• Lifestyle changes include eating healthy, exercising, resting, and relaxing.
• Wearing loose-fitting clothes that allow your skin to breathe
• Medication – taking medication such as paroxetine or venlafaxine
• Thermogenic agents – applying cooling creams or gels to the skin

Vaginal health during menopause

Low estrogen levels cause vaginal dryness during menopause. The estrogen helps keep the vagina moist and elastic. As you reach menopause, your ovaries are less able to produce enough estrogen to keep your vaginal tissue healthy.

So the vaginal walls become thinner and less elastic, which makes them more susceptible to tearing or injury from sex or exercise. In addition, your cervix (neck of the womb) becomes drier and more fragile, making it easier for bacteria to enter the body through the cervix during intercourse.

Vaginal dryness during menopause can be managed with lubricants or prescription medications containing oestrogen or testosterone (which helps maintain vaginal health).

If you’re experiencing symptoms of vaginal dryness during menopause, talk with your doctor about treatment options that are right for you.

Sexual health during menopause

Sexual health is an important aspect of quality of life. It impacts an individual’s physical and mental health, social relationships, self-esteem and overall well-being.

Many women experience changes in their libido throughout their lives, particularly after childbirth or around menopause. In addition, there can be vaginal dryness, irritation and itching due to reduce estrogen levels.

Here are some tips to help you stay sexually active during this time:

• Talk to your partner about your sexual needs. He will likely be more than willing to accommodate your needs.
• Don’t forget about foreplay! Foreplay helps increase arousal and lubrication before penetration, making sex much more enjoyable for both partners.
• Use lubricant! Lubricants make any sex feel better – they’re beneficial when you have vaginal dryness.

Non-pharmacological measures to comfort in menopause

There are several physical and emotional symptom that occurs during menopause.

Menopausal symptoms can be managed using non-pharmacological measures, and these include:

• Acupuncture. Acupuncture aids in relieving hot flashes and night sweats. It can also help with mood swings, vaginal dryness and other symptoms of menopause.
• Herbal remedies. Herbs such as black cohosh, chasteberry and soybean can help ease hot flashes and night sweats by increasing blood flow to the uterus and vagina. However, these herbs may not work for everyone.
• Evening primrose oil: Evening primrose oil is high in gamma-linolenic acid (GLA), which helps reduce hot flashes. It also contains linoleic and oleic acids, important fatty acids that help reduce inflammation.
• Massage therapy. Massage has been shown to help alleviate symptoms of menopause, such as sleep disturbances and anxiety.

Lifestyle modification for menopause

Lifestyle modification can be a valuable way to manage menopausal symptoms.

The following lifestyle modifications help manage menopausal symptoms:

• A healthy diet (with low fat and high fibre) and exercise
• Weight loss if have a higher body weight 
• Avoidance of alcohol, caffeine, and nicotine (smoking)
• Acupuncture
• Relaxation techniques

Diseases linked with menopause

• Menopause can be a difficult time for many women. Still, it can also be a period of increased risk for several health conditions.
• Heart disease is the leading cause of death among postmenopausal women. In addition, blood pressure tends to rise after menopause, as does cholesterol, thus increasing the risk of heart attack and stroke.
• Breast and uterine cancer risk is higher in the postmenopausal period. In addition, the risk can be further increased with hormone replacement therapy.
• Women who don’t take calcium or vitamin D supplements after menopause are at the highest risk for osteoporosis. These supplements help build healthy bones and prevent them from becoming weak and brittle.
• Women who go through early menopause may be at an increased risk for type 2 diabetes mellitus (DM2).

The Bottom Line

Menopause is part of life; if you learn what to expect and plan for it, you can learn how to control it better.