Menopause

Vital and balanced through the menopause A new phase of life often brings changes - for the body too. During the menopause, many women are suddenly faced with new challenges: The menopause is a time of change when hormone levels fluctuate and many different, sometimes distressing, symptoms can occur. Some women report that self-care and a balanced diet help them to maintain the desired balance during this significant period of change. So be extra considerate of yourself and take the time to make yourself a priority. Your needs and wellbeing are important!

The menopause - both a curse and a blessing

Sooner or later, every woman will experience the menopause.

It marks the change in the female hormone balance, when the fertile phase ends and a new phase of life begins. However, for most women, this change can cause major discomfort, including sleep disorders and osteoporosis.

Find out more about this topic here and learn about the symptoms and the best way to deal with them.

What is the menopause?

The menopause, medically known as the climacteric, is the female transition phase during which the ovaries cease their reproductive function. After the menopause, a woman can no longer have children. Although this can have a positive effect on the sexuality of affected women, which is why some look forward to this time, the hormonal changes caused by the menopause can also bring with it many negative symptoms, as oestrogen and progesterone levels in the blood drop. [1]

What age does the menopause begin?

The menopause appears individually for each woman. The onset, duration and intensity of symptoms can even vary greatly from woman to woman. Overall, the entire menopause process can last between 10 and 20 years. The menopause is divided into the following phases [1,2]:

Premenopause: Often between the ages of 40 and 50. The first changes and irregularities in the menstrual cycle occur during this phase. Periods become either heavier or lighter, cycles become longer or shorter and bleeding between periods can occur frequently. Many women have no or few other symptoms during this period of hormonal change.

Perimenopause: This is the term used to describe the period around the last menstrual period, i.e. shortly before and after the menopause. During this phase, the production of oestrogen and progesterone fluctuates greatly, so that ovulation and therefore also menstruation become increasingly irregular and ultimately lead to menopause - the cessation of menstruation. The year after the last menstrual period also belongs to this phase, as the time of the menopause can only be determined retrospectively one year after the last menstruation. Menopausal symptoms often become more pronounced during this phase.

Menopause: The period of the last menstrual period. The average age is around 51, although any age between 40 and 55 is considered normal. The menopause is defined as the time when there is no further bleeding for 12 months after this menstruation.

Postmenopause: The period of the menopause from 12 months after the menopause - the last menstrual period. During this phase, the respective hormone levels in the blood reach their lowest point, which can intensify or even change the symptoms.

What symptoms do you have during the menopause?

First of all: Typical symptoms are not transferable to every woman. Some have little or no symptoms during the hormonal change phase, while other women experience very severe symptoms very early on, which then last for several months or many years.

In the perimenopause:
Irregular menstruation can be the first sign of a perimenopause. These often occur more frequently at first, then at longer intervals. Hot flushes are one of the most common symptoms and affect around 75 to 85% of women as they get older. They usually occur before the period stops and can last for many years.

Physical changes such as weight gain and joint pain are often mentioned in connection with the menopause. Inner restlessness and psychological complaints such as irritability, anxiety, nervousness or depression can be exacerbated by the drop in oestrogen levels during this phase. Sleep disturbance due to hot flushes at night can also lead to concentration problems and thus in turn to problems finding words during the menopause. As oestrogen levels fall, the risk of osteoporosis also increases, as this hormone contributes to bone maintenance [2].

In the menopause and postmenopause:
As oestrogen levels fall, the skin loses collagen and elastin, making it thinner, drier and saggier. The vaginal mucosa becomes thinner and drier, which can cause pain during sexual intercourse. The urethra shortens and its mucous membrane also becomes thinner, making this area more susceptible to urinary tract infections (urogenital menopause syndrome). Frequent urge to urinate and even urinary incontinence can also occur. In the first 5 years after the menopause, bone density is greatly reduced due to the drop in oestrogen, which can lead to bone fractures more easily. Cholesterol levels now often show a higher concentration of unhealthy low-density lipoprotein (LDL), which can make cardiovascular diseases such as atherosclerosis more common [2].

Why do hot flushes occur during the menopause?

While the exact cause is not known, it is thought to be a change in the hypothalamus in the brain, which regulates body temperature. Fluctuations in hormone levels may also be the cause. During a hot flush, the blood vessels on the surface of the skin (often in the head and neck area) dilate, making it red and hot. This can make those affected feel so warm that the body reacts by breaking out in a sweat. This phase can last from a few seconds to several minutes and often leads to chills afterwards. Night sweats in particular (hot flushes at night) can have a negative impact on sleep and lead to constant tiredness, irritability and mood swings [2].

What helps with menopausal symptoms?

If the symptoms of the menopause cause a great deal of stress, it is possible to treat them with hormone therapy. Although this can ease the hormonal change, hormone therapy also harbours the risk of supporting other illnesses [2,3].

It is essential to consult a doctor before starting such treatment, especially in women with an increased risk of cardiovascular disease, strokes, blood clots and dementia [2]. Alternative measures against hot flushes can include light clothing, fans and cooling compresses. Spicy food or alcohol promote the development of heat. Routines, avoiding stress, relaxation exercises and yoga can help against sleep disorders and inner restlessness.

Due to the possible side effects of hormone therapies, many women are interested in herbal remedies such as yams and soya. In hormone replacement therapy, these products are referred to as bioidentical hormones, as they have almost the same molecular structure as those produced by the female body [2].

Which hormones to use during the menopause?

In hormone therapy for typical symptoms associated with the menopause, such as night sweats, sleep disorders and mood swings, oestrogen and progestogens are usually used to reduce symptoms [2]. In the postmenopausal phase, treatment is often helpful not only to alleviate menopausal symptoms, but also to counteract osteoporosis. This risk can arise particularly in the period after the last menstrual period, as the lack of the hormone oestrogen means that bone maintenance can no longer be supported.

Which type of hormone therapy or hormone replacement therapy is appropriate in each individual case must be determined by a doctor in order to alleviate the respective symptoms, but also to minimise or even avert the risk of side effects and other diseases.

The type of treatment can be carried out in different ways: It is possible to take the hormones oestrogen and progestogen orally as tablets, as skin patches or lotions via the skin or vaginally via creams, suppositories and other variants.

With a good medical assessment, women in the phase of hormonal changes can usually be helped well, so that not only symptoms such as sweating, sleep disorders and mood swings can be alleviated, but above all the risk of serious illnesses can be minimised.

Finally, we also have good news:

Contraception, unwanted pregnancy and menstrual problems are no longer an issue after the menopause. There is a likelihood of improved quality of life for women with endometriosis or previously severe symptoms during their periods. Migraines can also disappear after the menopause [4].

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Sources:

[1] https://www. frau-gesundheit.de/wechseljahre-erklaert-wechseljahre
[2] https://www.msdmanuals.com/de-de/heim/gesundheitsprobleme-von-frauen/wechseljahre/wechseljahre
[3] https://www.thieme-connect.de/products/ejournals/abstract/10.1055/s-0034-1384624
[4] https://www.gesundheitsinformation.de/wechseljahrsbeschwerden.html