There comes a time in the life of a woman where her menstrual period stops completely and her body is totally incapable of producing children. Certain cultures around the world have different perceptions about the concept of menopause. For example, a tribe in Cross River, Nigeria, has a certain fabric called ‘Ukara cloth’ that is only dyed by postmenopausal women. This dyeing is also done in secret. And in a part of Akwa Ibom State, it is believed that the best, most potent and effective palm kernel oil is the one prepared by post menopausal women.
Menopause is also known as ‘climacteric’. Menopause is an inevitable but natural physiological process that marks the end of your menstrual cycle. It refers to a period occurring 12 months after your last menstrual period. Menopause is not an illness rather it is a stage in life that happens in every woman between their late 40s or 50s.
Menopause occurs when the ovaries progressively cut down production of oestrogen and progesterone; it begins as a gradual process and the period of progression of symptoms is known as peri-menopause. In this state, menstrual periods will occur every two to four months and could last one to two years before menopause begins. Note: despite irregular periods, pregnancy is possible during perimenopause.
There are numerous symptoms associated with menopause, some women breeze through it without noticing much of a difference, while a few others feel their world has come to an end, and it need not be so. The truth is if you educate yourself, and know about what is happening to your body, the better equipped you will be at handling what comes your way.
Menopause has some physical and emotional symptoms affecting the brain, heart and bone are most affected. A lot of these symptoms is as a result of a decrease in hormone levels/hormonal changes after menopause. The symptoms are similar in many women, but the intensity is subjective and even varies within the same person. Cultural differences, society, awareness, individual perception, expectations and mindset play a role.
For instance, in communities like my village, where age is respected and the older woman is believed to be the wiser and better woman, menopausal symptoms are significantly less bothersome because they are welcome. But in societies where older is not better, many women equate menopause with devastating symptoms and unhealthy ageing.
As menopause approaches, you will notice irregularities in your menstrual periods such as lighter flows. Whilst menopause occurs naturally, the process can be experienced much earlier in women who smoke tobacco or have had both ovaries removed along with the uterus (total hysterectomy), primary ovarian failure also causes premature menopause. Some forms of chemotherapy also speed up the rate up menopause.
Symptoms of menopause
Menstrual periods become largely irregular during the onset of a menopausal transition. Menstrual patterns tend to display shorter cycles with the possibility of irregular bleeding (usually lighter). Other symptoms that occur during menopause include vaginal dryness, painful intercourse and heart palpitations. The following physical symptoms may also occur; breast enlargement and pain, headaches, dizziness, urinary incontinence, hot flashes, weight gain, back aches and a host of other physical symptoms. Women going through menopause may also experience a number of psychological symptoms such as anxiety, depression, irritability and even poor memory. The most likely cause of menopause is age and the average age for the onset of menopause in the western world is 51 years.
Different strokes for different folks! While some women fret so much about the menopause, a few feel relieved because they no longer need to worry about pregnancy or periods. Although menopause marks the end of fertility, you can remain healthy, vital and sexual. Effective treatments range from education, lifestyle adjustments, acceptance to mindset changes.
Menpausal symptoms can however be managed well through lifestyle modifications. In the past the main treatment was hormone replacement therapy but this was frought with complications such as developing cancers. Although safer modes of replacement have been found, it is still not suitable for all. Fortunately, many of the signs and symptoms associated with menopause are temporary. Take these steps to help reduce or prevent their effects:
- Cool hot flashes Dress in layers, have a cold glass of water or regulate the temperature of your room. Find out what sets off your hot flashes; it could be hot beverages, caffeine, spicy foods, alcohol, stress, hot weather and even a warm room. Have icepacks or it’s substitutes by your bedside or work station so you can put it on your skin to cool off the heat.
- Decrease vaginal discomfort Use over-the-counter, water-based vaginal lubricants or moisturisers, anti-yeast pessaries. Avoid products that contain glycerin, because glycerine could cause burning or irritation in some women. Staying sexually active prevents disuse atrophy and also helps by increasing blood flow to the vagina. Vitamin C supplements will help keep the acid balance in the vagina and thus prevent overgrowth of unfriendly bacteria.
- Get enough sleep: Avoid caffeine, which can make it hard to get to bed, if you most drink alcohol, take it in moderation and not just before bedtime. Exercise and be physically active during the day, although not right before bedtime. Make your sleeping area as comfortable and inviting as possible. Avoid the use of the computer, watching movies that leave you wanting more or using your cell phone just before going to bed, as the light can disrupt your sleep. Bathing, reading or listening to soothing music before bed may help you relax.
- Practice relaxation techniques such as deep breathing, paced breathing, unwinding, relaxing massage, and progressive muscle relaxation (a good physiotherapist will teach you how) can help relieve menopausal symptoms.
- Kegel exercises assist in strengthening the pelvic floor and using a topical vaginal oestrogen may help relieve symptoms of incontinence.
- Eat a balanced diet, include a variety of fruits, vegetables and whole grains. Limit saturated fats, oils and sugars, add calcium, magnesium and vitamins A, C, E and D, supplements to meet your daily needs.
- Smoking may increase your risk of heart disease, stroke, osteoporosis, cancer and a range of other health problems. It may also increase hot flashes and bring on earlier menopause and I am sure you would not want that.
- Exercise regularly. Get regular physical activity or exercise 6 days a week to help protect against heart disease, diabetes, osteoporosis and other conditions associated with ageing.
Many interventions have been shown to aid in reducing the symptoms of menopause, but few have scientific proof. Examples include but not limited to:
- Plant oestrogens also known as phytoestrogens are naturally occurring oestrogens found in certain foods. There are two main types of phytoestrogens — isoflavones and lignans. Isoflavones are found in soybeans, chickpeas and other legumes. Lignans occur in flaxseed, aloe Vera juice, whole grains, and some fruits and vegetables. Speak with your doctor before using isoflavone pills especially if you have cancer of the breast.
- B vitamins may help women deal with the stress of menopausal symptoms.
- Evening primrose oil or black currant oil are sources of essential fatty acids that help influence prostaglandin synthesis and help moderate menopausal symptoms.
- Bioidentical hormones, not readily available in Nigeria. These “bioidentical” hormones are chemically identical to those your body produces.
- Black cohosh has been popular among many women with menopausal symptoms, handle with care because this supplement can be harmful to the liver.
- Yoga Some studies show that yoga may be effective in decreasing the number of hot flashes in perimenopausal women. We have very few Yoga experts in Nigeria, find one, or you look for a good physiotherapist, take a class to learn how to perform postures and proper breathing techniques. It also takes the stress of daily living away.
- Acupuncture may have some temporary benefit in helping to reduce hot flashes, very new in Nigeria, but people are trying it out.
- Other dietary supplements are red clover, kava, dong Quai, DHEA, evening primrose oil and wild yam (natural progesterone cream). Talk with your doctor before taking any herbal or dietary supplements for menopausal symptoms.
Recommended screenings at menopause
- Eye checks
- Dental checks
- Lipid screening
- Thyroid testing if suggested by your history
- Breast and pelvic exams
Please seek medical advice if you have bleeding from your vagina after menopause.
The mind, culture and society have a lot to do with how you accept menopause. Menopause is an inevitable but natural physiological process that marks the end of your menstrual cycle. Look at it as a natural transition to the next phase of life, not as a tragic end to youth, fertility and sexuality or a disease.
Be wary of unproven menopause treatments that promise eternal youth. Find out if hormone replacement is safe for you, carefully consider the risks and benefits. Remember, a lot of women do well on lifestyle modifications, which ends up killing two birds with one stone – improves symptoms menopause as well as other pre-existing health conditions.