Menopause corresponds to the last menstrual cycle, that is, the last menstruation. It generally occurs between 45 and 55 years of age. When it occurs around 40 years, it is called premature or early menopause.
The term menopause is often misused to refer to the climacteric, which is the transition phase from the reproductive, or fertile, period to the non-reproductive period in a woman’s life.
The main characteristic of menopause is the cessation of menstruations. When talking about menopause symptoms, some people may see it as a health problem. Although it can present difficulties, the climacteric is an important and inevitable period in a woman’s life, and should be regarded as a natural process, not as a disease.
For many women, the onset of menopause causes menstrual irregularities, scantier periods, hemorrhages, more or less frequent menstruations. Other characteristic signs and symptoms such as hot flashes, changes in sleep, libido, and mood, as well as atrophy (weakening or withering) of the genital organs, follow soon after.
Causes of menopause:
All the eggs that a woman will produce throughout her life originate from germ cells (or follicles) in the ovaries that are already present when a girl is born. This reserve is used from the first menstruation (menarche) to the last (menopause). No woman is capable of forming new follicles to replace those that are gone. When the last ones die, the ovaries fail and the concentrations of female hormones, estrogen and progesterone, fall irreversibly.
Among other possible causes of menopause are gynecological surgeries that include the removal of the ovaries.
Symptoms
• For some women, the menopause and climacteric phase presents no symptoms; however, most of them start having symptoms at the beginning of the climacteric and, with the progressive decrease in female hormones, the symptoms intensify.
The most common are:
• Hot flashes: sudden episodes of feeling hot in the face, neck, and upper trunk, usually accompanied by facial flushing, sweating, heart palpitations, dizziness, and muscle fatigue. When more intense, they can interfere with daily tasks;
• Irregularities in the duration of menstrual cycles and the amount of blood flow;
• Manifestations such as difficulty emptying the bladder, pain and urgency to urinate, urine loss, urinary and gynecological infections, vaginal dryness, pain on penetration, and decreased libido;
• Psychological symptoms: the reduction in female hormone levels interferes with the release of neurotransmitters essential for the harmonious functioning of the central nervous system, leading to increased complaints of irritability, emotional instability, uncontrollable crying, depression, anxiety disorders, melancholy, memory loss, and insomnia;
• Changes in the skin, which loses vigor, in the hair and nails, which become thinner and more brittle;
• Changes in body fat distribution, causing it to concentrate more in the abdominal region;
• Bone mass loss characteristic of osteoporosis and osteopenia;
• Increased risk of cardiovascular diseases: coronary disease is the leading cause of death after menopause.
Treatment
Hormone replacement therapy has the advantage of relieving physical symptoms (hot flashes), psychological symptoms (depression, irritability), and those related to the genital organs (vaginal dryness, urinary incontinence) during the climacteric. In addition, it acts as protection against osteoporosis and ensures a better quality of life for the woman. However, there are contraindications that must be carefully evaluated by the doctor and the woman; self-medication is not recommended, as it may increase the risk of cardiovascular diseases, thrombosis, breast and endometrial cancer, liver disorders, and vaginal bleeding of unknown origin.
Scientific studies have shown that soy isoflavone has an action similar to estrogen in controlling hot flashes.
A healthy diet, regular physical activity, not smoking, avoiding alcohol consumption, and oral health care are some simple measures that, when incorporated into daily habits, can help minimize the negative symptoms of the climacteric.
Other recommendations:
• Even after menopause, the woman should maintain regular gynecological check-ups;
• Avoid gaining weight;
• Find time for daily physical activity. In addition to being important for physical well-being, it is essential for controlling blood pressure, preventing osteoporosis, cardiovascular diseases, and alleviating mood changes.
IMPORTANT: Only properly qualified physicians and dentists can diagnose diseases, indicate treatments, and prescribe medications. The information available on Dicas em Saúde is for educational purposes only.
Sources: Blog da Saúde, Ministério da Saúde, by Dr. Dráuzio Varella