Menopause - Everything you should know about it!
Menopause (climacteric) is something that every woman actually likes to do without. Most women think of hot flashes, dwindling libido and bitching. You can live with that, you think at this point? Here you can find out what additional complaints you should expect, how you can deal with them and what options for help, therapy and other assistance exist so that you can get through menopause well - without going completely crazy.
The individual complaints - an overview
The most common complaints that you have certainly heard of are the hot flashes and unpredictable mood swings that we have just mentioned. All complaints are caused by the hormonal changes during menopause. In some women, this can even lead to depressive moods. Some women cry a lot and do not know why, the next moment they worry or are madly irritable. Physically, menopause shows itself in many ways. In addition to weak bladders, dry mucous membranes or aching joints, many women also experience hair loss, brittle nails, pale skin and fatigue. It should be emphasized, however, that it is not necessarily the case that you will actually experience all the symptoms listed here. Menopause varies from woman to woman and manifests itself in many different ways.
Dealing with the different symptoms
It is important for you to know how to deal with the different symptoms. Dealing with them in the right way will make it easier for you to get through menopause. For the most typical complaints, you can find out here which procedures are recommended for dealing with them.
Dealing with hot flashes
Hot flashes appear differently in every woman during menopause. One experiences them several times a day associated with a flushed head and accelerated heartbeat. The other is rarely affected, but then very intensively and over a longer period of time. Which type you are, you will unfortunately only find out when the time comes. However, the cause is always a sudden widening of the blood vessels, which is hormonal. Doctors see an increased release of adrenaline and an increasing lack of estrogen as the main cause. This expansion causes, among other things, that the outer skin areas are supplied with more blood, which causes the mentioned reddening of the skin. In some women, the circulatory system reacts naturally to this situation and accelerates the heartbeat. This all sounds quite dramatic, but you can do something about it:
- Medicinal plants
- Physical therapy
- Hormone replacement therapy
Many women trust the power of nature and prefer medicinal plants such as black cohosh, yarrow or sage, each of which is presented in tablet form. Whether this will help you is another matter, as every body is individual. But there is no harm in trying: try it out for yourself!
More obvious, since the female body always works the same way from a physical point of view, are physical therapy methods. These include alternating showers, acupuncture or even mud baths.
Hormone replacement therapy (HRT) is considered by most medical professionals as a last resort; namely, when menopause throws your life completely off track. As the name implies, your body is given substitutes for the deficient hormones, which is a major intervention in your hormone balance. However, this intervention can promote diseases such as breast cancer or thrombosis. You must therefore carefully consider whether HRT is an option for you.
Dealing with bladder weakness
With decreasing estrogen levels, the bladder is strongly affected. The connective tissue that supports the bladder becomes weaker. As a result, the muscles of the bladder lose their support. The result is that you either feel a sudden urge to urinate or that you lose urine involuntarily. This can occur more frequently when you laugh or sneeze. In addition, due to hormonal changes, your bladder also reacts to substances contained in urine. These substances influence the bladder sphincter. This in turn favors the penetration of bacteria into the urethra, which leads to bladder infections. The whole thing can be compared to the condition of your bladder after pregnancy: you may get an early insight into what your bladder can expect during menopause.
The good thing, however, is that you can work specifically against it, just as you can after pregnancy: With regular pelvic floor training, you strengthen your pelvic floor muscles. A well-trained pelvic arch provides renewed support for your bladder. However, you must make sure that you really do the exercises correctly, otherwise they will have a counterproductive effect. It is very difficult to train a muscle that you - unless you are already a mom - did not know existed until now... Hormone replacement products also have the potential to counteract bladder weakness. However, this is just like hot flashes: Replacement hormones may lead to far worse diseases.
Dealing with dry mucous membranes
In addition to the nasal mucosa, against which simple care products are helpful, it is mainly the vaginal mucosa that loses moisture due to the lack of estrogen. Possible consequences:
- Itching
- Burning
- Pain
In addition, a dry vaginal mucosa is more susceptible to malignant bacteria, which in turn leads to infections. The lactic acid bacteria present in the mucous membrane, which regulate the natural pH value, work less intensively on a dry mucous membrane. The result is an unfavorable pH value, which creates a good nutrient carpet for bacteria.
There are various treatment options for vaginal dryness: Although the administration of hormone replacement therapy is possible, there is little justification for it, since the effect of the symptoms on everyday life is hardly noticeable. HRT is therefore disproportionate to the symptoms. However, it is possible to take preparations that are absorbed directly and only by the vaginal mucosa. These include vaginal suppositories, creams and tablets. This means that the hormones supplied are absorbed exclusively where they act and thus have no further influence on your body.
Dealing with depressive moods
Depressive moods are a symptom of menopause that should be taken seriously. Often, not only you, but also indirectly your fellow men are affected, who notice your condition. If left untreated, depressive moods are a major challenge for most women, because very few know how to deal with them. Those around you are also likely to be perplexed, as they are in the dark about what will make you feel better. The difficult thing about depressive moods is that at first you don't notice them yourself and those around you can't name what's wrong with you. In addition, depressive moods during menopause are unpredictable: they disappear as suddenly as they appeared.
Hormonal change during menopause
Estrogens and progesterone are the most important female sex hormones. With the onset of menopause, the number of viable eggs in the ovaries has dropped to zero. Thus, no more follicles grow, which in turn alters the hormonal regulatory cycle.
Estrogen dominance in perimenopause
While a woman is fertile, the follicles that mature each month produce the hormone estrogen. In perimenopause, the function of the ovaries declines sharply. The ovaries hardly respond to certain control elements and follicle-stimulating hormones are increasingly released. This causes increased estrogen production. Progestin and progesterone do not increase during this time, resulting in a progesterone deficiency. Progesterone is responsible for regulating estrogen. If progesterone is too low, estrogen is insufficiently regulated. This results in estrogen dominance.
Estrogen dominance in women often leads to intermenstrual bleeding, pre-menstrual bleeding and increased bleeding with abdominal pain in the second half of the cycle. In addition, hot flashes are possible as estrogen levels plummet from now to now. Circulatory problems are also a potential side effect.
Estrogen deficiency during menopause
Over time, there are too few follicles to mature in the ovaries. Accordingly, the ovaries gradually stop producing female hormones completely. The period is history. However, the absence of the period for a few months is not meaningful. Only when your period has been missing for more than a year can it be assumed that you have reached menopause. This happens when your ovaries have completely given up their function.
Hormone replacement therapy (HRT) as a solution?
In the case of hormone deficiency, there is the possibility of hormone replacement therapy. This means that the resulting hormone deficiency is compensated by artificial hormones. The hormones are supplied to you from outside. Once the concentration of hormones has returned to a normal level with the help of HRT, the symptoms decrease and ultimately disappear completely. The prerequisite, however, is that the complaints that occur during menopause have really only begun with the onset of menopause, i.e. when they can be reliably attributed to menopause.
And even then, not all menopausal complaints are suitable for HRT. The main focus is on hot flushes and tissue loss of the vaginal mucosa, due to which urological complaints arise. These complaints are safely eliminated by means of HRT. Depression or osteoporosis, for example, are not indications for HRT. In these cases, HRT is only recommended if the risk of bone fractures is considered very high and there is also an intolerance to other medications for osteoporosis.
If you are considering HRT, a thorough medical examination is necessary. You will also be questioned in detail by a doctor about your symptoms. It may be necessary to determine your hormone levels through a blood test. Based on these results, a decision will be made as to whether HRT and the associated risks are in proportion to your symptoms. If the decision is made to use HRT, medicine adheres to the following principle:
Use the lowest effective dose over an individually required treatment period.
Regular reviews are needed during the course to ensure that your symptoms are improving with HRT. The length of time HRT is given varies from person to person, so there are no recommendations or guidelines. If HRT is to be discontinued, it is important to make sure that you do not stop taking the medication from one day to the next, but slowly over a longer period of time. The time period for discontinuation is usually set at a few months. If you find that the symptoms increase again when you stop taking the medication, it is possible to extend the HRT.
Active substances and dosage forms of hormone replacement therapy
There are two types of hormone replacement therapy:
- Monotherapy
- Combination therapy
In monotherapy, only estrogens are used as replacement drugs. This option is chosen if the symptoms are exclusively due to hormone deficiency. It is thus an estrogen substitution. On the other hand, there is combination therapy, in which estrogens and progestin are administered in combination. The hormone replacement preparations are administered either by mouth (oral) or through the skin (transdermal). In addition to tablets, replacement preparations exist as patches, creams or gels. For the vaginal area, vaginal suppositories or vaginal rings and pessaries are used.
Phytoestrogens: Natural alternative
In addition to chemical hormone replacement drugs, there are those from alternative medicine - phyto-therapeutics. These are herbal medications that adjust hormone levels in a natural way. However, so far there are no clear and conclusive studies on their effectiveness and tolerability. For this reason, we do not recommend such products at this point.
Benefits and risks of hormone replacement therapy
As you've already read, hormone replacement therapy may come with health risks. These include:
- Breast cancer
- Thrombosis
- Stroke
For this reason, a risk-benefit assessment is essential. You need to be aware of how your symptoms, their intensity and the way they affect your life are related to any resulting diseases. The fact that you can change the type of therapy, its duration and the dosage of the medication at any time in consultation with your doctor will help you in your decision-making.
Various active ingredients can be considered as hormone replacement products. Depending on the active ingredient, the possible risks are different. Decision criteria for the individual agents are the following:
- Own and family medical history
- Age
- Time of menopause
Before deciding on HRT, you should think about your previous medical history and tell your doctor about it. In addition, it is informative if you know about any diseases in your family. If your family history indicates that you are at increased risk for one of the active ingredients, you can switch to a hormone replacement product with a different active ingredient. In addition, your age and the time of your menopause are important in deciding which preparation is suitable for you. In younger women, some hormone replacement products have a reputation for preventing colon cancer, heart attacks, and type II diabetes mellitus.
Risk factor #1: Breast cancer
Particularly in women over the age of 60, the risk of developing diseases as a result of hormone replacement therapy increases. For breast cancer in particular, incalculable risks arise if hormone replacement therapy lasts longer than 3 to 5 years. By means of an additional administration of progestogens, this risk is reduced, which means that women over the age of 60 are advised to use combination therapy more often than monotherapy.
Risk factor #2: Thrombosis
Studies show that the risk of thrombosis increases, at least in women with a family history of thrombosis or with advancing age. Thrombosis is a blockage of the blood vessels by the body's own substances. For example, if you are overweight or have been in bed for a long time due to an injury, you are also a woman who is susceptible to thrombosis. However, studies have shown that the risk of thrombosis only increases when the hormone replacement product in question is administered orally. This was not observed with transdermal preparations.
Outside of HRT, there are numerous other factors that increase the risk of breast cancer and cardiovascular disease:
- Severe obesity
- Lack of exercise
- Regular alcohol consumption
Adjustment of the lifestyle during menopause
The hormone deficiency during menopause can only be compensated by medication. However, there are side effects of menopause that are not due to hormone deficiency. As your muscle mass decreases during menopause, your energy requirements also decrease. If your lifestyle remains the same, you are bound to become overweight. You can prevent this by either changing your eating habits and eating more consciously or by increasing your energy requirements through sport and exercise. The more sport you do, the more calories you burn and the more you can feast even after menopause.
Myths about menopause
There are many myths about menopause. Almost every woman - and, strangely enough, many men - think they know exactly what's going on and end up sharing their knowledge at family gatherings. Here we show you the five biggest myths you should know about menopause.
Myth #1: Menopause begins at age 50
"Well, then I still have 10 years to go..." thinks Mrs. Meier. Fiddlesticks. But menopause actually starts at the age of 40. From then on, the ovaries begin to produce fewer sex hormones. As a result, periods become irregular until they finally stop altogether. As you have already read, menopause is when periods stop for a period of one year. However, the age of 40 should be seen in relative terms. There are women who do not reach menopause until they are 55. Or don't you know one or the other report from the media, according to which, for example, a 60-year-old woman became the mother of quadruplets? The age of 40 can also be put into perspective. There are cases of women who have already reached menopause at the age of 35. You think to yourself, "Just out of your teens, already in menopause!"
Myth #2: Menopausal symptoms are always hormone-related
That would be great, because it meant: pill and good. Unfortunately, this is not the case. Men are observed to suffer from cardiovascular diseases or osteoporosis at the same age as women. The reason for this is that the corresponding age brings several possible changes:
- The children leave the parental four walls.
- Some people cut back on their careers because health problems force them to do so.
- Some marriages drift apart.
- There is suddenly more time for career or hobbies.
These things are often associated with stress, which in turn affects physical and mental well-being.
Myth #3: The teeth are spared from menopause
This is not so. Every woman who already has children knows the saying:
Every pregnancy a tooth - Mrs. Wollny has a problem.
There is actually some truth to this, because the hormonal changes during pregnancy affect oral health. It's the same during menopause. The oral cavity now becomes more susceptible to bacteria and inflammation, as the gums become softer. This makes thorough brushing even more necessary than it already is.
Myth #4: Special diet, exercise and plant power help against menopause
A healthy diet and sufficient exercise are beneficial to health. Avoiding alcohol and sugar generally contributes to improved physical well-being. Some women swear by ginseng, red clover or kava kava during menopause, for example. Others have many needles inserted into their bodies and go for acupuncture. Effectiveness has never been proven. Herbal alternatives even not infrequently have vehement side effects: Kava Kava, for example, was known for some time to cause liver damage, whereupon its approval was withdrawn.
Myth #5: Dead pants in bed
Not necessarily. Of course, there are sometimes complaints about dry mucous membranes that negatively affect your sex life. But you can do something about it. In fact, in quite a small percentage of women the libido decreases. Likewise, the libido increases in another part. Studies now show that a decrease in libido is not so much due to hormonal changes, but rather to psychological and physical problems, such as physical pain during exercise or problems in the partnership. In addition, some medications taken by women in advanced age for health problems are known to have a negative influence on libido. In a well-functioning partnership, your partner will definitely respond to you. It is important that you do not endure your discomfort and also changes silently alone. Gynecologist, girlfriends or doctors are in most cases the right contact persons. But maybe it is enough for you and your partner to become more curious and try new things. In this way, you can even see menopause as an opportunity in some cases. It is possible that your love life will change, but this does not necessarily have to be in a negative direction...
