Sexual Health (5) ... Men-o-pause!

Sexual Health (5) … Men-o-pause!

MENOPAUSE is the time when a woman naturally stops to menstruate. It marks the end of the woman’s reproductive years.

Although this can happen anytime between 40 and 55 years, the time of menopause averages around 50 years. This does not just happen suddenly. It is not an event like a birthday. It is a long, gradual process of lowering hormone levels.

When the reproductive hormones begin to fall below the level necessary to signal the uterine lining to thicken and gather blood (for possible pregnancy), the menstrual cycle flows become less and irregular and eventually stop alltogether. The ovaries stop producing eggs.

In addition to regulating the menstrual cycle and reproduction, the two female hormones – oestrogen and progesterone – assist with mineral balance, sugar control and response to stresses like inflammation. Thus, lack of these two hormones lead to multiple symptoms in a woman.

These symptoms can start up to six years before menopause and continue for several years after the final menstrual period. The most common symptom is that of hot flashes or flushes. This usually comes suddenly as heat starting from the chest up to the face, lasting a few seconds to minutes. This results in sweating and even palpitations. It may be severe enough to wake a woman from her sleep.

Other symptoms include: sleeping disturbances; weight gain and bloating; mood changes like irritability; changes in the menstrual cycle, such as bleeding between periods, bleeding after sex or bleeding that is heavier or lighter than usual; loss of bladder control and frequent bladder infections; lack of sexual desire; dryness of the vagina with concomitant painful sexual intercourse; breast pain; depression; bone pains; fatigue; lack of concentration and short-term memory and headache.

Not all women have these symptoms, yet they all have a drop in their hormonal levels. The symptoms may be mild, not requiring more than an explanation and reassurance. Or they can be so severe as to cause major disruption of the woman’s life. We have treated women who were convinced that they were going completely mental! Leading a stressful life can cause the symptoms to be more severe.

The symptoms are usually more severe earlier in the postmenopausal period and become less as the years progress.
Menopause occurs earlier in women who smoke or consume lots of alcohol or caffeine and in women who receive chemotherapy or radiation therapy for cancer.

Treatment for these symptoms need to be individualised. This ensures that specific risk factors for individual women are taken into consideration.

Women can help themselves by leading a healthier lifestyle: avoid consuming lots of sugary foods like chocolate; avoid toxins; do regular physical exercises; reduce your alcohol intake; do not smoke; manage your stress levels; do not eat too late in the evening.
The mainstay treatment for the hot flashes is hormone replacement therapy. Estrogen (for women who’ve had a hysterectomy) and a combination of estrogen and progesterone are given to relieve the hot flashes.

Other benefits of hormonal replacement therapy include: reducing the risk of unwanted pregnancy during the peri-menopausal period and avoiding the irregularity of menstrual periods.

There have been concerns of these hormones causing breast cancer, but detailed research has shown that-given for a shorter period early in the peri – and postmenopausal period – the benefits outweigh the risks. Your doctor will give you the treatment with the lowest effective dose of the hormones and evaluate periodically if you still need to continue the treatment.

For osteoporosis, specific medicines exist. Your doctor will discuss these with you and decide on what suits your situation best. Estrogen replacement helps with preventing bone loss as well. But regular weight-bearing exercises like jogging, also help.
For vaginal and urinary symptoms, estrogen replacement will relief most. Water-based lubricants are recommended for mild vaginal dryness.

At the end, menopause needs to be expected and understood. It is a natural stage for every woman who lives long enough. Managing it is easier if the woman knows what to expect. The doctor’s role is to explain the symptoms and give treatment to relieve the more troublesome symptoms.

For the rest, live a reflective, relaxed life and you will get through this interesting phase of your life with relative ease.
For comments or questions, please contact us at:hilja@gmail.com or daveu@africaonline.com.na/061-269971.

Sexual Health (5) ... Men-o-pause!