Menopause
Description
Menopause marks the transition from the reproductive to the post-menopausal phase. In the period between 45 and 60 years of age there is a hormonal adjustment in which the body produces ever fewer estrogens. The decline in estrogen production often leads initially to variations in the menstrual cycle, and then finally to the complete cessation of menstruation: menopause.
Menopause is divided into four phases. Premenopause is the period beginning about 2 to 7 years before menopause, which entails the first menstrual irregularities. During menopause, menstruation is an absent, then following this phase comes post-menopause. Perimenopause is what the interval between pre- and post-menopause is called.
Symptoms
Estrogen deficiency during menopause leads to a number of distinct ailments and symptoms which are referred to as "menopausal syndrome." The symptoms can be both somatic and psychological in nature. These include hot flashes, sweating, palpitations, dizziness, insomnia, apathy, mood changes, nervousness, disgruntlement, depression, headaches, weight gain, hair loss, atrophy of the vaginal skin, dry skin or dry mucous membranes.
Causes and Risks
Menopause is caused by hormonal adjustments. Hormone levels in women change with age. There is a decline in ovarian function and thus less estrogen is produced. The stock of follicles present in the ovaries, which can mature to be capable of ovulation and are responsible for estrogen production, is completely exhausted by around 50 years of age.
To compensate for the lack of estrogen and stimulate hormone production of the ovaries, hormones of the gonadotropins group are increasingly distributed, particularly the follicle stimulating hormone (FSH). Its several-fold increased concentration often leads to hormonal imbalances which in turn can cause symptoms such as hot flashes, listlessness or palpitations.
Examination and Diagnosis
Crucial factors in the diagnosis are age, the symptoms that occur and the results of a gynecological examination. If the patient is beyond the age of 45 and complains of hot flashes and menstrual cycle disturbances, or physical changes in the uterus, vagina or breasts are detected, these are clear signs of menopause. For further evaluation a blood test can be performed: a change in hormone levels - an estradiol decrease and significant increase in follicle stimulating hormone (FSH) - is additional evidence of menopause.
Treatment
Robust treatment during menopause is necessary due to debilitating ailments that may affect the woman's quality of life. Within the scope of hormone therapy, various estrogen and progestin preparations or estrogen and progestin combined medicines are used. Hormone replacement therapy is focused primarily on alleviating existing symptoms, and affects vegetative symptoms like hot flashes and sweats. Long-term hormone treatment can prevent osteoporosis, but it can cause a number of side effects. Advantages and disadvantages of hormone therapy should be reviewed and discussed with each woman individually.
Course and Prognosis
Menopause is a natural process which every woman goes through after a certain age. The duration and severity of menopausal symptoms are very individual. On average menopause may last about 10 to 15 years. The problems caused during that time by estrogen deficiency symptoms often abate after a few years. A balanced diet and regular exercise can have a positive impact on the quality of life of women in menopause.