Menopause Magic

At a certain time in a woman’s life comes an event commonly known as menopause, or “the change”. This event, unbidden and unstoppable, brings with it some problems, and some opportunities.

What could be the reason for this shift in body functions? Is there something good to be enjoyed from this transformation? Men frequently retain the ability to become fathers well into their advanced years, so why should this delight be denied to women? There may be a specific benefit for our species when younger women have the undivided attention and support of their mothers while they are having babies and to help care for those grandchildren. Actually the opportunity to live past the end of reproductive years is a recent phenomenon. In centuries past many women died in childbirth, or from some infectious disease or calamity long before ovarian function ceased.

The ovaries are mysteriously programmed to end their predictable cyclic production of fertile eggs and a wondrous array of hormones. The first sign of the “change” may be loss of fertility, the end of menstrual cycles, or, less defined but clearly discernable, hot flushes and mood swings. The experience is different for every woman, and usually occurs between the ages of 45-55 as ovarian function ceases after using up all the eggs deposited in the ovaries long before birth.

Some women sail happily through these events with little disruption of their days, while others may experience long and heavy menstrual periods, irregular menstrual bleeding, and hot flashes with or without insomnia, mood swings, and depression.

Known to the medical profession as “vasomotor symptoms,” hot flushes, or flashes are the sudden onset of a feeling of rising hotness which expands from the core of the body to intensely involve the entire body with reddening of the skin, sweating, and a pounding heart. These may occur once or twice daily, merely an interesting occurrence. Some women experience them 20-30 times daily, causing embarrassment, frustration and sometimes moodiness and difficulty sleeping. They may begin years before the Last Menstrual Period, or may occur at a time when menses are becoming infrequent and unpredictable.

Lowered levels of estrogen in the bloodstream cause thinning of the skin lining the vagina, and a loss of fluid secretions. This sometimes results in a waning interest in sexual adventures, diminishing sex drive, difficulty achieving orgasm, vaginal dryness or discomfort during intercourse which may cause some women to avoid sexual encounters.

Several changes in bodily functions are without symptoms. Bone loss begins after menopause, increasing risk of osteoporosis and hip or spine fractures with advancing age. There is no pain or ache to alert one to the gradual leaching away of bone strength, until, suddenly, a fracture occurs causing pain, possibly requiring surgery, and interfering with mobility and independence.

Cardiovascular disease such as coronary artery disease, arteriosclerosis (hardening of the arteries) sometimes associated with high blood pressure has been linked to diminished levels of protective estrogens in the blood stream. Women encounter higher rates of heart disease and strokes after menopause. Diabetes mellitus is sometimes a contributing factor to the blood vessel damage which can cause kidney disease, strokes and blindness.

Menopause may bring with it a series of difficult adjustments and new health issues to challenge our well-being and productivity. Frequently it is the abnormal menses, vaginal dryness or hot flushes that prompt women to visit their gynecologist to seek some relief from these symptoms. Difficulties with sexual function including loss of interest, vaginal dryness and painful sexual intercourse may contribute to marital stress. Coping with maturation and increasing independence of children, adjusting to transitions to college, work or outside attachments that diminish the importance of “mothering” may bring sadness or regret with feelings of “empty nest”.

Many women become caregivers for aging parents who suddenly need daily supervision, who need to be helped with doctor visits and tasks of daily living, so the freedom from childcare may be replaced by other family needs.

On the positive side, menopause is an important opportunity for physicians to recommend “wellness” screening, to consider breast cancer screening, heart disease prevention, screening for uterine cancer, colon cancer, immunization update, evaluation of risk for osteoporosis and hip or spinal fracture, and provide counseling on healthy lifestyles. It may be time to evaluate diet, exercise, nutritional supplements, and other lifestyle changes that could bring improved quality of life and prevent disease.

There are treatments for hot flashes. Estrogen (hormone replacement) may be considered for a brief period of time. Other treatments for hot flushes include weight loss, reduction of stress and other lifestyle changes, regular exercise and a healthy diet. Data show that regular Yoga or omega3 fish oil may reduce frequency and intensity of hot flashes.

Vaginal dryness may respond to lubricants or estrogen creams. Osteoporosis may be prevented by a variety of strategies including calcium and Vitamin D supplements, hormones or medications such as bisphosphonates. Measuring and managing cholesterol levels and adhering to a regular exercise schedule are important measures for prevention of cardiovascular disease. The ravages of Diabetes mellitus may be avoided with weight management and careful dietary regulation.

The magic of menopause is this introduction to the rest of your life. As puberty heralded the beginning of reproductive years, menopause is the gateway to the Golden Years. As we grieve the passing of those wonderful years of having babies, of developing our careers, of finding our pathway in life, so we may also celebrate the dawning of a new time, a different time, and its up to us to make it magical!


Disclaimer: The facts presented in this article and the views expressed are solely those of the author(s) and do not necessarily reflect the views of the Board of Directors or other members of West Texas Physicians Alliance.