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MENOPAUSE is a phase in life shrouded in mystery. Most women don’t know what to expect until it hits them. Compounding the problem is the fact that some women sail through menopause, while others struggle, often for years, dealing with weight gain, mood swings, hot flashes and skin problems.

For most women, menopause is like being strapped to a roller-coaster with no control over when, and how, they can get off. Menopause is when a woman’s ovaries stop producing eggs and she stops menstruating. Medically, menopause is confirmed when a woman has not experienced menstruation after one year. Generally, this takes place between the ages of 45 and 55. The global average menopausal of women reaching early menopause between the ages of 40 and 45. However, before this happens, women go through the perimenopausal stage, which usually lasts four to five years. During this time, it’s normal to have irregular menstruation that may include heavier bleeding as well as infrequent or skipped cycles. This is due to changes in a woman’s endocrine system that leads to reduced oestrogen levels and is often accompanied by hot flashes, fluctuating emotions, difficulty sleeping and vaginal dryness. Women may also experience forgetfulness, low energy levels and reduced libido, which, combined with vaginal dryness, can lead to lower interest in sex and intimacy. Once menopause has occurred, these symptoms can become more severe and last up to five years. “Overall, the entire process can take be severe, with intense waves of heat that get worse at night, disturb sleep and cause irritability or difficulty concentrating. This can be managed with hormone therapy, but only 30 per cent actually seek treatment, either because they are unaware that treatment exists or they prefer natural, home remedies instead. Dr Nazimah explains that hormone therapy is generally well-tolerated and can be very helpful in providing relief from hot flashes and improving sleep quality, vaginal dryness and urinary incontinence. Hormone treatment can come in various forms and doctors will usually recommend one based on the needs of the individual as well as her family history. Options include tablets to relieve overall symptoms or topical creams to reduce vaginal dryness. “Your doctor may recommend tablets that contain both oestrogen to relieve symptoms and progesterone to protect the uterus, or for women who have gone through a hysterectomy (removal of the uterus), a treatment that only contains oestrogen, such as a tablet or vaginal ring.” Most women, unless they have breast cancer or conditions such as liver disease, thromboembolism and heart disease, are able to receive hormone therapy as it is generally considered safe for women who are in good health, even those with chronic conditions as long as they are well-managed. Dr Nazimah says menopause signals a new stage in every woman’s life and it can be embraced with confidence. It means an end to dealing with menstrual cramps and bleeding and no more concerns of possible pregnancies or the need for contraceptives. A healthy sex life during menopause is still possible too. “At the end of the day, menopause is neither a disease nor is it the end of the world. Being knowledgeable about the changes your body goes through will mitigate any anxiety,” says DrNazimah. In turn, women should help pass along information, from mother to daughter, friend to friend, so that other women can also understand what to expect before and after menopause.

MANAGING MENOPAUSE

• Increase calcium in take to 1,200mg a day along with Vitamin D3 to prevent osteoporosis.
• Quit smoking.
• Carry out regular Kegel/ pelvic floor exercises, weight-bearing exercises (such aswalking,running) and strength training with weights.
• Have mammograms to detect lumps in the breast, pap smears to check for signs of cervical cancer and a colonoscopy to check for bowel cancer.
• Have blood tests for conditions like anaemia and diabetes and bone density scans for osteoporosis.