Hot flushes, mood swings, incontinence and issues related to sexual life are unfortunately the reality for many women who have reached menopause. This transitional period marks the years just prior to the last menstruation, and the years that come after it. On average, women enter menopause around their 52nd year, but this can vary significantly between different women. For some, onset of menopause can begin as early as in their 30s, while others might be having regular periods even in their 60s. Similarly to this, the subjective experience of symptoms also depends on the individual case, with some women having extreme difficulties coping with the symptoms, while others almost do not notice any significant changes. If you fall into the first category – here are some good news! Most of the unpleasant symptoms you experience can be successfully mitigated and diminished with proper hormonal treatments.
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Definition of Menopause – What is it?
Hormones are fundamental elements of bodily functions, they influence a number of different processes, features and characteristics, strongly influence our mood and perception of the outside world, and their balances and ratios continue changing throughout our lives. And this is especially true for women. For example, the onset of puberty is marked by profound hormonal changes, and the same goes for pregnancy and menopause.
Symptoms commonly associated with menopause are caused by the changes in levels of oestrogen and progesterone, also known as female sex hormones. When the menopause starts, the level of progesterone decreases since this hormone is formed immediately after ovulation, in order to help the egg cell on its way. However, when no egg cells are present in the women’s body, the need for this hormone also disappears. After some time, the body will also stop producing oestrogen, the second female sex hormone. These changes, namely, the decreasing levels of female sex hormones and the subsequent subjectively experienced symptoms are what we call menopause.
Symptoms of menopause
As mentioned, the presence and severity of menopause symptoms vary significantly, so it’s hard to give a full and all-encompassing list. However, we can mention the most common ones which have been reported by countless women around the world.
Hot flushes and sweating
Hot flushes are one of the most common and especially annoying signs of menopause. Many women complain about the sudden onsets of “feeling hot” and subsequent excessive sweating. While hot flushes can occur at any time of the day, they are especially common at night, when they are also called “night sweats”, or in medical terminology nocturnal hyperhidrosis. This feeling of intense heat can be so annoying and disruptive when it comes to everyday activities and regular sleep pattern, that some women have no other choice but to seek medical help. If that is the case, hormonal treatment is usually prescribed, but there are also some things that you can do yourself in order to combat the hot flushes.
Many women claim that sleeping in a cool room and showering with cold water prior to bedtime makes all the difference between a good night’s sleep and another episode of the night sweating and hot flushes. For others, certain foods and beverages such as coffee, alcohol, sugar-rich products and strong food can be a trigger for hot flushes, so it can be advisable to avoid them.
Headaches and migraines can sometimes be caused by women’s hormonal cycles. Even prior to the onset of menopause, some women will notice that certain parts of their monthly cycle are marked by annoying headaches. However, after the last menstrual period, these symptoms can significantly increase in severity and even become long-lasting due to major hormonal changes associated with menopause. There are different ways to alleviate these symptoms and they include:
- Common headache medicine
- Staying hydrated (drinking plenty of water)
- Fresh air
- Hormonal treatment of menopause
When oestrogen levels fall within the body, they may cause mucous membranes to dry out, especially in the vagina. If this happens, sexual intercourse becomes very difficult due to the feelings of itching and irritation in the vagina. This can be remedied by the use of moisturizing creams and lubricants, but it still remains an annoying problem. What’s more, for many women, it can be difficult to talk about this symptoms as the topic is still considered somewhat of a taboo. It is important to note that while most of the symptoms such as hot flushes can and will decrease over time, dry mucous membranes can last for a very long time. Sometimes, the hormonal supplements that will maintain the balance of hormones can be the only viable solution.
Bladder Infections and Incontinence
For many women, menopause is the period when problems with cystitis and incontinence first occur, or become more severe and common if there were prior onsets of these conditions. This is due to the fact that the lack of oestrogen can cause changes in the bladder urethra and mucous membranes, making one significantly more prone to infections. Both of the mentioned conditions can be extremely unpleasant and uncomfortable, but luckily, both can be treated without addressing the menopause as a broader issue.
If you suspect you might have a bladder infection, it is best to visit the doctor and get informed about possible treatment options, while incontinence can often be remedied by simple exercises, designed to strengthen the pelvic floor muscles. These exercises, also known as Kegel exercises have several simple steps:
- Identify the right muscles – you can do this by simply stopping urination midstream. The muscles you moved are the ones you need to train
- Contract the muscles for 6-8 seconds and then relax them again
- Repeat this 5 times, 3 times per day
- As you progress, repeat the exercise steps up to 20 times (3 times per day)
It is common knowledge that hormones help control our mood, so it is only expected that once sex hormones are out of balance, after the onset of menopause, mood swings can occur significantly more often. What’s more, other changes caused by menopause, such as poor sleep quality due to night sweats or incontinence can also make one more irritable and contribute a significant amount to the mood swings. Due to this, there is no medication or treatment that can successfully eliminate this symptom, but getting enough sleep, eating healthy food and paying attention to your general health and wellbeing might be a good start that is sure to minimize the severity and reduce the occurrences of mood swings even once you’re well into menopause.
Irregular menstruation and other disturbances of the period are probably the clearest signs of menopause. Although this transitional phase for women is a sign that menstrual periods are about to stop, one may experience more severe bleeding prior to the onset of menopause. For some, spotting might be common, and for others, bleeding can last for just one day. There are no certainties when it comes to this topic and the individual cases can vary significantly.
Hormone treatment options for menopause
With an array of signs and symptoms that make menopause a rather awkward and uncomfortable period, it’s only natural that many women are looking for ways to mitigate the symptoms and keep their quality of life at the same level as prior to the onset of menopause. Since the lack of female sex hormones is the root cause and the bio-physiological foundation of menopause, hormonal treatments and supplements are the obvious choice.
However, since the severity and the subjective experience of symptoms of menopause vary significantly, the same will be true for the treatment. Different types, amounts and combinations of hormones are usually prescribed for different cases, with the exact choice depending on numerous factors.
Hormone plasters: Evo-Sequi
Evo-Sequi® is a hormone patch that contains oestrogen and progesterone and falls into the category of so-called two-phase treatments. This type of hormonal therapy releases different amounts of hormones in the first and last parts of the cycle. By doing so, it can contribute to establishing hormonal balance and alleviate symptoms such as hot flashes or dry mucous membranes.
The treatment consists of applying Evorel patch every 3-4 days for 2 weeks, thus releasing 50mg of estradiol and 170 mg of norethisterone acetate every day. However, prior to beginning this treatment, it is important to consult with a doctor, since not every woman will be affected the same way by it.
Lival is a hormone supplement in a tablet form usually prescribed to women who are affected by symptoms of menopause and the changes in hormonal balance. The tablets should be taken once a day and they rely on the active substance Tibolon that affects both oestrogen and progesterone. When on this treatment, the woman usually will not experience a monthly bleeding.
Activelle hormone pills are monophasic in terms of their mechanism of action. Aside from oestrogen, they contain the recurrent replacements for women in menopause, including estradiol and norethisterone acetate. It releases the same amount of hormones throughout the cycle, unlike the polyphasic Lival. The choice of one of the other should be made by your doctor after detailed consultations regarding your condition.