Hot flushes, vaginal dryness, depression and insomnia are some of the menopausal symptoms. It can appear around the age of 50, or even before the age of 40 (when it is considered precocious). Here we detail what to consider at this stage of life, from lifestyle adjustments to hormone replacement.
What is menopause?
At first, the menopause is the last periodwhich is only determined with certainty after 12 months without bleeding. The climacteric is the transition period that occurs from the fertile phase to the last menstruation. On average, he goes from 45 to 55 years of age – and that’s when symptoms start to appear. Now, it is during this period that the menstrual flow can come and go, female hormones begin to decline and so on.
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Around age 40, menstruation starts to become more spaced and unpredictable. Until, in a moment, the woman stops menstruating.
Remembering that there is early menopause. She enters the picture when symptoms arise before age 40. “Within a period that would still be reproductive, the woman goes into ovarian failure”, explains Nilka Donadio, gynecologist and obstetrician and consultant for Dasa Genomic.
Over time, some of the discomfort of menopause tends to go away. But some discomforts may remain, such as vaginal dryness. In addition, post-menopause is marked by an increased risk of diseases such as osteoporosis and heart failure. Hence the need to go to the doctor and monitor the state of health.
How does menopause occur and what are its symptoms?
The climacteric woman’s body significantly reduces the production of the hormones estrogen and progesterone, which act in ovulation. These are the main symptoms that come as a result of the lack of these hormones (as we said, many of these sensations are transient):
- Hot flashes (heat waves)
- dryness in the vagina
- loss of libido
- depressive condition
- Pain in sexual intercourse
- mood fluctuation
- reasoning difficulties
The heat appears, because the brain has estrogen receptors, and the lack of it affects the functioning of neurons and neurotransmitters in the hypothalamus, where our temperature control center is.
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The lack of these hormones also infers in the utilization and in the rates of vitamin D, protein and calcium in the organism. And these deficits favor osteoporosis, in addition to acting on the health of the heart, muscles, blood vessels.
At this point, it is important take care of food, do physical exercises and avoid habits such as smoking or drinking to excess.
“Physical activities are essential because they improve sleep, keep muscles healthy and even reduce the risk of cardiovascular diseases”, says Nilka.
Classic treatment: what is hormone replacement?
If a woman’s body drastically reduces the production of estrogen and progesterone, the idea would be to replace these hormones, right? But it’s not that simple. This treatment has contraindications and each woman needs a different prescription.
For when the woman still has a uterus, it is customary to use progesterone to reduce the risk of endometrial cancer – as estrogen stimulates the growth of this organ. Testosterone, in turn, can be used to restore libido.
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Other health factors and more the will of the woman are evaluated when defining if there will be replacement, and in what way. In fact, you can even adopt treatment cycles that keep menstruation for a while longer.
And there are some prerequisites for hormone replacement. Women with a history of gynecological cancer or hormone receptor breast cancer, infarction or thrombosis should not resort to it, for example. “This is because these diseases are hormone-dependent”, explains Nilka. That’s because extra doses of hormones sometimes trigger these problems to come back.
In addition to this strategy, adopting a healthy lifestyle helps to contain the symptoms of menopause. If the woman feels that she is going out of her way, health professionals (from nutritionists to psychiatrists) can help.
“The most correct thing is that this evaluation is totally personalized”, defends Nilka.
What other alternatives does the woman have?
To resolve menopausal heatfor example, for years the solutions have been phytoestrogens, acquired through diets with foods that have this molecule. “Soybeans, lentils, apples, flaxseeds, whole grains, wheat, among others, are on this list”, says the gynecologist. There are also supplements based on soy and cimicifuga isoflavones that can be part of the scenario.
In short, every consequence of the climacteric must be evaluated and addressed. If the woman develops depression, therapy and antidepressants are commonly prescribed. If she is diagnosed with osteoporosis, she will likely be encouraged to take in more calcium and vitamin D, in addition to specific exercise and medication. And so it goes.
Is it possible to prevent menopause?
Not. At some point, that moment will come.
Those who have always incorporated a healthy lifestyle are more protected from the effects of the climacteric, but not completely free. This woman will have a lower risk of cardiovascular problems, for example. But it doesn’t completely disappear. In addition, the drop in hormones tends to cause that hot flash and other uncomfortable signs, at least for a while.
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Lifelong medical follow-up to prevent diseases is part of this care. “There are those who do genetic tests today to understand predispositions to diseases”, points out Nilka.
Challenge is to keep women active and healthy
Menopausal women today are sexually active, at the height of their careers, and often have young children. This is why managing symptoms is particularly important.
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“She can use a gel that will help with vaginal dryness and other specialties can help her keep the rhythm of life, without this phase – which lasts more than ten years – affecting her routine”, defends Nilka.