Menopause: What Does It Exactly Do to Your Body?

Meaning of Menopause and Age of Onset 

Menopause is a natural change, not a disease. It is inevitable for women. When it happens, there is a huge dropoff in hormone production in the ovaries (i.e. oestradiol and progesterone). This will cause the body's processes which depend on these hormones to change, most prominently the menstrual cycle. The ongoing menstrual cycles are maintained by the production of oestradiol and progesterone. During menopause, these hormones diminish. Menstrual cycles, which prepare the body to bear a child, stop. Therefore, the child-bearing ability is no longer present. Clinically, menopause is defined as the absence of menstruation for a year. 
 

For most women, the last menstruation occurs at 44 to 58 years old. This marks the onset of menopause. In rare cases, due to other reasons like surgeries or faults in the endocrine system, menopause comes earlier.

Causes of Menopause

Menopause is a natural process in most cases. The ovary ages, causing the cells inside to deplete and stop producing and releasing sex hormones, leading to menopause. 
 

However, there is a slim chance that menopause comes in other ways. Most causes are not known. The known causes include:

• Primary ovarian insufficiency: The ovary cannot produce enough sex hormones and this propels menopause to start earlier.
• Concomitant conditions: These include celiac disease, thyroid disease, diabetes mellitus, endometriosis, cancers, and some autoimmune disorders. Some conditions may also become the premise of premature menopause: the carrier of fragile X syndrome genes. 
• Treatments and surgeries: Some surgeries are likely to affect ovary function and hormone production, including the removal of ovaries and uterus, radiotherapy, and chemotherapy.
• Injury to the ovary

Inducers of Menopause 

Menopause may, sometimes, occur at an earlier age. The following factors might accelerate it:

• Smoking
• High body mass index (BMI)
• Being one of the twins

Signs and Symptoms of Menopause

Menopause, sometimes, can be troublesome. As the sex hormones produced by ovaries are involved in many body processes, their diminishment causes much disturbance in many females’ daily lives and for those around them. The more observable signs and symptoms of menopause include:

• Cessation of menstruation: This is the most prominent sign of menopause. When a female approaches menopause, the frequency of menstruation will decrease. The volume of blood will change. Upon menopause, menstruation will completely stop.
• Vasomotor symptoms: Examples like hot flashes, night sweats, and flushing are very common.
• Vaginal symptoms: These symptoms include vaginal dryness, painful intercourse, and urogenital atrophy.
• Psychological symptoms: It can be bothersome to the females experiencing menopause and those around them. The symptoms include mood swings, anxiety, depression, and insomnia.
• Weight gain
• Impaired cognitive function: Menopausal women will have difficulty concentrating and memorizing.
• Reduced sex drive
• Dry mouth, eyes, and skin
• Palpitations
• Loss of breast fullness

Long-term Effects of Menopause

Menopause symbolizes an enormous change in the female sex hormones, which are essential in a lot of processes in a women’s body. As the absence persists, the long-term effects will start to show up, which may include:

• Cardiovascular diseases: Menopause will increase the risk of atherosclerosis, acute myocardial infarction, hypertension, and other cardiovascular diseases. Female sex hormones can lower blood cholesterol and protect one from atherosclerosis. Therefore, postmenopausal females should consider avoiding the risk factors for cardiovascular diseases.
• Osteoporosis: Female sex hormones can help maintain the health of bone by preserving bone density. After menopause, bone density decreases. Thus, postmenopausal females should intake more calcium and vitamin D.
• Urinary incontinence: Vagina and urethra lose elasticity after menopause, leading to a stronger urge to urinate. What can be done is to train and strengthen the pelvic floor muscles so that one can hold urine longer in their bladder.
• The faster decline of lung function 
• Cataracts
• Periodontal disease

Diagnosis of Menopause

Menopause can be diagnosed with actual evidence, other than reporting signs and symptoms despite that being sufficient usually. Test confirming if the level of female sex hormones has decreased can be used to diagnose premature menopause.

• Blood test: The level of hormones in blood will be examined to see if there is a downward trend. If so, it can be an indication of a female approaching or currently being at the stage of menopause. The lipid level, thyroid, liver, kidney, and other organs' functions will also be examined.

Treatments of Menopause 

Menopause, in most scenarios, does not require medical treatment as it is just a natural process. However, sometimes, the impact of the symptoms of menopause, physical or mental, will have a large impact on daily life. That is when certain interventions or managements come into play: 

• Psychological therapy: Mindfulness and cognitive behavioral therapy may be able to relieve hot flashes and night sweats.
• Lifestyle modifications: Being physically active can help to relieve menopausal symptoms by raising endorphin levels in the blood and increasing bone density. Losing weight and stopping smoking may also be useful too.
• Alternative medicines: Soy isoflavones are useful to treat menopausal symptoms, mainly hot flashes, and vaginal dryness.
• Hormone replacement therapy (HRT): The therapy is to replenish the decrease in the production of female sex hormones, estrogen, and progestin. Estrogens include oestriol, oestradiol, and ethinyloestradiol. Progestins include progesterone, norethisterone, and dydrogesterone. However, the supply of these hormones will produce other side effects including stroke, blood clots, cardiovascular diseases, and breast cancer. Sometimes, testosterone may also be added to the therapy to enhance sexual function.
• Selective estrogen receptor modulators (SERMs): It is a class of drugs that can selectively act on estrogen receptors in different body parts to reduce the negative impact on some body parts like blood clotting or breast pain. It can relieve menopausal symptoms by resembling the effect of estrogen on other body parts. Examples include raloxifene.
• Antidepressants: Paroxetine has been approved to relieve the vasomotor symptoms of menopause. More SSRIs and SNRIs are waiting to be approved.

There are also some specific treatments for the symptoms:

• Moisturizers: It is indicated for the overall dryness of the vagina.
• Lubricants: It is indicated for the lack of lubrication during sexual intercourse.
• Vaginal estrogens: It is not the same as HRT as HRT is targeted to the whole body (systemic) while vaginal estrogen products are used locally in the vagina. It is used to target vaginal problems brought on by menopause.
• Vitamin D: It will help to reduce the risk of postmenopausal osteoporosis.
• Bisphosphonates: It is used to reduce the risk of postmenopausal osteoporosis. They include alendronate, risedronate, and ibandronate.