Menopause is a normal physiological process that usually begins between the ages of 45 and 55.
In this process, the decrease in the levels of hormones produced by the ovaries, estrogens and progesterone, causes changes in menstruation until it disappears completely.
In the Institute of Gynecology of Barcelona Dra. Gómez Roig we serve women with problems associated with menopause. In our Gynecology consultations we offer you these medical services with warmth and professionalism.
Your physical and emotional well-being is very important to us.
What is Menopause?
Menopause or climacteric is a stage of life in which the menstrual cycles disappear. That is, there is no period.
The reason this happens is that the ovaries stop working regularly. The ovaries, with age, stop producing correct ovulations. At the same time, they also stop secreting Female hormones called estrogens and progesterone.
The average age at which menstruation disappears is around 51 years.
Despite this, it is considered normal for it to occur between the ages of 45 and 55.
How can I know if I am Menopausal?
You can consider the possibility of being close to menopause when your menstrual cycles start to change.
Usually, the changes that occur in the period occur progressively.
At the beginning of this period the menses are less frequent, irregular, and also scarce. Despite this, some women may experience heavy bleeding during this period.
Any menstrual disorder may be due to a deficiency of hormones produced by the ovaries.
When a woman reaches menopause she may have:
- Irregularities in the period: periods with more or less frequency, for example, every 5 to 6 weeks.
- Having bleeding of less duration and quantity.
- Menstruations separated by 2 or 3 months without bleeding.
- Have symptoms of menopause, such as hot flashes or decreased mood.
In women who undergo a hysterectomy: removal of the uterus, if this is accompanied by bilateral adnexectomy: if the ovaries are also removed, the woman enters menopause abruptly. This type of affectation is called Surgical Menopause.
If, on the other hand, the ovaries are spared in the hysterectomy, the intervention does not influence the secretion of hormones and therefore does not occur.
In gynecological surgeries it is important to discuss with the doctor the need or not to remove the ovaries, due to its possible consequences.
If the withdrawal of the period occurs before the age of 45, we can talk about early menopause.
What will I notice when I reach menopause?
When a woman reaches menopause, it may happen that she has symptoms (clinical) or that she does not notice anything at all. The clinic is not always the same.
Some women have mild symptoms and others more severe.
As the years go by, they also change their characteristics and intensity.
Among the clinic that can appear we can highlight:
- Hot flashes: The hot flashes in menopause are like a wave of heat that starts on the chest and face. Later, this sensation can pass to the rest of the body. Usually, these can start as early as perimenopause.
- Night sweats: These are hot flashes that occur at night, while the woman is sleeping. These hot flashes can contribute to worsen or cause insomnia.
- The insomnia: Women may have trouble falling asleep or wake up very easily.
- Decreased mood and/or depression:Depression or anxiety can appear more easily at this time. Decreased libido also occurs regularly.
- Greater difficulty in concentration: Insomnia and the lack of sexual hormones can favor it. Some experts claim that estrogen is important for the proper functioning of the brain.
- Some memory decline: Not resting and the issue of hormonal deficit can also influence it.
- Dryness in the genitals and vagina: Lack of female sex hormones can cause the vagina and vulva to become dry and weak. The lack of lubrication also makes sexual intercourse difficult, usually causing discomfort.
How do I know if I am Menopausal?
Different tests can be used to find out if a woman is menopausal.
Using a blood test doctors can tell whether or not the ovaries are making hormones.
The hormonal study can warn and report that a woman has entered menopause.
The practice of a gynecological ultrasound can also help to see indirect signs of decreased ovarian function. Thinner lining of the uterus endometrium and absence of follicles in the ovaries, functional cysts due to hormones.
Normally the tests are not requested unless you debut in early stages, for example, before the age of 45, as well as in special situations.
Can I get pregnant?
A woman can get pregnant despite having irregular periods.
It is very important to use birth control whenever you have sex during perimenopause.
The advice given by specialist doctors is that only after a year of not having any period can we ensure that a woman is in menopause.
For this reason, only after a year without periods can you be calm and we can consider that a woman cannot get pregnant.
Should I go to the gynecologist if I don't have periods?
We always recommend that a woman see her doctor, regardless of age, to enhance her usual gynecological check-ups.
On the other hand, during menopause if you have symptoms or symptoms that bother you on a day-to-day basis, you should also consult a specialist.
The absence of cycles at a certain age is a normal process and not a disease.
Despite this, if a lady has uncomfortable hot flashes, insomnia, or depression, among others, it is common for her to consult her doctor to find a solution.
If your periods begin to change and you are under 45 years of age, you should also consult.
It should also be consulted if there is:
- Bleeding or periods more frequent than usual.
- Very heavy bleeding during her period.
- Loss of blood between your periods.
- It has been more than 12 months since you had your period and you start bleeding again.
When in doubt, it is always better to consult your doctor. Preventive medicine is very important in today's medicine.
Should menopause be treated?
We must treat menopause if it is accompanied by symptoms that interfere with the woman's usual quality of life.
It should also be treated if the specialist considers it as prevention of deficits derived from the absence of menstrual cycles. For example, affectation of the bones.
In women without symptoms and without pathology, treatment is not usually given.
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What diseases develop in Menopause
During the menopause some diseases can develop based on:
- Decreased estrogen hormone levels.
- Diseases that are associated with older ages coinciding with menopause.
Diseases associated with decreased hormones
The diseases associated with decreased hormones like estrogens are:
- La dry skin, so constant hydration is recommended.
- Vulvar dryness and a decrease in vaginal lubrication. This is associated with less elasticity of the skin of the vulva and vulvovaginal atrophy. Due to these changes, there is also a greater probability of pain with sexual intercourse. Decreased livid due to decreased estrogen level is also characteristic.
- Osteoporosis, such as decreased calcium concentration in the bones. Osteoporosis doesn't hurt. If joint pain appears, it is usually more associated with osteoarthritis, which also increases with age. The Osteoporosis must be diagnosed by means of bone densitometry, because if risk situations appear, preventive treatment can be given. Proper treatment of osteoporosis can prevent future fractures.
- Changes in voiding habits. With menopause there may be a more frequent need to urinate, having to get up at night, and a lack of control of the moment of urination.
- Mood swings or accentuation of psychological affectations are also more frequent. States of anxiety or depression can be accentuated. Lack of self-esteem and some more emotional irritability can also appear.
Diseases Associated with advancing age
With advancing age, and coinciding with menopause, the frequency of:
- Increased cholesterol, high blood pressure and diabetes. All these diseases are included in what is called the Metabolic syndrome. This syndrome can favor a greater risk of cardiovascular accidents such as heart attacks that also occur in women. A healthy diet, practicing sports and avoiding toxic habits help prevent these diseases.
- With age, the incidence of some cancers also increases, and for this reason it is very important not to stop doing medical check-ups and gynecological check-ups.
What are the treatments?
The treatments for menopause include:
Hormones (estrogen)
Estrogen is the most effective treatment to appease the bothersome symptoms of menopause.
Women who do not have a uterus can take estrogen alone. Women who have a uterus must take estrogen with another hormone called progesterone.
It is currently known that these hormones are effective and safe for women with symptoms between the ages of 40 and 50.
Hormones should always be given under medical prescription and justified indication.
There are cases that contraindicate its use, such as a history of breast cancer, a heart attack, a stroke or thrombosis.
Women with vaginal dryness can use the vaginal estrogen. This medication is applied directly into the vagina using a cream or suppositories.
Antidepressants
In cases of depression associated with menopause, this medication can be effective.
Antidepressants also improve hot flashes.
Changes in lifestyle
Changes in certain life habits may improve tolerance to menopausal symptoms. Stress and nervousness increase the frequency of hot flashes.
Avoiding coffee, tobacco, and alcohol can help you feel better.
Relaxing therapies are also helpful.
If you have the menopause, and you have doubts or concerns, do not hesitate to contact the Institute of Gynecology in Barcelona Dra. Gómez Roig. Its professionals, experts on the subject, will accompany you and inform you in a humane and professional manner.
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- About the Author
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Head of the Obstetrics and Gynecology Service at the Sant Joan de Déu Hospital in Barcelona. Associate Professor of Obstetrics and Gynecology and Coordinator of the Sixth Course of Medicine at the University of Barcelona, UB. Director of the Dra. Gómez Roig Institute and Coordinator of Obstetric and Gynecological Processes at the Corachan Clinic in Barcelona.