MENOPAUSE (CLIMACTERIUM)

Climacterium is a natural stage in life of every woman. Menopause symptoms appear often in advance and cause anxiety. Menopause treatment intends to provide the background for normal and productive lifestyle every woman should have after climacterium. How to distinguish menopause symptoms from symptoms of other conditions and diseases? What does an unnatural menopause mean? As well as what are the modern ways of menopause treatment? All those questions will be reviewed below.

The menopause or climacterium is a condition which occurs in women whereby they stop having periods and are no longer able to get pregnant naturally.

FACTS ABOUT CLIMACTERIUM

  • Less frequent periods over a few months or years before stopping, in rare cases they stop suddenly.
  • Menopause occurs in women between the ages 45 and 55. This is a result of the decline in oestrogen levels.
  • In UK, the average age of woman to reach climacterium is 51, however, 1 in 100 women experience it before the age of 40. This is known as premature menopause or premature ovarian insufficiency.

Peri-menopause refers to the time from the start to the last menstrual period, this can last on average of 4 to 8 years. Peri-menopausal symptoms can occur when periods are still regular but worsen in the premenstrual days. Climacterium is the last menstrual period, a woman is considered post-menopausal one year after menopause. Menstrual changes are common and it is common to have periods that are less frequent or irregular. More frequent periods or those that are heavy may not be normal and suggest pelvic or systemic pathology. Climacterium is said to have occurred when there has been no menstruation for a year.

Unnatural menopause can be caused by surgery in the removal of ovaries (oophorectomy), some breast cancer treatments, chemotherapy radiotherapy. It can also be caused by an underlying medical condition such as Down’s syndrome or Addison’s disease.

IF IT IS NOT CLIMACTERIUM, WHAT IS IT?

Depression, anaemia and hypothyroidism are the most reasons why periods may not occur; they are conditions that mimic the symptoms. Other reasons include unstable diabetes and medication such as the SSRI family of anti-depressants. Carrying out iron studies, erretin and or TSH level usually establish the diagnosis. Hair loss may be a sign of iron deficiency or hypothyroidism rather than climacterium.

MENOPAUSE SYMPTOMS

In the months or years leading to climacterium, these symptoms may be experienced:

  • Irregular periods
  • Vaginal dryness
  • Hot flashes
  • Night sweats
  • Mood changes
  • Sleep problems
  • Weight gain and slowed metabolism
  • Thinning hair and dry skin
  • Loss of breast fullness

Menstrual periods often occur every two or four months during peri-menopause especially one or two years before climacterium. Pregnancies are possible during irregular periods.

 

MENOPAUSE TREATMENT OPTIONS

  • Hormone Therapy: Depending on personal and family medical history, the doctor may recommend estrogen in the lowest dose needed to provide symptom relief. Progestin may also be added in the use of estrogen if the uterus is still present. Hormone therapy benefits the heart if started within five years after the last menstrual period.
  • Vaginal Estrogen: In relieving vaginal dryness, direct administration of vagina cream, tablet or ring to the vagina is advised.  This treatment releases a small amount of estrogen that is absorbed by the vaginal tissues. This treatment helps to relieve vaginal dryness, intercourse discomfort and some urinary symptoms.
  • Low Dose Antidepressants: A low dose of antidepressant is recommended to women who can’t take estrogen for health reasons. SSRIs classed antidepressants may decrease menopausal hot flashes.
  • Gabapentin (NEURONTIN): This is an approved drug for seizure treatments but has also been known to reducing hot flashes. This drug is useful in women who can’t use estrogen therapy and those who have migraines.
  • Medication to prevent or treat osteoporosis: Doctors may recommend medication for the treatment of osteoporosis depending on individual needs. These medications help to reduce bine less and risk of fractures.

CLIMACTERIUM DIAGNOSTIC SERVICES

  • Physical examination: The symptoms of menopause are usually enough to let women know they are achieving climacterium. Concerns of hot flashes and other symptoms can be discussed with the doctor.
  • Blood tests: This test is not necessary in diagnosing climacterium but can be carried out to check hormone levels such as:Follicle Stimulating Hormone and estrogen:
      • FSH and estrogen levels decrease as climacterium occurs.

    Thyroid Stimulating Hormone:

      Hypothyroidism cause symptoms similar to menopause.
  • Bone mineral density scans: This is another test that can be carried out through the use of x-rays.