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Symptoms of Menopause
The most common symptom is hot flushes affecting the face and neck. These vary greatly in frequency and duration. For some women they are very brief and infrequent; others may have many episodes in a day that last for as long as 15 minutes.
Flushes do not indicate a rise in blood pressure, but merely a rise in the flow of blood through the affected parts. The cause of flushes remains uncertain, but it is thought they have something to do with oestrogen deficiency.
Other reported menopausal symptoms include night sweats, insomnia, headaches, weight gain and general irritability. Often these symptoms are severe enough in themselves to justify hormonal treatment.
Most of the physical effects associated with the menopause are due to oestrogen deficiency. Pubic hair becomes more sparse, the labia flatten, the walls of the vagina become thinner and smoother and the secretions diminish with the fall in oestrogen levels. The womb becomes smaller and its lining thin.
Ligaments that support the womb become weaker and, as a result, the tendency for the womb to ‘come down’ (prolapse) increases, especially if the pelvic floor muscles have been weakened in childbirth.
The changes in the vagina and the reduction in lubricating secretions can cause difficulty and discomfort in sexual intercourse. The reduction in acidity from lactic acid deficiency often leads to changes in the germ population of the vagina, and this can result in bladder infection (cystitis). Much of the bladder trouble in post-menopausal women is now recognised as originating in this way.
During the reproductive period, women are strongly protected by oestrogens against the major arterial disease atherosclerosis. As a result, heart attacks and strokes are rare in non-smoking women during this span of life. Unfortunately, this protection is lost after the menopause, and the incidence of these diseases soon rises to equal that in men.
Loss of bone bulk and osteoporosis is a natural feature of ageing, but loss of oestrogen accelerates the process in post-menopausal women. It is important to include enough calcium in the diet.
