Menopause. Let’s face it: Nothing can stop “the great change”. You can duck, you can dive, but the hot flushes and raging hormones are inevitable, darli.
October marks World Menopause Month and the 18th is observed as World Menopause Day. This is an effort which seeks to raise awareness of menopause and the support options available for improved health and well-being.
But what is menopause?
Menopause is the physiological result of oestrogen production, explains Cape Town gynaecologist Dr Malikah van der Schyff. It is simply “a normal part of ageing and womanhood”.
Changes typically begin when a woman is over the age of 40, signalling the end of menstruation.
What to expect
Van der Schyff explains that the process of menopause occurs in three stages.
Stage one: Perimenopause
During perimenopause, oestrogen production begins to decrease. Perimenopause can last several years. “This is a time period commencing one year before [and ends] one year after menopause.”
Stage two: Menopause
This is the permanent cessation of menstruation; the permanent loss of ovarian function and reproduction, says Van der Schyff. “It is a functional consequence of declining hormones – oestrogen and progesterone.”
Many of the uncomfortable symptoms, such as hot flushes, peak during menopause.
Stage three: Postmenopause
During postmenopause, many of the menopausal symptoms begin to dissipate. As the woman ages and loss of oestrogen takes effect, health conditions can arise.
You are not alone
The process may be stressful, but all you can do is roll with the punches and learn how your body is going to change, advises Van der Schyff.
“It is just one of those inevitable things every woman knows will creep up on her.”
Van der Schyff answers some common readers’ questions about the dreaded change.
“Why me? I still feel young!”
Sleepless in the mess asks: I have less energy than I used to have just two years ago. I was like a machine at work, but I am tired now. In my 30s I could also just lay my head down and be lights-out. Now sleep is a pipe dream. But why me? I still feel young!
Van der Schyff answers: Menopause is the physiological result of declining oestrogen production. Eventually oestrogen production stops, the menstrual cycle stops and the woman enters menopause. The average age for menopause is 51.
Coupled with age, many postmenopausal women are also at an increased risk for other health conditions such as heart disease and osteoporosis.
“Why am I sweating buckets?”
Hot & Heavy asks: “I just feel hot. I am sweaty and hot, but my feet are always ice-cold. I can have socks on and a blanket over my feet, but I am sweating!”
Van der Schyff says: The exact cause of this is not known but it may be related to changes in circulation. It starts when blood vessels near the skin surface dilate and result in the woman breaking out in a sweat. It can often be exacerbated by stress, smoking, caffeine, spicy foods and alcohol.
“These were the best years of my life. Now I have a belly”
Spare tyre writes: “I have always been slim. I would eat very healthily and even lose weight. Now one slice of bread appears on my spare tyre on what feels like that same day. My belly is growing by the day and I hate it.”
Van der Schyff: The hormonal changes of menopause might cause weight gain around the abdomen. This is often labelled “the middle age spread”. Causes for this, other than hormonal changes, may be the loss of muscle mass, inadequate sleep as well as increased insulin resistance or diabetes mellitus. The average weight gain may vary from one to ten kilograms.
“I feel like a teenager again and can’t make sense of my emotions”
Anxious and angry writes: The anxiety is the worst part. I worry about anything. It starts small and then, suddenly, I am having a panic attack. I must take slow, deep breaths to calm down. It usually happens days before my period. Yes, I still get them.
Van der Schyff: Emotional shifts during perimenopause can cause sleep disturbance. Lack of sleep can lead to fatigue and a decreased sense of well-being. Hormonal shifts can also cause mood swings like those some women experience during the menstrual cycle – only less predictable.
During middle age, there are many emotional changes happening within a woman’s life and career and sometimes these emotional swings can erroneously be blamed on the perimenopause.
Women are advised to see a health practitioner if any symptoms have them worried about their physical or mental health.