When does the menopause occur? 

The menopause usually occurs in a woman’s early 50s, but can happen earlier or later. Although the symptoms may go on for a number of years, menopause is said to have taken place when a woman has not had a period for 12 months.

Premature menopause or premature ovarian insufficiency (POI) can affect women in their late thirties. In some women this can occur as a result of some form of surgical or medical treatment, and sometimes it can run in families.

It can be very difficult for women to come to terms with a diagnosis of premature menopause, especially if they haven’t yet had a family and were hoping to do so in the future. Treatment in the form of HRT or combined hormonal pill to replace the ovarian hormones is recommended in these young women, both to help with any menopausal symptoms and to reduce the long-term risks such as cardiovascular disease and osteoporosis.

What are the symptoms?

– Changes in the Menstrual Cycle

The perimenopausal years may be marked by skipped menstrual periods, heavier or lighter than usual bleeding, and changes in the frequency of cycles.

“Classic” Menopausal Changes Hot flashes, flushes, or night sweats are the most common. Some experience a simple warming sensation throughout the body, Others feel acute flushes that begin with a sensation of pressure in the head similar to a headache, which then leads to a feeling of heat or burning in the face, neck, and chest, followed immediately by an outbreak of sweating. In most cases, hot flashes are mild and disappear after a year or two.

– Emotional issues 

Though there is no increase in serious psychiatric disorders minor emotional distress, however, may be a natural response to the changes a woman faces during this period. Hot flashes may keep one up at night, leading to chronic sleep deprivation which can reduce one’s mental and coping abilities. Vaginal changes that result in painful intercourse may interfere with one’s sexual pleasure and psychological health.

– Muscle Tone and Elasticity

Skin and mucous membranes in various parts of the body become drier. As the body ages and the estrogen level declines, the fatty layer beneath the skin surface that makes the skin appear supple and youthful begins to shrink from a loss of elasticity and moisture. The outer skin layer is now looser than the deeper layers, and begins to fold and wrinkle. The skin may also develop a rougher texture.

Vaginal Changes are the first sign of approaching menopause for some while many do not notice changes until five to ten years after menopause. As estrogen levels drop, the vulva and vagina lose elasticity, resulting in vaginal dryness, itching and a shrinking process known as vaginal atrophy Vaginal membranes also become thinner, hold less moisture, and lubricate more slowly. The thinner vaginal lining becomes more susceptible to tears, vaginal infections, and painful intercourse.

– Breast Changes

Glandular tissue shrink and loss of elasticity causes the breasts to droop and flatten. Nipples become smaller and flatter and may lose their erectile properties. Women who have been bothered by breast tenderness and cysts related to the menstrual cycle are often relieved to find that these symptoms disappear after menopause. Abdominal wall tone may lessen gradually, resulting in a protruding stomach

– Hair, Bones, and Teeth

Hair all over the body can change in texture and quantity. The increased effects of the body’s androgens can result in darker, thicker and wiry body hair on the pubis, underarms, face, chest, lower abdomen, and back. A loss of luster occurs because individual hair shafts begin to thin and dry as a result of hormonal changes. The replacement process for normal daily hair loss becomes slower.

– Bone strength

As estrogen and progesterone levels fall drastically, the bones begin to lose mass. Osteoporosis strikes at least half of all women age 50 and older leaves a woman vulnerable to bone fractures, especially in the hip, spine, and wrist. In fact, by the time a woman is 80, she may have lost 40 percent of her bone mass. Teeth and the mouth are similarly affected. Dental problems that can occur around midlife, such as receding gums or loose teeth.

Short term memory loss has been cited as a problem. Forgetfulness may be related to stress or lack of sleep.

Weight gain, is not directly related to menopause. There is a natural redistribution of fat over the abdomen and hips. Weight gain most likely results from reduced muscle tone, reduced physical activity, increased appetite .

– Cardiovascular Health

A women’s risk of cardiovascular disease rises dramatically after menopause .The younger a woman is when her ovaries stop functioning, the greater her risk for MI. Thus menopause itself is a risk factor for cardiovascular disease, along with high blood pressure, smoking, family history, poor diet, high blood cholesterol, diabetes, and obesity.

– Bladder Control

Women in peri – and postmenopause may experience mild stress incontinence, urge incontinence. These problems occur when declining estrogen levels cause cell deterioration and diminished muscle control in the urethra, bladder, and vagina. Repeated UTIs, are also common. The deterioration of cells in the urinary tract produces an easily torn and bruised surface, creating an hospitable environment for the bacteria