A Professor of Obstetrics and Gynecology at the University of Ilorin, Adegboyega Fawole, discusses menopause and its management with EMMANUEL OJO
What is menopause?
Menopause is the cessation of menstrual flow for at least six months in a woman who has had her period before, or in a woman who has a cycle longer than 28 days but has missed her period more than three times.
When is the normal onset of menopause in women?
Usually this happens between the ages of 45 and 55. Many women, most often, have complaints, and the most common is the irregularity of the menstrual cycle. Menstrual bleeding may also be light. This continues over and over again until it stops completely.
Can menopause begin prematurely or before the age of 45?
Yes. Premature menopause occurs when menstruation stops before the age of 40. This is abnormal and often associated with a family history, meaning it runs in the family.
Second, it could be a chromosomal problem, stemming from how the person is genetically modified.
Early menopause can also be due to certain diseases. For example, if a health problem results in the removal of the ovaries, the woman in question will enter menopause.
Are there bodily changes that accompany the onset of menopause?
Menopause is associated with the withdrawal of certain hormones in the female body, primarily estrogen and progesterone. The most dominant is estrogen, which gives a woman her allure, her softness, her curves. When menopause arrives, the level of estrogen is greatly reduced and this is the cause of all these major bodily changes. The breasts become saggy and every part of the body undergoes certain changes.
Sometimes the woman may have unexplained itchy blisters. The itching can be terrible in the private parts, i.e. the vulva area, and this requires treatment. Then this estrogen that is removed affects the bones in the long run. Bones that were strong before become thin inside and this makes them weak. Thus, they are prone to fractures, especially the hip bone. Estrogen also confers some level of protection against heart attacks; with its weaning, women are exposed to the risk of a heart attack, a little more than any other person. Usually, men are generally more prone to heart attacks than women, but a postmenopausal woman has the same level of risk as a man.
The body also shows signs of aging, like wrinkling of the skin – the skin won’t be as lush as it used to be and it will look a bit dry and all that. Then there may be some kind of hair loss from the scalp, especially on the sides; hairlines begin to recede like men’s, then the woman may experience a kind of mood swing, becoming a little more irritable or calmer.
The other more characteristic sign is what are called hot flashes. This is a situation where the woman experiences sudden intense heat from head to toe. And it doesn’t matter whether she’s sitting under a fan or an air conditioner. This sudden feeling of heat can last between a few seconds and two to three minutes. But the heat is so intense that sweat breaks out. These are called hot flashes and can be very upsetting for some women. This and other previously mentioned signs can begin about five years before full menopause.
What are the triggers of menopause in the female body?
The cause of menopause is like a thermostat. Women, in their anatomical makeup, have ovaries and these ovaries are programmed to start ovulating and then menstruating at a particular age, usually between 10 and 13 years old. It actually varies. We found that menstruation starts earlier in well-nourished girls.
At the same time, these ovaries are also programmed to stop working or ovulate at a particular age, which is between 45 and 55 years old. This is called the ovarian period and it is a natural occurrence.
Does menopause affect libido in women?
Sexual drive at menopause has been shown to be ambivalent. For some women, entering menopause brings some relief, psychologically, from anxiety or the risk of getting pregnant after sex. This freedom can lead to increased libido or sexual urge in these women.
On the other hand, some women, especially in our environment, see menopause as a time to take a break or stop having sex because menopause for them comes with a drop in libido and, in some cases, pain, because they dry out faster or they don’t even get wet at all or enough during sex.
The two extremes, explained above, can coexist or interchange in a woman.
How can women cope with the negative psychological effects of menopause?
For some, there might be a psychological upheaval about changes in their body and appearance. And often, when they are at home, their partners do not understand that these changes are happening, which complicates things, hence more complex. This can cause the woman to withdraw from people or even go out more frequently, especially to look and feel good. But it has been found that the more they mingle with people in the environment, the better it is for them. They need psychotherapy, guidance and understanding from immediate family, extended family and friends.
Much more than that, they may need to see a behavior consultant or behavior specialist – a clinical psychologist first, then a behavior specialist later. As I said, menopause can be accompanied by a lot of psychological exhaustion.
Second, they need certain substances to help them look good and stay healthy. They need certain creams for their body, and most of the time when intercourse gets difficult, they need to use an appropriate cream as a lubricant to make intercourse successful and satisfying. They also need to be careful what they wear. Menopause is no longer the time to wear high-heeled shoes, because just one slip can lead to a bad fracture. Instead, they are encouraged to wear comfortable flats or slippers. They don’t have much to prove to anyone.
They may need hormone replacement therapy to replenish their estrogen levels. It is available in the form of creams or tablets but should be used under the supervision of a gynecologist, as excessive use of these products can have adverse effects on the uterus and breasts. For example, too much estrogen can cause lumps to form on the breasts, and the lumps can become not only painless, simple lumps, but also complex lumps that can lead to cancer.
When the bones have problems, they are given things, like calcium, vitamin D, which help to harden and strengthen the bones. Of course, a number of our seniors use vitamins and supplements.
Menopause also coincides with the time when the body experiences certain age-related diseases. There are problems like high blood pressure, for example. Menopause is a reality that comes with age for every woman; the best approach is to prepare for the changes it brings. Those who cannot be coped with, seek help from family members, friends, groups, community, etc. If one must seek professional help, he must be from a professional in this field.
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