Menopause does not come overnight: today there were menses, but in the next cycle they did not come – and you are free. Menopause is a process.
When does menopause occur?
A modern woman spends a third of her life in menopause. The average age of menopause is 50 years. 45 or 55 years is also the norm. If the ovaries “turn off” at 40-45 years old, we consider this early menopause. If up to 40 years, then we can talk about premature ovarian failure.
Hormonal changes begin already in the early phase of menopausal adjustment: the duration of the menstrual cycle begins to fluctuate within a few days. The ability to bear children is reduced. The first hormone to drop is progesterone. It is very important for women, as it ensures the preservation of pregnancy, acts not only on the uterus, but also on the mammary glands. In addition, it controls metabolic processes in adipose tissue, protects the brain and improves sleep quality, and has a general calming effect.
Therefore, during the transition period, women may experience sleep disturbances, panic attacks, and anxiety disorders.
At the next stage, in the late phase of the transition period, the production of estrogens, the main female hormones, begins to decrease. At this time, there are delays in menstruation up to 1-3 months or more, well-known and such frightening symptoms appear: hot flashes, often accompanied by profuse sweating, depressive mood, emotional lability. Previously, it was believed that such a syndrome lasts 1-5 years. Today we received the results of long-term studies – and it turned out that its duration can reach 10 years or more.
This is the phase of menopause, when the body gets used to living without ovarian hormones.
How to alleviate the symptoms of menopause?
30% of European women use menopausal hormone therapy (MHT) during menopause. They are better informed than Russian women about the benefits and safety of this method and understand that if the therapy is prescribed on time, chosen correctly, then it provides tremendous benefits.
Treatment initiated during the transition period can significantly slow down the development of age-related changes in organs and systems, reduce the risk of type 2 diabetes, the risk of coronary heart disease, and increase not only the quality, but also life expectancy. At this stage, we can simply prevent the female body from developing the full range of menopausal symptoms.
According to current protocols, this treatment can be prescribed during the transition period and in the first ten years of postmenopause in women up to 60 years of age. It is at this time that the benefits of hormone therapy usually outweigh the risks. It is not recommended to start this treatment in women over 60 years of age with a postmenopausal period of more than 10 years: the risks of adverse events increase.
Hormone therapy during menopause is prescribed after examination. Usually, ultrasound of the pelvic organs and mammography are performed. It is also desirable to look at the lipid spectrum of the blood and thyroid hormones. The dose of the drug is selected individually for each woman. Just like its form: tablets, gels, patches…
There is a contingent of patients with whom we are always more careful – these are women who smoke. Their vessels are worse, the risk of atherosclerosis and thrombosis is higher. They are most often prescribed transdermal treatment – so that hormones enter the body through the skin, which can significantly reduce risks. Transdermal hormonal preparations are also prescribed for those who are overweight, because obesity in itself is a risk factor for thrombosis and breast cancer.
If there is a risk of developing breast cancer, it is advisable to conduct a genetic examination.
If there were any complications during pregnancy, the pressure increased or there were edema, then the risk of cardiovascular diseases is increased. Such patients require a thorough examination, and therapy is selected with caution.
The behavior of the patient is also important. The patient should take the prescribed treatment on time and regularly come to the specialist for a scheduled examination. After the appointment, two or three months later, you need to meet and check whether everything is going well. This is very important for correcting treatment. In the future, control of treatment should be carried out once a year.
Learn more about women’s health at the Women First website, sponsored by Abbott.