Upon entering menopause many changes occur, and symptoms may arise from estrogen deficiency. Some women may have no symptoms or only mild or brief ones, while others may experience severe symptoms that disrupt daily life. Hormonal changes during menopause can cause important symptoms as follows.
Changes in menstruation Menstrual patterns in women beginning menopause vary. Some may stop menstruating entirely, while others gradually have fewer periods until they stop, which is normal. However, any bleeding lasting longer than seven days or abnormal spotting requires thorough examination, with cancer considered until ruled out. Some women mistakenly believe these symptoms are normal for menopause and neglect proper testing, instead taking medications, supplements, or certain herbs to cleanse or detoxify the body, which can lead to complications such as abnormal bleeding or lower abdominal pain. By the time they see a doctor, the condition may have worsened significantly.
Hot flashes and night sweats result from changes in the autonomic nervous system. Hot flashes often start in the chest and spread to the neck and face, usually accompanied by sweating followed by chills. These symptoms can disrupt daily life and may disturb sleep when occurring at night.
Irritability Estrogen deficiency affects mood and mental state, causing irritability, mood swings, lack of concentration, headaches, fatigue, and depression.
Vaginal dryness In the reproductive system, estrogen deficiency causes vaginal dryness. Tissues and muscles around the urethra and bladder shrink and loosen, leading to burning pain during urination, frequent urination, urinary leakage when coughing, sneezing, or laughing, and increased susceptibility to bladder infections.
Fragile bones due to osteoporosis Normally, the body continuously builds new bone and breaks down old bone. In childhood and adolescence, bone formation exceeds breakdown. Studies in Thailand show Thai women reach peak bone density between ages 30-34. After 35, bone density slowly declines by about 0.3-0.5% per year. This gradual loss over 5-10 years can thin bones enough to cause osteoporosis, increasing fracture risk even from minor injuries. Osteoporosis usually shows no symptoms until fractures occur, making it a silent threat for menopausal women.
Possible coronary artery disease Estrogen decline affects blood lipids and vessels by increasing cholesterol and LDL (bad cholesterol) while reducing HDL (good cholesterol). This promotes blood clot formation on vessel walls, especially in coronary arteries, raising the risk of coronary artery disease.
Forgetfulness During menopause, memory may decline, including difficulty recalling names or important information. Alzheimer's disease, caused by brain cell degeneration, accounts for about 70% of dementia in the elderly. Its incidence rises sharply after age 65 and is more common in women. It is especially prevalent among those who do not regularly engage their brain. Menopausal women should keep their minds active with regular mental exercises.Such as doing mathor solving puzzles.
Insomnia Some may experience complete sleeplessness until dawn, while others have fragmented sleep with multiple awakenings per night. These symptomsprevent the brainfrom getting adequate rest, significantly impacting overall health and potentially leading to other illnesses.
Hormone replacement therapy is a menopausal treatment using hormone medications. In women, natural bio-identical estrogen hormones, structurally identical to the body's female hormones, are used, sometimes combined with progesterone, also similar to natural female hormones. Most often, natural forms taken orally are preferred. Doctors may also prescribe other forms such as skin patches, gels, vaginal suppositories, or nasal sprays, especially for patients with liver, gastrointestinal issues, diabetes, high blood lipids, or migraines.
In the caseof hormone replacement therapyfor men, testosterone can be given orally or by injection to improve overall health, comfort, and sexual function. However, sexual dysfunction has many causes, not solely related to hormone decline.
It can relieve menopausal symptoms, particularly reproductive issues like vaginal dryness.The vaginal liningmay become thin, lose elasticity and moisture, causing inflammation. Hormone therapy also helps reduce depression, fatigue, palpitations, and insomnia, while improving skin firmness and hydration, reducing skin inflammation, enhancing memory and concentration, and increasing bone density. However, effects vary depending on individual health factors.
Hormone replacement is given at low doses equivalent to normal levels, so side effects are minimal. In women, the most common side effect is vaginal bleeding, mostly during initial treatment, which usually resolves with continued use. Other possible side effects includebreast tendernessand migraine headaches, typically only when starting therapy.
However, hormone replacement alone does not guarantee better overall health; it is just one method of care. The key is lifestyle: regular exercise, healthy diet, avoiding high-fat foods, alcohol, smoking, sufficient rest, and stress avoidance. Combining these factorshelps womennavigate this critical life stage without problems.
Information provided by: Women's Health Center, Phyathai Phaholyothin Hospital