Removing the myths from menopause

By Clare E. Urwin

This is the first of a two-part series on the menopause. The writer is a nutritionist and health advisor based in Surabaya. All the writer's articles are interactive and readers are encouraged to ask questions or make comments through the writer's e-mail address: clareu@attglobal.net or features@thejakartapost.com.

SURABAYA (JP): The menopause is a very important time for a woman. Her body is going through changes and these changes can affect her whole life. How she feels about herself, her family responsibilities, social experiences and work performance.

Until recently, the menopause has been shrouded in secrecy. A taboo subject, surrounded by myths and ignorance, that was hardly ever mentioned in public, apart from the odd cruel joke.

Happily, the menopause is now recognized as just another step in the process of living. It's a perfectly natural occurrence and as we are all alive much longer than ever before, it stands to reason that "the change" can no longer be regarded as the beginning of the end in a woman's life.

Contrary to the old-fashioned idea that everything goes downhill after the menopause, most women today find that the years stretching ahead can offer fresh discoveries and bring many new challenges. There is still a lot of living to do!

However for some, the menopause can also bring numerous unwanted symptoms. Sadly, these often cause total misery. Frequent hot flashes during the day and sweats at night result in exhaustion and despondency.

A dry vagina and reduced libido can wreck sex lives. Insomnia leaves women wondering if their normal life is now over.

It's vital that we understand the menopause. Being familiar with the process will allow us to make informed choices about the health care options available. Furthermore, extra knowledge about our own bodies will bring added security and confidence.

Let's start at the beginning. What exactly is the menopause? Well, it's a process that usually takes about 10 years to complete and in most women it starts around the age of 45 and ends at 55.

Although the average age for the menopause is 50, it can happen as early as your late fifties and finish in your sixties. The timing of the menopause is usually genetically predetermined. However, smokers tend to have an earlier one and of course it can also take place when the ovaries are surgically removed or stop functioning for any other reason.

The menopause itself is merely the day menstruation stops. Something you can only be certain about, with hindsight. In fact, most of the symptoms experienced, occur during the perimenopausal stage, which means "around the time" of the menopause.

This phase covers about four years, spread equally before and after the "last" period. Women are also usually termed premenopausal in their mid to late forties and postmenopausal following the perimenopausal stage.

The menopause is a natural part of aging and it affects the balance of the sex hormones. The ovaries cease producing eggs while at the same time they slow down making estrogen and stop making progesterone.

In the past, a long list of hysterical characteristics were attributed to "the change", but medically there are only three classic short-term symptoms of the menopause. These are erratic periods, hot flashes and vaginal dryness. All three are caused primarily by the drop in estrogen and progesterone.

There are also two other recognized groups of symptoms that accompany the menopause; physical ones and mental ones. Physical problems consist of aches and pains, irritable bowel syndrome, urinary incontinence, constipation, fatigue, migraines and headaches. Some women also notice changes in their hair and skin.

The mental symptoms include anxiety, panic attacks, palpitations, irritability, aggressive feelings, mood swings, depression and confusion. Interestingly, these physical and mental problems are more related to dietary and lifestyle inadequacies, rather than to falling hormone levels.

Every woman entering the menopause will experience a change in her menstrual cycle. But, not all women will experience hot flashes or even notice vaginal changes. With regard to the other symptoms, this all depends on the individual.

The time leading up to the menopause is characterized by irregular periods. In fact, changes such as shorter or longer periods, heavier or lighter bleeding and varying lengths of time between periods may be a sign that the menopause is near.

Generally, menstruation times will become erratic approximately two years before the final period. However, some women may experience a longer premenopausal process than others.

Roughly 85 percent of all premenopausal and perimenopausal women have "hot flashes", as they are known in America, or "hot flushes", as they are called in the U.K. These are the most common symptom of the menopause and are more likely to be a problem in women who have had a hysterectomy, are thin, are young or don't sweat easily.

Women who are overweight when they are going through the menopause may have fewer problems with hot flashes and osteoporosis. Both of these problems are related to lack of estrogen which is stored in fat cells. However, heavy women also tend to be more at risk for estrogen dependent cancers.

Hot flashes can begin when periods are either still regular or have just started to become irregular. They usually stop two years after menopause but may go on longer.

A hot flash can feel different for each woman. Some experience a feeling of warmth in their faces and upper bodies, others experience sweating and chills. Sometimes they happen during the day, other times at night. In fact some women report that their bedclothes become soaked with sweat when they have a hot flash during the night.

Estrogen loss will also cause a change in the vagina and surrounding tissues. There is a loss of elasticity and a shrinkage in the cells. A thinning of the tissue lining the vagina may lead to pain during intercourse and vaginal dryness can also occur.

If this is rather grim reading, do remember that we are all individuals. Some women will sail through the menopause without really noticing anything, others will dread it and find it difficult to come to terms with.

Going through "the change" is nature's way of helping you adjust, both physically and mentally. It's all a question of perception. Your expectations of your menopause may well influence the kind of menopause you actually have.

The favored treatment for menopausal women is Hormone Replacement Therapy (HRT). Some women swear by it but they are greatly outnumbered by those who cannot tolerate it. Unfortunately, because many doctors are not widely educated about alternative treatments, women are often left to fend for themselves.

Menopausal symptoms, including those related to estrogen withdrawal, can be overcome by a natural method of dietary change, exercise, relaxation and specific nutritional supplements.

As well as helping with the short-term problems, this will also improve any woman's well-being and quality of life. Equally, it can compliment or substitute HRT. Next week, in part two, this natural method will be discussed. Good luck.