Studies help to demystify menopause

By Dewi Anggraeni

MELBOURNE (JP): If our foremothers can be believed, menopause is a woman's curse, along with menstruation and other things which only attach themselves to women. In this era of free- flowing information, it is easy to understand why these things, which are no doubt natural phenomena in a woman's life, are regarded with a combination of awe and suspicion.

One of the reasons is that they are usually accompanied by unpleasant symptoms, such as abdominal cramps with menstruation and a myriad of others associated with menopause.

Various studies around the world have helped to demystify menopause. One of these is conducted by a research team at the Key Center for Women's Health at the University of Melbourne. The study, called the Melbourne Women's Midlife Health Project, began five years ago, involving 2001 urban Australian-born women, then aged between 45 and 55 years. The core of the study is menopausal transition in women, and its correlation with their health, lifestyle and well-being.

One of the co-investigators, Professor Lorraine Dennerstein, finds that there has been an over-generalization of views that menopause is a time of considerable distress and ill-health. In reality, the majority of middle-aged women do not necessarily suffer from distress and ill-health. Women who are healthy, and happy with their lives, are less likely to be affected by negative symptoms reported by those who do not enjoy good health and general happiness.

Women seeking treatment for menopause generally complain of hot flushes, back pain and other joint pains. They also complain of depressive moods. Janet Guthrie, the team's project director, points to hot flushes as the only symptom directly related to menopause, caused by the change of hormone level prior to the final menstrual period. Joint and back pain are consequential to old age. And depression is a separate problem.

Interestingly, hot flushes afflict predominantly Caucasian women, 60 to 70 percent of whom suffer from them during their perimenopausal period. Guthrie speculates that perhaps diet has a great deal to do with this difference. Asian women eat more food that contains plant estrogen, which helps maintain the estrogen level.

However, the hormonal change in menopausal women makes them susceptible to osteoporosis, caused by a rapid decline in bone density, and cardiovascular disorders, caused by sudden change in the blood's lipid level. Here again, Caucasian women seem to fare less well compared to American Negro and Pacific women, who do not suffer as much from loss of bone density. Guthrie points to genetic factors behind this discrepancy in nature's fairness.

At present, the most common treatment given to hormone-related symptoms is hormone replacement therapy. And of course this should be accompanied by a modified lifestyle, including diet. Exercise is highly recommended, because it activates the production of HDL cholesterol, which reduces instances of cardio- vascular diseases.

And to delay the massive loss of bone density, weight exercises are recommended. One's diet should be aimed at maintaining the plant estrogen level. "High calcium intake and plenty of vegetables and soy products. Avoid a high intake of caffeine and a high fat diet," Guthrie emphasized.

Lifestyle does not only affect menopausal symptoms, it also plays a part in the timing of it. There has been evidence, for example, correlating women who smoke with an early onset of menopause.

Another inevitable symptom of menopause brought about by low level estrogen is vaginal dryness that often makes sexual intercourse unpleasant and painful. Provided there are no underlying psychological problems, this symptom can be easily overcome by using estrogen cream. In fact, the 220 women surveyed for this purpose reported that they had sexual intercourse twice a week and maintained their level of sexual fantasies.

While a modified lifestyle towards better health and better self-esteem can lead to a less symptomatic menopause transition for women, there are genetic factors that are not easily explicable. For instance, women who suffer from premenstrual tension and pain are likely to suffer from depressive moods during their perimenopausal period.

The good thing about today's modern medical technology -- even if you are one of those women susceptible to hot flushes, osteoporosis, depressive moods and back pain -- treatment is not so far round the corner. So bear up and charge on, since you can't turn back the time.