Transition

What is menopause?

The menopause occurs in the years surrounding the last menstrual period. Menopause is often confused with menopause, but these are not exactly the same terms. Menopause is the last time you menstruate, and it occurs on average around age 51. Menopause, on the other hand, often begins earlier, sometimes several years before menopause and can continue until your body has fully adjusted to the new hormonal balance.

The menopause usually begins between the ages of 40 and 60. In some women, menopause can begin before age 40, which we call early menopause. This can happen because of hereditary factors, medical treatments such as chemotherapy or radiation, or because the ovaries have been surgically removed.

What happens in your body?

During menopause, your body makes less and less estrogen, the hormone that controls your menstrual cycle. Your eggs run out, so no more mature eggs are released from the ovaries. As a result, your periods become more irregular. Sometimes your periods may be longer or shorter than you were used to, or you may bleed more or less heavily than before.

In addition, you may also experience other typical menopause symptoms, such as:

• Flushes: These are sudden heat attacks that often last only a few minutes. This may include sweating, and your skin may turn red. Many women also experience these hot flashes at night, which can lead to sleep problems.
• Vaginal complaints: Due to reduced estrogen production, the skin of the vagina becomes thinner and drier. As a result, you may experience itching or burning. It may also take longer for your vagina to become moist during sex.
• Mood swings: The hormonal changes may cause you to experience mood swings, gloominess or irritability. Forgetfulness and muscle aches are also common.

Medication and treatment of menopause symptoms

Many women experience menopause symptoms to varying degrees. For some women, the symptoms are mild, while others are severely restricted in their daily lives. Fortunately, there are several medications available that can help you reduce symptoms.

Female sex hormones

Female sex hormones, such as estrogen and progestogen, play an important role in your menstrual cycle. During menopause, estrogen levels in your body may drop. Medications containing estrogen can help replenish these reduced levels.

Transition Symptoms

If you suffer from menopausal symptoms such as hot flashes, sweating attacks, sleep problems, irritability, osteoporosis, mood swings or a dry vagina, estrogen hormones can provide relief. These hormones are prescribed only if your symptoms are severe and interfere with your daily life. However, women taking these hormones have an increased risk of breast cancer. Therefore, it is important to discuss with your doctor every six months whether the use of these hormones is still necessary.

Combination of estrogen and progestogen

Oestrogen hormones can be prescribed alone, or together with progestogen hormones. Progestogen hormones keep your endometrium from growing too much under the influence of estrogen. If your uterus has been removed, estrogen without progestogen may be prescribed.

Testrogen administration forms

Examples of estrogen without intake include estradiol nasal spray, patches or vaginal use. There are also estrogen hormones that you do take, such as estradiol, estriol and conjugated estrogens.

Progestogen for women with uteruses

If you still have a uterus, you often get a combination of estrogen and progestogen to prevent excessive growth of the endometrium. Examples of progestogens are dydrogesterone, medroxyprogesterone and tibolone. These combinations are often used for menopause symptoms. Women who still have their uterus usually get this solid combination of estrogen and progestogen.

Other medications for menopause symptoms

In addition to hormones, there are other medications that can help with menopause symptoms:

• Clonidine: Works against hot flashes and sweating attacks, but not other symptoms.
• Gabapentin: Reduces hot flashes in women undergoing antihormone treatments for breast cancer.
• Antidepressants: Drugs such as paroxetine and venlafaxine help with hot flashes and sweating attacks.
• Oxybutynin: Reduces hot flashes in women being treated with antihormones for breast cancer.

Contraception and pregnancy in menopause

Even during menopause, it is possible to become pregnant while you are still menstruating, even though it may not happen as often. Therefore, it is important to continue using birth control until you have not had your period for at least a year. After age 52, the chance of pregnancy is very small and you can stop using contraception in consultation with your doctor.

Advices for coping with menopause symptoms

If you find that you have menopause symptoms, there are several things you can do to relieve the symptoms:

• Lifestyle: Healthy eating, adequate exercise and quitting smoking can help you feel better. It also helps to watch your weight, because being overweight can make symptoms worse.
• Sleep: Try to take good care of your sleep. Avoid caffeine and heavy meals right before bed, and make sure you have a quiet sleep environment.
• Stress Management: The transition can be an emotionally challenging time. Talk to people around you about what you are going through, and try to reduce stress with relaxation techniques such as yoga or meditation.

When to see your doctor?

In most cases, menopause symptoms are annoying but harmless. However, there are situations in which it is important to consult your doctor, for example if your periods are extremely heavy or if you haven't had a period for more than a year and yet you start bleeding again.

The menopause is a natural phase, but that doesn't mean you have to walk around with severe symptoms. There are many treatments available, from medication to lifestyle advice, that can help you get through this period as pleasantly as possible. If you have questions or concerns, you can always contact us for more information and advice.