Those niggly menopause questions...


Menopause is a normal part of life. It is a physiological reality all women experience. 

Dr Tobie de Villiers, a gynaecologist based in Cape Town, clears up some confusion surrounding menopause. 

What is menopause? 
Menopause is the transition phase after a woman has had her last menstruation. The average age for the onset of
menopause is 51, but it can begin at any age between 45 and 55. Periods end because the ovaries no longer
release eggs for fertilisation every month. As a result, the production of the female hormone oestrogen stops. 

Menopause is an excellent opportunity for women to pay attention to their overall health. It can encourage women to better
their eating habits, lose weight, get fitter, stress less, and go for the relevant health screenings. 

What are the symptoms? 
The sudden absence of oestrogen has a huge impact on a woman’s body and emotions. The temperature-control centre
in the brain is affected, and that’s the reason you're feeling hot. This is the most common symptom, experienced by
75 to 80% of menopausal women. A hot flush usually lasts about five minutes, but some women experience a hot
flush every 15 minutes. 

Mood swings are also a problem, especially in women with a history of premenstrual syndrome or postnatal depression.
Night sweats, insomnia, joint pains, and forgetfulness are other common symptoms. As menopause progresses, your skin and hair gradually thin and you have a greater chance of developing a belly. The vagina wall also begins to thin, which can lead to sexual discomfort. There is also a greater risk of heart disease and osteoporosis. 

The best way to treat symptoms? 
Hormone therapy (HT) is the only treatment that offers dramatic improvement of all the symptoms. HT involves either
only oestrogen hormone therapy (EHT) or a combination of oestrogen and progesterone therapy (EPT). It’s available in
pill form, as a patch and in gels. Your hot flushes and night sweats should stop after 14 days of using HT. You’ll also sleep
better and be less moody, and your quality of life will improve. 

HT also reduces the possibilities of osteoporosis and heart disease if you start the therapy as soon as possible after
menopause. The sooner you start treatment, the more effective. 

Should all menopausal women have HT?  
No. Hormone therapy isn’t for everyone. But for those who can use it, it’s a safe and reliable option. 

Is HT safe? 
HT is perfectly safe, if used correctly. Dangers include:

  • A higher risk of breast cancer as time goes on.
  • A higher risk of blood clots, especially among patients older than 60. The risk is small and increases with age, but is at
    its greatest during the first year of treatment.
  • A greater risk of a stroke if you start HT after 60. The risk remains the same after the first year of treatment.

Who shouldn’t use HT?
HT isn’t for patients with a personal or family history of blood clots, strokes or breast cancer. It should also not be used for
the first time if you’re older than 60.

What are the side effects of HT? 
Bloating, tender breasts and mood swings.

Survive the symptoms

Hot flushes: avoid hot drinks and spicy food. Sit in front of a fan at home or at the office. Dress in layers, so that you can
take off or put on clothing as needed.

Night sweats: wear light pyjamas. Have a quick shower if you wake up drenched.

Sleep disturbances: make sure your bedroom is dark and cool. Avoid smoking, heavy meals, coffee and alcohol after 4pm,
and working late. Exercise for 30 minutes every day to curb insomnia. Avoid exercising late in the afternoon or at night. 

Mood swings: HT may help. If your moods swings are out of control, make sure that it isn’t depression.

Vaginal dryness: use over-the-counter internal creams or oestrogen cream.

Forgetfulness: make sure you get enough sleep and exercise every day.

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