Marge is almost 60, but she remembers the months preceding her menopause. She had hot flashes—feeling very warm, looking very red and sweaty despite being in an air-conditioned room. At home, she also had problems going to sleep, or would wake up before dawn. She was irritable and the smallest things would set her off. Her husband and children avoided her to prevent arguments. She says she often felt nervous or sad, cried frequently, got depressed, and had no energy to do anything at all.
According to the American College of Obstetricians and Gynecologists (acog.org), menopause is the time in a woman’s life when she stops having menstrual periods. This marks the end of fertility or the reproductive years that began in puberty. The body undergoes several changes and a woman can no longer get pregnant. The ovaries make less estrogen, and when it’s no longer produced to thicken the lining of the uterus, menstruation becomes irregular and the menstrual periods eventually stop. The irregularity in menstrual periods can mean a duration of more than a week, can be more frequent or less often. There may be heavy bleeding or spotting in between. Menopause happens or is “complete” after one year without menstruation.
Perimenopause is the transition period approaching menopause, when changes and symptoms appear. Women can still get pregnant. Only after a full year has passed without a period one can say menopause has occurred and one’s reproductive capacity is gone.
The average age for menopause is 50 years. Some women may have it late in their forties or until they are mid to late fifties. The changes begin several years before the actual menopause and can last for months up to years. These changes appear as initial irregularities that occur gradually over time. Most women can only identify menopause after it happens, or in hindsight.
According to a survey by the North American Menopause Society (menopause.org), some women consider menopause as a medical condition requiring treatment while others view it as a natural transition to be managed by natural means. Women past this stage encourage others to look at menopause as the “beginning of many positive changes in their lives and health.”
Surgical menopause is brought about by treatments that can drastically affect estrogen levels. Examples are removal of the ovaries or chemotherapy. Symptoms are more severe because hormone levels decrease abruptly.
Spectrum of symptoms
Gay Mencias-Talapian, M.D., an OB-GYN from St. Luke’s Medical Center in Quezon City, says although menopause is a normal part of life, it helps if women know what to expect. The experience of menopause is different for each woman. When the ovaries change, hormonal imbalances occur. Some may go through with the changes without having any bothersome symptoms. Others may need a tremendous amount of adjustment. Common changes include: