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Prepare for menopause now

Though a natural and inevitable course of life, menopause may still be baffling to some women.

By Celine Blancas-Evidente, M. D.


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.

Menopause 101

According to the American College of Obstetricians and Gynecologists (, 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.

Lifestyle adjustment

According to a survey by the North American Menopause Society (, 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:

Hot flashes or flushes are the most common menopause-related discomfort. Three in four women will experience this. The exact cause is not fully understood but is thought to be related to fluctuating estrogen levels or a result of changes in the part of the brain, called the hypothalamus, which regulates temperature. The hypothalamus mistakenly senses the warm body temperature and then sends signals to the body to cool down. The blood vessels in the skin dilate and there is more blood flow to dissipate heat. There is a sudden feeling of a wave of heat which can last anywhere from 30 seconds to 10 minutes. This causes the red or flushed appearance of the face or neck. Heavy sweating and cold shivering can follow. Hot flashes can appear from one to five years, or even longer.

Difficulty sleeping or sleep deprivation, in turn, is sometimes triggered by hot flashes at night.

Mood symptoms may be triggered by sleep deprivation. Depression is common. Some women also note memory issues. Vaginal dryness and discomfort during sexual intercourse occurs.

Urinary incontinence, vaginal or urinary infections are common. Urine leakage is associated with aging but partially affected by menopause. Lack of estrogen causes thinning of the urethral lining, and pelvic muscles grow weaker with aging.

Joint stiffness, aches and pains, and fatigue often occur.

Others features include weight gain and skin changes such as acne or wrinkles.

Osteoporosis and other risks

Menopausal women are at higher risk for osteoporosis because bone density is controlled by estrogen. Without it, bone mass is lost, and bones become weak and brittle. The first sign is usually an unexpected fracture, most likely in the bones of the hips, wrists or spine. A bone density test can be done, and once osteoporosis is detected, several options for treatment are available.

Women are also at higher risk for heart disease or stroke after menopause. Changing estrogen levels are thought to affect the body’s chemical balance and make women more susceptible to heart disease. Others attribute weight gain to an increased risk for hypertension and heart disease.

Practical coping strategies

- Exercise regularly for weight reduction, better strength and flexibility.

- Include Kegel exercises for strengthening the muscles of the vagina and pelvis.

- Eat well and have a healthy diet. Include calcium rich foods like low fat milk, yogurt, cheese.

- Get enough sleep.

- Limit caffeine and alcohol. Avoid smoking.

- Practice meditation other relaxation techniques to reduce stress.

- Pamper yourself, find a hobby or a pastime that you enjoy.

Get some doctor-certified advice on dealing with the symptoms of menopause when you grab a copy of the September issue of HealthToday from major bookstores and newsstands.

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