The menstrual cycle is an episodic uterine bleeding in response to cyclic hormonal changes. Normally, a female had her first menstrual period for as early as 8 or 9 years old or as late as 17 years old. Her menstrual cycle has an average length of 28 days but can be as short as 23 days or as long as 35 days every cycle. There comes a time when the female menstrual cycle slowly stops known as perimenopause which usually starts between in the early 40s. At 55 years of age, menopause or the complete cessation of a woman’s menstrual cycle usually becomes evident. Menopause is determined by a woman’s menarche or the start of a menstrual cycle. The earlier you start menstruating; you are also likely to have an earlier menopause. It is because of the fixed number of egg cells in a woman’s ovary and the hormones that stimulates these cells to mature that determines a woman’s menstruation. So hypothetically, if your egg cells depletes, your menstruation stops.

Signs and Symptoms:

The earliest symptom of “the big change” is the irregularity of menstruation experienced in perimenopausal period. A woman with a regular menstrual period of 28 days can turn into 35 for long periods then relapsing back to her regular period. Sometimes she can have light bleeding then suddenly it becomes heavy. It commonly happens in the midforties where women approach menopause. Sometimes you can have regular bleedings but you can experience infertility. Infertility is the least expected sign of menopause of the woman. Most of these women find out that they’re in the premature menopausal period when they consult their physician or reproductive endocrinologist to know why they’re not getting pregnant. Other reproductive changes include the loss of libido and vaginal dryness. Pain during coitus due to lack of vaginal lubrication is the main culprit. Other uncomfortable signs include “hot flashes” or a sudden, transient feeling of heat or warmth that scatters all over the body producing a flushing (redness) noticeable on the upper body and face. Night sweats or nocturnal hyperhydrosis is not a sleep disorder, but a normal perspiration disorder that happens during slumber. Breast tenderness, tingling or itchy skin, weight gain, bladder incontinence, hair loss and increase in facial hair are all physical changes in menopause that is attributed to hormonal instability. Emotional signs include irritability, mood swings, anxiety, “brain fog” or confusion, memory lapses, fatigue and because of these physical and emotional changes, depression. Also, the most dreaded disease than can be attributed to menopause is osteoporosis. Since osteoblasts, the bone cells responsible for bone formation are proportional to a woman’s estrogen levels. If estrogen level drops, so as the woman’s bone formation, making her bones brittle and susceptible to pathologic bone fractures.

How to manage menopause:

There are no treatments for menopause since this is a normal degenerative process a woman should undergo. Medicines and hormonal replacement therapies however alleviate the woman’s discomfort during menopause. If your symptoms disturb your everyday living, you should consult your doctor for an estrogen replacement therapy. Estrogen replacement therapy is the medical use of synthetic estrogen, which may sometimes include progestins, administered through pills or other forms of drugs to replace hormones which the ovaries no longer produces either through surgical or natural causes. With ERT, a woman who suffers menopausal symptoms can no longer experience it at all. Studies show estrogen use started in the premenopausal period and continued later into life is associated with the highest preservation of bone density, although beginning ERT after age 60 has no significant findings (Journal of American Medicine, February 19, 1997.) For more information about ERT, consult your doctor now.