Menopause without problems

A delicate period can be managed serenely, just keep the symptoms under control with the right remedies.

When we talk about menopause we commonly refer to the period of female life that starts from the last menstruation.

From a clinical point of view, however, menopause is part of a wider time window called “climacteric” and which begins a few years before the complete disappearance of the menstrual cycle.

It generally occurs between 45 and 55 years of age, while if it occurs before 40 it is called “early menopause“. In the latter case, the genetic component is important, even if it is not the only one involved.

Hormonal upheavals and what comes with them involve not only a physical change but also a psychological and emotional change that can be dealt with more or less serenely.

However, menopause should not be confused with amenorrhea. The latter indicates the lack of one or more menstrual cycles within the fertile phase, unlike menopause which instead marks the beginning of sterility.

Most frequent disorders

There are numerous symptoms of menopause that lead many women to experience it as a disease rather than as a natural change:

• Hot flashes
• perspiration
• sleep disorders
• migraine
• tachycardia at rest
• increased blood pressure
• weight gain
• vaginal dryness
• increased sensitivity to vaginal or bladder infections (cystitis)
• swelling
• urination disorders (incontinence).

Also from the psychological point of view, the end of reproductive capacity often creates considerable discomfort, as well as moments of irritability, nervousness, anxiety and depression especially in women who cannot deal with it actively and energetically. These can be associated with sexual disorders, which can manifest themselves for example with a decrease in sexual desire or libido in general.

Changes in sexuality can also be influenced by changes in the genitals that make sexual intercourse more painful: the vaginal mucosa becomes thinner and less elastic, lubrication may be poorer and the woman may feel itchy.

The origin of the disorders

Explaining hot flashes and other physical symptoms of menopause is easy. It is now known that everything depends on sex hormones or, better, on their lack.

The lack of estrogen and progesterone that marks the end of fertility involves the alteration of the thermoregulation system, hence the sensation of sudden heat and sweating, changes in the rhythm of sleep but also in fat metabolism, cardiac function, neuronal, musculoskeletal etc.

From this derives the appearance of the disorders described above and the increased risk of real diseases such as:

• osteoporosis
• hypertension
• infarct
• hypercholesterolemia
• hyperglycaemia
• overweight.

Even the habit of smoking would seem to influence the trend of disorders favoring the decrease especially of estrogen with consequences on ovarian function even in the perimenopausal period.

It is more complex, however, to understand the reason for psychological distress.

Not all women react in the same way to this radical change: some perceive it as a passage towards a phase of greater freedom and self-affirmation outside the family sphere.

For others, the awareness of the exit from the exclusive role of mother leads to emotional declines.

This causes us to resign ourselves to physical symptoms, sometimes considered an inevitable disorder.

As we have seen, even the sexual sphere can be affected by the changes that take place in the female body at the onset of menopause.

However, the end of fertility does not have to coincide with the disappearance or decrease of sexual desire: the couple can discover a new balance that makes relationships satisfying.

In reality, menopause is the ideal time to recognize one’s value in front of oneself and the world, rediscovering new roles from a social point of view and taking care of oneself.

Therefore, the “empty nest syndrome” is banned: there must be no sense of abandonment or uselessness. Enriching the day with interesting activities, taking care of nutrition, quitting smoking, limiting the use of alcohol and doing physical activity help to live this new phase in a more serene way and allow, at the same time, to limit the physical symptoms of menopause.

Quando dura la menopausa

Many women wonder “how long does menopause last?” or, better, “how long do the disorders associated with it last?”

On average, menopausal symptoms can last for about 7 years, although there is no one-size-fits-all response, as can the intensity with which they occur.

Women of African-American and Hispanic descent or, in general, all those who had their first menstrual cycle at a younger age seem to suffer more in terms of duration.

In addition, women who begin to feel the first signs already in perimenopause, or the transition phase during which the cycle becomes irregular, and then slowly appear, are predisposed to a more prolonged symptomatology.

But beyond these factors, much depends on how you deal with this change. Stress, depression and anxiety in fact would seem to prolong the persistence of symptoms in postmenopause.

Diet and physical activity are key

During the fertile period the action of estrogen protects the female body from a series of diseases ranging from cardiovascular disorders to osteoporosis.

With menopause this protection is lost and some risk factors for osteoporosis and cardiovascular diseases tend to become acute.

A balanced diet is essential to face menopause with as few ailments as possible.

Since being overweight is one of the biggest enemies of cardiovascular and bone health, we must first reduce the number of calories consumed daily, in order to avoid weight fluctuations as much as possible. The ideal is not to exceed 2,000-2,200 calories per day.

The diet must be varied and rich in simple foods. Complex sugars should be preferred, contained in pasta, rice, cereals and legumes.

Also make way for foods rich in plant estrogens (phytoestrogens), such as tofu and soy milk and proteins of vegetable origin, abundant in cereals and legumes, which, at the same time, provide fiber, iron, zinc and copper.

Instead, animal fats should be avoided, to which extra virgin olive oil or quality dietary oils, such as rice and omega-3 fats, present in fish, should be preferred.

Fruits and vegetables, on the other hand, provide vitamins and minerals. In particular, the calcium so important for the bones can be taken, rather than with milk and derivatives rich in cholesterol and triglycerides, with cabbage, chard, radicchio, dried fruit and legumes.

Even water, which in addition to ensuring proper kidney function can be a good source of calcium, must be taken in adequate quantities (1.5-2 liters per day).

Limit the salt, avoiding canned foods, sausages and add it to dishes. Spices, caffeine and alcohol are also to be avoided, because they can trigger hot flashes.

The following table summarizes the foods to prefer or avoid in menopause.

On the other hand, physical activity helps burn excess calories, limiting weight gain, but not only. It is optimal for preventing cardiovascular diseases, osteoporosis and improving mood.

Long daily walks (30-45 minutes) help to lose a few pounds and improve the quality of life.

Peace of mind

During menopause, taking care of your mind is just as important as taking care of your body. For this reason, relaxation and meditation techniques, such as yoga, can be useful.

By helping to combat anxiety and tension, they counteract the emotional disorders typical of this phase.

Even the interaction with those around us is not to be underestimated. Sharing your problems with family and friends helps you stay abandoned and overcome the crises associated with menopause.

Women’s friendly hormones

Sometimes, however, acting only on lifestyle is not enough to counteract the symptoms of menopause.

If necessary, the doctor may prescribe hormone-based therapy, the so-called hormone replacement therapy. The administration can take place through pills, patches, gels or nasal sprays and allows to reduce the number and intensity of hot flashes, appease sweating, redness in the face and insomnia.

Anxiety, depression and vaginal discomfort can also be alleviated. In addition, women undergoing hormone replacement therapies reduce the cases of bone fractures and colorectal cancer.

Only the doctor can prescribe this treatment, which, in any case, should last only as long as necessary to resolve the symptoms of menopause.

Some recent research has shown negative effects, such as increased incidence of breast cancer, stroke and venous thromboembolism.

However, a hormone therapy based on drospirenone, a synthetic estroprogestin that has a good tolerability profile, has recently been developed.

According to some research, the same hormone is able to offer, associated with estrogen, protection against cardiovascular risk.

During hormone replacement therapy it is necessary to undergo regular check-ups, to be planned from time to time with your trusted gynecologist.

Combinations of herbs (cimifuga, evening primrose, clover and ginseng) and antidepressants can also help relieve some symptoms.