MENOPAUSE

BY: DR BUVANESH M.D (MSMU

MOSCOW)
LOURDES MEDICAL SERVICES SDN
BHD

MENOPAUSE

Absence of menstrual periods for 12 months

It is the time in a womans life when the function of the ovaries

ceases

Perimenopause- time around menopause- refer to

menopausal transitional period

Postmenopausal- refer to the time after menopause has

occured

AT WHAT AGE DOES A WOMAN TYPICALLY REACH

MENOPAUSE?

Average age of menopause is 51 years old

Most women reach menopause between the ages
of 45 and 55, but menopause may occur as earlier
as ages 30s or 40s, or may not occur until a
woman reaches her 60s

Women tend to undergo menopause at an age

similar to that of their mothers.
Perimenopause, often accompanied by
irregularities in the menstrual cycle along with the
typical symptoms of early menopause, can begin
up to 10 years prior to the last menstrual period.

WHAT CONDITIONS CAN AFFECT THE

TIMING OF MENOPAUSE?
-CERTAIN MEDICAL AND SURGICAL CONDITIONS CAN INFLUENCE THE TIMING
OF MENOPAUSE.

Surgical removal of the ovaries- result in immediate menopause,

termed as surgical menopause or induced menopause

If a hysterectomy is performed without removal of both ovaries in a

woman who has not yet reached menopause, the remaining ovary or
ovaries are still capable of normal hormone production. While a
woman cannot menstruate after the uterus is removed by a
hysterectomy, the ovaries themselves can continue to produce
hormones up until the normal time when menopause would naturally
occur

Cancer chemotherapy and radiation therapy

Premature ovarian failure-Premature ovarian failure is defined as the
occurrence of menopause before the age of 40. This condition occurs
in about 1% of all women, related to autoimmune diseases or
inherited (genetic) factors

SYMPTOMS OF MENOPAUSE
Irregular vaginal bleeding-

Menstrual periods
(menses) may occur more frequently (meaning the cycle
shortens in duration), or they may get farther and farther
apart (meaning the cycle lengthens in duration) before
stopping.

Hot flashes and night sweats- A hot flash is a feeling of

warmth that spreads over the body and is often most
pronounced in the head and chest. A hot flash is
sometimes associated with flushing and is sometimes
followed by perspiration.

Vaginal symptoms- Vaginal symptoms occur as a result of

the lining tissues of the vagina becoming thinner, drier,
and less elastic as estrogen levels fall. Symptoms may
include vaginal dryness, itching, or irritation and/or pain
with sexual intercourse (dyspareunia). The vaginal
changes also lead to an increased risk of vaginal
infections.

Urinary symptoms-

increased risk of urinary tract infection, feeling the

need to urinate more frequently, or leakage of urine (urinary incontinence).
The incontinence can result from a strong, sudden urge to urinate or may
occur during straining when coughing, laughing, or lifting heavy objects.

Emotional and cognitive symptoms-Women in perimenopause

often report a variety of thinking (cognitive) and/or emotional symptoms,
including fatigue, memory problems, irritability, and rapid changes in mood.

Other physical changes- weight gain along with menopause. The

distribution of body fat may change, with body fat being deposited more in
the waist and abdominal area than in the hips and thighs. Changes in skin
texture, including wrinkles, may develop along with worsening of adult acne
in those affected by this condition. Since the body continues to produce small
levels of the male hormone testosterone, some women may experience some
hair growth on the chin, upper lip, chest, or abdomen.

COMPLICATIONS AND EFFECTS OF MENOPAUSE ON

CHRONIC MEDICAL CONDITIONS

Osteoporosis is the deterioration of the quantity and

quality of bone that causes an increased risk of fracture.

Osteoporosis treatment and prevention

measures are:
Lifestyle changes including cessation of cigarette
smoking, curtailing alcohol intake, exercising regularly,
and consuming a balanced diet with adequate calcium and
vitamin D.
Calcium and vitamin D supplements may be recommended
for women who do not consume sufficient quantities of
these nutrients.

Cardiovascular disease
Prior to menopause, women have a decreased risk of
heart disease and stroke when compared with men.
Around the time of menopause, however, a women's
risk of cardiovascular disease increases.
Coronary heart disease rates in postmenopausal women
are two to three times higher than in women of the
same age who have not reached menopause. This
increased risk for cardiovascular disease may be
related to declining estrogen levels.

TREATMENT OPTIONS FOR MENOPAUSE

Menopause itself is a normal part of life and not a disease that

requires treatment. However, treatment of associated symptoms is
possible if these become substantial or severe

Hormone therapy for menopause- Estrogen and progesterone

therapy

Hormone therapy (HT), also referred to as hormone replacement

therapy (HRT) or postmenopausal hormone therapy (PHT), consists
of estrogens or a combination of estrogens and progesterone
(progestin). Hormone therapy has been used to control the
symptoms of menopause related to declining estrogen levels such
as hot flashes and vaginal dryness, and HT is still the most effective
way to treat these symptoms

Hormone therapy is available in oral (pill), transdermal form (patch)

Oral contraceptive pills- another form of hormone therapy often

prescribed for women in perimenopause to treat irregular vaginal
bleeding.

Local (vaginal) hormone and non-hormone treatments- for relieving

symptoms of burning and vaginal pain

OTHER PHARMACEUTICAL
THERAPIES FOR MENOPAUSE
Alternative medical therapies for
menopause
-Plant estrogens (phytoestrogens,
isoflavones)
Antidepressant medications

Thank you