Menopause: Welcome Aboard, Fasten your Seatbelt and Enjoy the Flight

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Jan 29, 2021
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Life is full of experiences. Every set of age group you encounter something that makes you sit around and wonder how you are going to deal with it. Women transition from childhood through menarche, which lasts very fast before they realize Menopause sets in.

Menopause comes with a lot of new experiences that sometimes leaves the other mouth open not knowing what to do next. For most women is as surprising as many other changes in their bodies, moods, psych, emotions and well being. Many think that menopause is that time of freedom, right? that time of seating down and counting your blessings, you made it.. they all wish it was just that, but sometimes it is not.

What do we see at hospital?
As a Doctor in Tanzania I and my colleagues we are seeing patient with various Medical Condition Menopause included.
1. Hello Doctor I don’t know what is happening to me, I am 52years old experiencing easy tiredness, sweating, inability to concentrate. I no longer sleeps as I used to and sometimes i have to take a medication just to help me sleep, nights are no longer easy.

I have to work up and change my bedsheets as that is not enough i have started to experience low back pains. Upon Medical evaluation, noted that she has stopped having regular menstruation for over 16months by now, We excluded many other causes like Thyroid disease and finally menopause was declared and management started.

She is on Medical Management for Menopause, on follow up care for three years now.Her sweating and backpain has disappeared, now she is sleeping without pills.

2. A young female patient and a mother to two children came at my clinic recently. She is 37 years old female who for some reason she hasn’t seen here menses for one year now. Before this she has been experiencing abnormal menstruation characterized by heavy bleeding that stirred three years after delivery of the second child, She had a family history, her mother died of ovarian cancer few years ago.

For many other reasons she had Surgery to remove the uterus and ovaries in 2020. During my evaluation she reported to have excessive sweating, easily bursting to anger shouting to everyone at work place and home. She is having reduced sexual desire and overtime she tries there was pain making her uncomfortable to plan next encounter.

Her husband who escorted her is also concerned. Upon evaluation and excluding all possible causes, Surgical Menopause was responsible. She is on Hormonal Replacement therapy and Symptoms has disappeared. Now she is happy and energetic enjoying at work place and home. The partner who accompanied her at clinic testified his unwavering support has contributed to not only improved sexual experiences but also general well being.

What is Menopause?
Menopause is simply defined as the complete absence of menstruation for twelve consecutive months in an aging woman. It is the end mark of women’s reproduction potential. Although women experience menopause in the late 40s and early or mid 50s, some may experience it earlier than before. Menopause is neither a disorder nor a disease, rather a natural aging process of all women.

In some women, it is a result of surgical removal of ovaries for different medical reasons and is referred to as Surgical Menopause. The period of transition towards menopause is called the perimenopause period, where you can still see irregular menses and it is the time when hormonal levels fall below' reproductive years' levels.

The period after menopause is called a post-menopausal period in which it carries significant risks for other disease conditions due to a similar aging process.

How do i know i have reached Menopause?
Menopause is accompanied by the common signs and symptoms that someone somewhere and at certain point in time may experience: hot flushes, mood swings, sleep difficulties, vaginal dryness, uncomfortable sexual intercourse, memory problems and change of body appearance, recurrent urinary tract infections or urine incontinence.

However, many women predominantly experience some signs and symptoms and not necessarily all of them. These may be solely related to menopause or be part of the aging process.

What Causes Menopause?
Menopause is caused by hormonal depletion, due to diminished and/or no production of hormones from the ovaries. The hormones are estrogen and Progesterone, which have the function of regulating menstruation and fertility.

The level of these hormones either naturally declines or may be due to surgical removal of ovaries or as a result of aggressive treatments like Chemotherapy and radiotherapy for different medical conditions.

How is life after menopause? What should I do?
Since menopause is inevitable , then coping with menopause as part of the management remains the greatest desire of all women. The coping mechanisms vary significantly depending on the severity of symptoms. Some coping strategies are symptom specific and also the response varies too from women to women.

Maybe there will be medical or non-medical interventions.

Lifestyle changes are among the key steps towards coping with Menopause. These include eating habits, stopping smoking or drinking alcohol, exercising and taking care of one's health.

These will also reduce the overall risks for other diseases that come with old age. I advise you to do the following as part of the coping process:

Generally
1. Eat a balanced and healthy diet. Fruits, vegetables and protein are included in every meal. Replacement of minerals and vitamins is key. Drink enough water.

2. Take physical exercise seriously, including running, walking, or dancing. You can also do some weight lifting or workouts. It is recommended that you do this 30 minutes for at least three days per week. It is also advised to take mind relaxing exercises like Yoga, Zumba and Meditations.

3. Have enough rest. This includes getting enough quality sleep. Aiming at Eight (8) Hours of quality sleep. For you to do so, have a good mattress and bed that gives you the comfort you want, a room that is well ventilated and not crowded, good and clean bedsheets.

4. Talk to peers, they say sharing is caring, thus discussing about what you are going through with others will provide support. Note that you may not be experiencing the same, or what helps others may not be working for you. Therefore, you should carefully take opinions carefully. These may be colleagues, friends or family.

5. See a medical doctor of your choice so that medical evaluation of your symptoms/signs may be done and that other age-related diseases may be excluded so that confirmation of your menopausal state may be done and proper advice and medical supportive treatment may be given.

This enables you to confirm what you are experiencing and if symptoms are severe and you are not comfortable with whatever you try. Doctors are trained to support you. He is the one to determine whether medical treatment for your symptoms is required.

6. About Hot Flushes, it is advised to wear light clothes, cool your room, void triggers like spicy foods, caffeine, hot drinks, smoking and alcohol. In addition, take cool showers, lose weight and control your stress and moods.

7. Vaginal dryness, pain during sex and sexual aversion can be addressed by talking to your partner, spending time together, using lubricants or hormonal replacement therapy, as sex should still be enjoyable even after Menopause.

Should I see a Doctor?
If necessary, your doctor may recommend Hormonal Replacement therapy which may either be in the form of Tablets, Pessary, Implant, Intrauterine, Skin Patch Or Gel. The Hormone may either be Estrogen alone or Estrogen and Progesterone and sometimes, depending on your sexual response to previous hormones, you may be offered testosterone tablets.

The Hormones will alleviate both Perimenopausal and Menopausal symptoms, including vaginal dryness and hot flushes. The symptom free life may take days or months depending on dose response and symptom severity. The Hormone Replacement Therapy comes with several risks that your doctor can discuss with you and all in all, the risk benefit ratio remains the key determinant to such use.

Do Menopausal women need any Support?
Support and Help for women in Menopause is very important. Society is responsible for offering support at the workplace or home. Men should equally do the needful and understand how to manage important menopausal discomforts like moods, vaginal dryness, low sex drive and the likes. The support from men improves women's experiences by far.

At the work place, women at menopause should be understood and given necessary support, like allowing/supplying them with extra uniforms, providing changing rooms, supporting their working environment by doing whatever is necessary.

Epilogue
Lastly, but not least, you need to be concerned about the symptoms of menopause since they occur at a similar age as other serious medical conditions like Diabetes, Hypertension, Cancer and Joint diseases occur. At the onset of these symptoms/signs, every woman should be aware and seek necessary evaluation and medical advice.

Coping and acceptance are a result of this knowledge of the condition, seeking and getting necessary medical advice and support, as well as psychosocial support. One should be diligent to differentiate the two and seek appropriate medical attention. And for you to cope with menopause is just to welcome it, and live with it.

Author; Dr. Mugisha Ntiyonza Nkoronko MD. Founder Netcare Foundation.
 
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