While menopause affects all women, its symptoms and timing vary greatly. With age there is a cessation of ovarian function, but it is not a sudden stop. Rather it is a waning over an average of two to 10 years.
Menopause occurs anywhere from age 40 to 60 with the average age of 51. (Obviously with a hysterectomy, menopause occurs regardless of age.)
Hot flashes and the vasomotor symptoms are the major complaint and occur in 75 to 80 per cent of women. These range from mild flushing in the chest, neck and face to intense heat and can occur several times a day, or even hourly.
The flashes can last for seconds or up to 10 minutes, with an average of four minutes. Typically, hot flashes can be experienced for three to five years, although some women are affected for up to 15 years.
Along with the vasomotor symptoms, there can be night sweats, sleep disturbances and personal dryness.
Menopause symptoms are certainly problematic for women. They can contribute to increased risk of incontinence, impaired concentration, irritability, mood swings, weight gain, fluid retention and even osteoporosis.
At one time hormone therapy was prescribed for menopause and its symptoms, which certainly made sense because it was replacing hormones that were being lost. However, the Women’s Health Initiative Study in the early 1990s showed that estrogen and progesterone therapy for menopausal women was linked to the increased risk of cardiovascular events.
As a result, hormone therapy was not considered appropriate for treating menopause.
Today, with ongoing studies and data gathering, hormone therapy is being used but for women with severe symptoms and no cardiovascular risk, and it is presecribed in lower doses, and for no longer than five years.
Antidepressant drugs are the newest agents used to treat hot flashes. They are usually used in lower doses than used to treat depression. They are very effective in that they act at the same sites in the nervous system that are affected by the declining concentrations of estrogen.
Venlafaxine, paroxetine and fluoxetine are the drugs most often used. Only once daily dosing is needed and if sedation is a problem, bedtime dosing is an option.
Of course there are a variety of non-drug approaches to coping with hot flashes, such as wearing layers of clothing that can be removed as needed, portable fans, sipping cool water, ice packs and relaxation techniques.
A food diary might help to identify foods or beverages that worsen the symptoms so they can be avoided.
Smokers experience menopause one to two years earlier than non-smokers, and alcohol and caffeine can have an impact on symptoms.
While family history is a definite indicator of the timing and severity of menopause and its symptoms, an active lifestyle and maintaining an ideal weight can help moderate symptoms.
A diet high in phytoestrogens such as soybeans, flax seeds and alfalfa sprouts may benefit some women, and ensuring a good calcium and vitamin D intake will help all women reduce their risk for osteoporosis regardless of their menopause symptoms.