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Symptoms of Menopause

Menopause, often referred to as menopause or menopause, is a natural stage in every woman’s life, marking the end of the reproductive period. Although it is a physiological process, it is associated with a number of hormonal changes that can cause a variety of often troublesome symptoms. Understanding these symptoms, the causes of their occurrence, and the available mitigation methods is crucial to maintaining a good quality of life during perimenopause.

Introduction to Menopause: What Every Woman Should Know?

Menopause is not a disease, but a natural biological process. It is defined as the last menstrual period in a woman’s life, after which there was no bleeding for at least 12 consecutive months. The average age of menopause in Poland is about 51 years, but it can vary from 45 to 55 years of age, and in some cases even earlier (premature menopause) or later.

Stages of menopause: Perimenopause, Menopause, Postmenopause – understand the differences

The menopause process is spread over time and can be divided into three main stages:

1. Perimenopause (Perimenopause): This is the transition period preceding the actual menopause. It can start even several years earlier (usually between the ages of 40 and 50) and is characterized by gradual cessation of ovarian function and fluctuations in hormone levels, mainly estrogen and progesterone. It is during this period that the first menopausal symptoms begin to appear, such as irregular periods, hot flashes or mood changes, which is a natural process during menopause. The length of perimenopause is individual and can last from a few months to even 10 years.
2. Menopause (menopause proper): As mentioned, this is the moment of the last menstrual period, confirmed by the absence of bleeding for the next 12 months. During this time, the ovaries stop producing eggs and estrogen levels drop significantly.
3. Postmenopause (Postmenopause): It begins after menopause and lasts for the rest of a woman’s life. Estrogen levels remain low, which can lead to long-term health effects such as an increased risk of osteoporosis or cardiovascular disease. Menopausal symptoms may still occur, although often with less severity.

The Role of Hormones: Estrogen and Progesterone in the Context of Menopause

Changes in the level of female sex hormones, produced mainly by the ovaries, play a key role in the menopause process:

• Estrogens are crucial for the health of the female body at every stage of life. It is a group of hormones responsible for the development and functioning of the female reproductive organs, regulating the menstrual cycle, maintaining skin elasticity, bone health, as well as influencing mood and cognitive functions. A drop in estrogen levels during menopause is the main cause of most symptoms.
• Progesterone: This hormone prepares the uterus for pregnancy and plays a role in regulating the cycle. Its levels also decrease during menopause, which contributes, m.in other things, to the irregularity of cycles during perimenopause.

Understanding these basic hormonal mechanisms is essential to understanding why specific menopausal symptoms occur and what options there are to alleviate them during perimenopause.

The most common early symptoms of menopause: signs that cannot be ignored

The first symptoms of menopause can be subtle and easy to overlook or attribute to other factors, such as stress or fatigue. However, being aware of these early signals allows for a faster understanding of the changes taking place in the body and taking appropriate steps.

Irregular menstruation: the first harbinger of menopausal changes

One of the earliest and most characteristic symptoms of perimenopause is changes in the menstrual cycle. They can take many forms, including hormonal changes that can be noticeable in the woman’s body.

• Shortening or extending the cycle: Menstruation may occur more often (e.g. every 21 days) or less frequently (e.g. every 35-40 days, or even every few months).
• Change in bleeding volume: Bleeding can become more sparse or, on the contrary, very heavy and long-lasting.
• Intermenstrual spotting: There may be some minor bleeding or spotting between regular periods, which is worth checking.
• Skipping some cycles altogether: Periods can disappear for a month or two, only to return later.

These irregularities are the result of hormonal fluctuations and the gradual cessation of ovarian function. It is important to consult any disturbing changes in the cycle with a gynaecologist to rule out other possible causes, such as uterine fibroids, polyps or inflammation.

Hot flashes (wary): how to deal with them effectively?

Hot flashes, also known as vars, are a sudden, intense sensation of heat that spreads throughout the body, most commonly involving the face, neck, and chest. They are often accompanied by redness of the skin, profuse sweating, and after the heat wave subsides, a feeling of cold and chills may appear, which are symptoms of menopause. Hot flashes can last from a few seconds to a few minutes and occur with varying frequency – from several times a month to a dozen or even several dozen times a day.

The cause of hot flashes are changes in the thermoregulation center in the brain, caused by a decrease in estrogen levels. There are many ways to deal with this troublesome symptom:

• Avoiding triggers: Caffeine, alcohol, hot spices, hot drinks, stress, tight clothes or staying in overheated rooms can intensify hot flashes.
• Dressing in layers: Wearing several layers of clothing allows you to easily adjust the clothing to the perceived temperature.
• Cool compresses and drinks: Applying a cool compress to the back of the neck or drinking cold water can bring relief.
• Relaxation techniques: Yoga, meditation, deep breathing can help reduce stress and the frequency of hot flashes.
• Regular physical activity: Moderate physical exercise can have a positive effect on thermoregulation.
• Phytotherapy: Some herbs, such as black cohosh or red clover, are traditionally used to relieve hot flashes (always after consulting a doctor).
• Hormone replacement therapy (HRT): In cases of severe symptoms, your doctor may consider HRT.

Night Sweats and Their Impact on Sleep Quality in Menopause

Night sweats are basically hot flashes that occur at night. They can be so intense that they lead to soaking of nightwear and bedding, which in turn disrupts sleep and leads to fatigue and problems with concentration during the day.

Strategies for managing night sweats are similar to those used for daytime hot flashes, with additional sleep hygiene tips:

• Keeping the bedroom cool: Regular airing, use of light bedding made of natural, breathable materials (e.g. cotton, linen).
• Avoiding heavy meals and alcohol before bedtime.
• Cool shower before bed.
• Keeping a glass of cold water by the bed.
• Use of mattresses and pillows with cooling properties.

Sleep problems during menopause can also have other causes, such as anxiety or restless leg syndrome, so it’s a good idea to discuss them with your doctor.

Physical Symptoms of Menopause: Changes in the Body and How to Relieve Them

The drop in estrogen levels affects many systems and organs in a woman’s body, leading to a variety of physical symptoms.

Changes in Weight and Metabolism: The Challenges of Menopause

Many menopausal women notice a tendency to gain weight, especially in the abdominal area (android obesity). This is associated with a slowdown in metabolism, a decrease in muscle mass and changes in the distribution of body fat caused by a decrease in estrogen.

To counteract weight gain and maintain a healthy weight, it is recommended to:

• Balanced diet: Rich in vegetables, fruits, whole grain cereal products, lean protein, healthy fats and soy-based protein. Limiting the intake of simple sugars, saturated fats and processed foods.
• Regular physical activity: Combining aerobic exercise (e.g., brisk walking, cycling, swimming) with strength training, which helps build muscle mass and boost metabolism, should be part of perimenopausal physical activity.
• Portion size control.
• Adequate hydration.

Vaginal Dryness and Intimate Discomfort: A Problem for Many Women

Vaginal atrophy (thinning and drying of the mucous membrane) is a common problem during menopause, resulting from estrogen deficiency. It manifests itself as dryness, itching, burning, pain during intercourse (dyspareunia) and increased susceptibility to intimate infections and injuries.

Methods of relieving vaginal dryness:

• Vaginal moisturizing preparations (lubricants): Used on an ad hoc basis, e.g. before intercourse, to reduce friction.
• Vaginal moisturizers with prolonged action: Used regularly, they help to keep the mucous membrane moisturized.
• Local estrogen therapy: Vaginal preparations (creams, globules, rings) containing low doses of estrogen, which act locally and are safe for most women.
• Avoid irritating cleansers and perfumed pads.
• Regular sexual activity: It can help keep the vagina elastic and lubricated.

Bladder Problems and Urinary Incontinence in Menopause

Estrogen deficiency also affects the tissues of the urethra and bladder, weakening the pelvic floor muscles. This can lead to:

• Stress urinary incontinence: Involuntary urination when coughing, sneezing, laughing or exercising.
• Urge incontinence: A sudden, strong need to urinate, difficult to control, can be one of the symptoms of menopause.
• Urinary frequency: The need to urinate more often, also at night (nocturia).
• Increased susceptibility to urinary tract infections.

The procedure includes:

• Kegel muscle exercises can support health during perimenopause. Regular strengthening of the pelvic floor muscles.
• Bladder training.
• Maintaining a healthy body weight.
• Avoiding diuretic drinks (coffee, alcohol).
• In some cases, pharmacological or surgical treatment in the perimenopausal period.
• Local estrogen therapy.

Skin Changes in Menopause: Dryness, Itching, Loss of Firmness

Estrogens play an important role in maintaining skin hydration, elasticity, and thickness by stimulating collagen and elastin production. Their decrease during menopause leads to:

• Dry skin: The skin becomes thinner, less elastic and more prone to dryness.
• Itching of the skin: It can be the result of dryness or changes in the innervation of the skin.
• Loss of firmness and the appearance of wrinkles may be the result of changing hormone levels during perimenopause. Reduced collagen production accelerates the aging process of the skin, which is a sign of aging in the female body.
• Slower wound healing.
• Increased sensitivity to the sun.

Skin care in menopause:

• Regular moisturizing: Use emollients and moisturizing creams rich in active ingredients (e.g. hyaluronic acid, ceramides, vitamin C, retinol – carefully and after consultation).
• Sun protection: Use creams with a high SPF all year round.
• Gentle cleansing of the skin.
• Drinking enough water.
• A diet rich in antioxidants.

Hair Loss and Changes in Hair Structure: An Aesthetic and Psychological Problem

Many menopausal women experience thinning hair, increased hair loss, or a change in structure (hair becomes thinner, drier, and brittle). This is associated with a decrease in estrogen levels and a relative predominance of androgens.

How to take care of your hair during menopause to minimize the effects of hormone loss?

• Gentle care: Avoiding aggressive hairdressing treatments, using mild shampoos and conditioners.
• Diet rich in vitamins and minerals: Especially biotin, zinc, iron, B vitamins.
• Scalp massage: It can improve circulation and stimulate hair growth.
• Hair strengthening preparations: Specialized rubs, ampoules and supplements are available (it is worth consulting a trichologist or dermatologist).
• In some cases, drug treatment (e.g. minoxidil).

Joint and Muscle Pain: Rheumatoid Complaints in Menopause

Joint pain (arthralgia) and muscle pain (myalgia) are common complaints reported by women during menopause. Estrogens have anti-inflammatory effects, and their deficiency can contribute to increased inflammation in the joints and increased pain sensation. They most often affect the knees, hips, arms, fingers and spine.

Joint and muscle pain relief:

• Regular physical activity: Low-impact exercises on the joints, such as swimming, yoga, tai-chi, walking, can help keep joints mobile and strengthen muscles.
• Maintaining a healthy body weight: Reduces strain on joints.
• Physiotherapy: Stretching and strengthening exercises, manual therapies.
• Warm or cold compresses.
• Non-steroidal anti-inflammatory drugs (NSAIDs): Used on an ad hoc basis to relieve pain (after consultation with a doctor).
• Supplementation: Glucosamine, chondroitin, collagen (effectiveness varies).
• HRT: It can provide relief for some women.

Palpitations and Other Cardiovascular Symptoms in the Menopause

Some menopausal women experience palpitations, which is an uncomfortable feeling of irregular or faster heartbeat. Although they are usually not dangerous, they can be disturbing. A decrease in estrogen can also affect the lipid profile (an increase in “bad” LDL cholesterol, a decrease in “good” HDL) and blood pressure, increasing the risk of cardiovascular disease in the long term.

It is important to consult a doctor about any disturbing cardiac symptoms in order to rule out more serious diseases. Prevention of heart disease during this period includes a healthy diet, regular physical activity, quitting smoking, controlling blood pressure and cholesterol levels.

Fatigue and Lack of Energy: How to Regain Vitality in Menopause?

Chronic fatigue, lack of energy, and general weakness are common complaints of menopausal women. They can be the result of sleep disorders caused by night sweats, hormonal fluctuations, stress, as well as other menopausal symptoms.

Ways to fight fatigue:

• Improved sleep quality: Implementation of sleep hygiene rules, treatment of night sweats.
• Regular, moderate physical activity: Although it may seem contradictory, movement gives you energy.
• Balanced diet: Avoiding processed foods and simple sugars, which can cause fluctuations in energy levels.
• Adequate hydration.
• Stress management techniques.
• Supplementation of vitamins and minerals (e.g. vitamin D, B vitamins, magnesium, iron – after consultation with a doctor and tests).
• Short naps during the day (if possible).

Emotional and Mental Symptoms of Menopause: How to Take Care of Your Well-Being?

Menopause is not only about physical changes, but also a period when many women experience mood swings and other mental problems.

Mood Swings, Irritability, and Tearfulness: Emotional Swings

Sudden mood swings, from euphoria to sadness, increased irritability, impatience, a tendency to cry for no apparent reason – these are common emotional symptoms of menopause. They are associated with fluctuations in estrogen levels, which affect neurotransmitters in the brain responsible for mood regulation (m.in. serotonin).

Dealing with mood swings is important, especially in the perimenopausal period.

• Acceptance and understanding: Knowing that these changes are hormone-related can help with their acceptance.
• Relaxation and mindfulness techniques.
• Regular physical activity: Endorphins released during exercise improve mood.
• Healthy diet.
• Support from loved ones.
• If necessary, psychotherapy or consultation with a psychiatrist.

Anxiety and Anxiety in Menopause: How to Find Peace?

Many menopausal women experience increased anxiety, anxiety, feelings of inner tension or panic attacks. They can be related to hormonal changes as well as concerns about aging, health, or changes in personal and professional life.

Methods of relieving anxiety:

• Breathing and relaxation techniques.
• Yoga, meditation.
• Regular physical activity is important to support a woman’s body at every stage of life.
• Limiting caffeine and alcohol is recommended to support the health of a woman’s body at every stage of life.
• Psychotherapy, including cognitive behavioral therapy (CBT).
• In some cases, pharmacological treatment (anxiolytics, antidepressants – prescribed by a doctor).

Problems with Concentration and Memory (“Brain Fog”) in Menopause

“Brain fog” is a colloquial term for problems with concentration, short-term memory, difficulty finding the right words or a general feeling of mental slowdown. Although the causes are not fully understood, it is believed that a decrease in estrogen, sleep disorders and stress play a significant role.

How to improve cognitive function:

• Mind Training: Solving crosswords, sudoku, learning new things.
• Regular physical activity: It improves blood flow to the brain.
• A healthy diet rich in omega-3 fatty acids, antioxidants.
• Taking care of the quality of sleep.
• Stress reduction.
• Good organization and task planning can help you manage the symptoms of menopause.

Menopausal depression: when to seek professional help?

Women during perimenopause and menopause are more likely to develop depression. Symptoms of menopausal depression can include persistent sadness, loss of interest, sleep and appetite problems, feelings of hopelessness, fatigue, difficulty concentrating, and even suicidal thoughts.

If these symptoms persist for a long time (e.g. more than two weeks) and significantly affect daily functioning, it is necessary to consult a psychiatrist or psychologist. Depression is a disease that can and should be treated (psychotherapy, pharmacotherapy), especially when it occurs after 12 months and menstruation has not stopped.

Changes in Libido and Their Impact on Sex Life During Menopause

A decrease in estrogen and testosterone levels (which is also produced in small amounts by the ovaries) can lead to a decrease in libido (sex drive) and a loss of interest in sex. Additionally, vaginal dryness and pain during intercourse can discourage sexual activity. These problems can affect a woman’s relationships and self-esteem.

How to take care of a satisfying sex life:

• Open communication with your partner.
• Treatment of vaginal dryness (lubricants, estrogen therapy).
• Exploring new forms of intimacy.
• Sexological therapy (individual or for couples).
• In some cases, your doctor may consider testosterone therapy (off-label, requires careful diagnosis and monitoring).

Long-Term Effects of Menopause on Health: What Should You Know?

Estrogen deficiency after menopause is associated with an increased risk of developing certain chronic diseases. Awareness of these risks and proper prevention are crucial for maintaining health in later life.

Osteoporosis: Risks and Effective Prevention After Menopause

Estrogens play a key role in maintaining bone mineral density. Their decline after menopause accelerates bone loss, which leads to osteoporosis – a disease characterized by weakened bones and increased susceptibility to fractures (especially of the vertebrae, hip and wrist).

Osteoporosis prevention:

• Diet rich in calcium and vitamin D: Dairy products, green leafy vegetables, fish, supplementation (as directed by your doctor).
• Regular physical activity: Exercises that weigh you down (e.g. walking, running, dancing) and strengthen your muscles.
• Avoid smoking and excessive alcohol consumption.
• Regular densitometric examinations (measurement of bone density) in women at risk.
• In the case of diagnosed osteoporosis – pharmacological treatment (e.g. bisphosphonates).
• HRT can prevent bone loss, which is especially important after menstruation has stopped.

Cardiovascular diseases after menopause: how to protect the heart?

Before menopause, estrogens have a protective effect on the cardiovascular system. Their decrease after menopause contributes to an increased risk of developing ischemic heart disease, heart attack and stroke. The lipid profile changes, blood pressure may increase and insulin resistance may increase.

Prevention of cardiovascular diseases:

• A healthy diet during perimenopause is crucial for maintaining well-being. Limiting saturated and trans fats, salt, simple sugars. Eating vegetables, fruits, fish, healthy fats (e.g. olive oil, avocado, nuts).
• Regular physical activity.
• Maintaining a healthy body weight.
• Quitting smoking.
• Regular monitoring of blood pressure, cholesterol and blood glucose levels.
• Treatment of hypertension, hyperlipidemia and diabetes, if present.

Risk of Other Chronic Diseases in Postmenopause

Postmenopause may also be associated with an increased risk of other conditions, such as:

• Type 2 diabetes: Metabolic changes and a tendency to gain weight can promote the development of insulin resistance.
• Some cancers: Although HRT may slightly increase the risk of some cancers (e.g. breast cancer with combination therapy), menopause itself and the aging of the body are risk factors. Regular preventive examinations (mammography, cytology, colonoscopy) are crucial.
• Neurodegenerative diseases (e.g. Alzheimer’s disease): Research suggests a possible link between estrogen deficiency and the risk of these conditions, although the mechanisms are not fully understood in the female body.

Menopause Diagnosis: When to See a Doctor?

The diagnosis of menopause is mainly based on medical history and symptom assessment.

How does a doctor diagnose menopause? Diagnostic Process

A doctor (usually a gynecologist) will conduct a detailed interview regarding:

• Menstrual history: Regularity, abundance, date of the last menstruation.
• Symptoms that occur: Type, intensity, frequency.
• Medical History: Other diseases, medications taken.
• Family history: The age of menopause in the mother and sisters.

A gynaecological examination can help assess the condition of the reproductive organs and rule out other causes of symptoms.

Hormonal tests in menopause: Are they necessary and what do they show?

Hormone levels (mainly follicle-stimulating hormone (FSH) and estradiol are not routinely necessary to diagnose menopause in women of typical age (over 45 years) with characteristic symptoms. Elevated FSH levels and low estradiol levels confirm the cessation of ovarian function.

However, these tests can be useful in unusual situations:

• In younger women (suspected premature menopause), reproductive function may disappear.
• In women who have had a hysterectomy (removal of the uterus) and who do not have menstruation as an indicator.
• In order to differentiate from other diseases.

Differentiating Menopause Symptoms from Other Conditions

Some symptoms of menopause may resemble those of other diseases, such as:

• Hot flashes: They can occur in hyperthyroidism, some cancers, with the use of certain medications.
• Irregular menstruation: They can be caused by polycystic ovary syndrome (PCOS), thyroid disease, uterine fibroids.
• Fatigue, mood swings: They can be accompanied by hypothyroidism, anemia, depression.

Therefore, it is important to consult a doctor in order to make a correct diagnosis and exclude other possible causes of the ailment, especially in the context of the loss of reproductive functions.

Methods to Alleviate Menopause Symptoms: From Lifestyle to Therapies

There are many ways to alleviate the troublesome symptoms of menopause, ranging from lifestyle modifications, through natural methods, to pharmacological therapies.

Diet and Lifestyle Changes: The Foundation of Well-Being

• The role of Physical Activity in Menopause: Regular exercise (at least 150 minutes of moderate activity or 75 minutes of vigorous activity per week) has numerous benefits: it helps control weight, improves mood, strengthens bones and muscles, reduces the risk of heart disease and diabetes, can relieve hot flashes and improve sleep quality.
• Healthy Diet in Menopause – What to Eat and What to Avoid?:
  • Include in your diet: Lots of vegetables and fruits, whole grain cereal products, lean protein (fish, poultry, legumes), healthy fats (olive oil, avocados, nuts, seeds), foods rich in calcium (milk and milk products, kale, broccoli, almonds) and vitamin D (fatty fish, eggs, fortified products).
  • Limit or avoid: Simple sugars, sweets, sweetened drinks, processed foods, saturated and trans fats, excess salt, alcohol, caffeine (if it exacerbates symptoms).
• Relaxation and Stress Management Techniques in Menopause: Stress can exacerbate many menopausal symptoms. Yoga, meditation, mindfulness, deep breathing techniques, tai-chi, aromatherapy, spending time in nature, hobbies can be effective.

Hormone Replacement Therapy (HRT): Benefits, Risks, and Contraindications

Hormone replacement therapy (HRT) involves the administration of oestrogens (alone or in combination with progestogen in women with a preserved uterus) to relieve menopausal symptoms. It is the most effective treatment for hot flashes, night sweats, and vaginal dryness. It can also prevent osteoporosis.

However, HRT also has some risks, m.in at every stage of treatment. increased risk of venous thrombosis, stroke, and with long-term use of combination therapy – breast cancer. The decision to start HRT should be made on a case-by-case basis, after a thorough assessment of the benefits and risks by a doctor, taking into account the woman’s health, the severity of her symptoms and her preferences. HRT is usually used at the lowest effective dose for the shortest possible time.

Contraindications to HRT include, m.in, undiagnosed vaginal bleeding, history or active thromboembolism, breast cancer, endometrial cancer, severe liver disease.

Phytoestrogens and Natural Methods to Relieve Menopause Symptoms

Phytoestrogens are plant compounds with a structure and effect similar to human estrogens, although much weaker. They are found, m.in, among others, in soybeans and its products, linseed, red clover, and black cohosh. Some research suggests that they may relieve mild menopausal symptoms, such as hot flashes. However, their efficacy and long-term safety are not as well documented as those of HRT.

Other natural methods may include:

• Acupuncture: It can help reduce hot flashes and improve sleep.
• Dietary supplements: E.g. vitamin E, evening primrose oil (effectiveness varies, it is worth consulting a doctor).

Treatment of Specific Menopausal Symptoms (e.g., Vaginal Dryness, Sleep Problems)

In addition to HRT and natural methods, there are also therapies that target specific symptoms:

• Vaginal dryness: Lubricants, vaginal moisturizers, topical estrogen therapy.
• Sleep problems: Sleep medications (short-term, under medical supervision), melatonin, cognitive behavioral therapy for insomnia (CBT-I).
• Urinary incontinence: Kegel exercises, urogynaecological physiotherapy, medications, treatments.
• Depression, anxiety: Psychotherapy, antidepressants and anxiolytics.

Menopause and quality of life: how to live life to the fullest after menopause?

Menopause is not the end, but a new chapter in a woman’s life. Although it can come with some challenges, the right attitude and self-care allow you to enjoy life to the fullest.

Acceptance of Change and Positive Attitude during the Climacteric

The key is to understand and accept that menopause is a natural process. A positive attitude, focusing on new opportunities, and taking care of your physical and emotional needs can significantly improve your quality of life.

Support from Relatives and Support Groups for Women in Menopause

Talking to your partner, family and friends about your feelings and needs is very important. Menopausal support groups (including online) can be a valuable source of information, understanding and peer support.

New Opportunities and Perspectives After Menopause

The postmenopausal period is often a time of greater freedom – children are already adults, professional career is stabilized. This is the perfect time to pursue your passions, travel, learn new things, volunteer or devote more attention to your own development.

Key Information about Menopause Symptoms

Menopause is a complex process that affects every woman differently. The most common symptoms are irregular periods, hot flashes, night sweats, vaginal dryness, mood changes, sleep problems, fatigue, joint and muscle pain, and skin changes. A decrease in estrogen after menopause increases the risk of osteoporosis and cardiovascular disease, which is especially important at any stage of life. There are many effective methods to alleviate menopausal symptoms, from lifestyle changes to natural therapies to hormone replacement therapy and targeted treatments, that can help manage menopausal symptoms. It is crucial to understand the changes taking place, take care of your physical and mental health, and consult your doctor regularly. Menopause is a new stage that, with the right approach, can be a time of fulfillment and well-being.