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The hormones, estrogen and progesterone, regulate menstruation (estrogen regulates menstruation, while progesterone is more involved with preparing the body for pregnancy). When the ovaries start producing less of these two hormones, the term “peri-menopause” is used to describe symptoms that usually happens three to five years before menopause.
In fact, by the time a woman is in her late 30s, the ovaries start producing less progesterone and estrogen. By the time she is in her 40s, the post-ovulation spike in progesterone becomes less emphasized, signaling a decrease in fertility long time before she may notice any menopausal or “peri-menopausal” symptoms.
Ovarian failure can occur at any age – but very rarely – and often the doctor and patient will not know the reason for this. Some who experience ovarian failure may still have periods and some degree of fertility for a while.
Some infections like mumps and tuberculosis, malaria and varicella may also be a factor as well as genetics factors and being a twin.
Menopause marks the time in a woman’s life when her menstruation stops for one year and she is no longer fertile (able to become pregnant). In the UK, according to the National Health Service, the average age for menopause is 52, while in the US, the National Institute of Aging indicates it is 51. However, in places like India, about one fifth of women experience menopause much earlier, before the age of 41.
This is usually the first symptom where the menstrual pattern changes. Some women may experience a period every two to three weeks, while others will not have one for months at a time.
When a woman’s estrogen levels drop significantly, this in turn lowers her The signs and symptoms chances of becoming pregnant.
This is usually accompanied by itching
and/or discomfort. Some women may
experience dyspareunia (pain during
sex). Some will also experience vaginal
atrophy, where the vaginal wall thins
out due to shrinking of the tissues, as
well as decreased lubrication caused by
a lack of estrogen.
Approximately 30 percent of
women experience vaginal atrophy
symptoms early in their menopause,
while 47 percent do so during the
later post-menopausal period. There
are cases of women who experience
vaginal atrophy more than a decade
after their final period. Unfortunately,
the majority of post-menopausal
women are uncomfortable talking
about vaginal dryness and pain, and are
reluctant to seek medical help.
It is a sudden feeling of heat in the
upper body. It may start in the face,
neck or chest, and then spreads
upwards or downwards (depending
on where it started). The skin on
the face, neck or chest may redden
and become patchy, and the woman
typically starts to sweat.
The heart rate
may suddenly increase (tachycardia),
or it may become irregular or stronger
than usual (palpitations). Hot flashes
generally occur during the first year
after a woman’s final period.
If the hot flashes happen in bed, they are called night sweats. Most women say their hot flushes do not last more than a few minutes, but are extremely uncomfortable and disrupt their sleep.
Apart from night sweats, insomnia or anxiety may also contribute to difficulty falling asleep and staying asleep as women go through menopause.
Women tend to be more susceptible to urinary tract infections such as cystitis. Having to urinate more frequently may also occur; this may herald the start of an overactive bladder syndrome (OAB).
This often goes hand-in-hand with sleep disturbance. Experts say that most mood disturbances are triggered by poor sleep.
Some women also experience shortterm memory problems, as well as difficulty concentrating on something for long. Some women may not be able to learn as well shortly before menopause compared to other stages in life.
Bone loss from calcium loss (osteopaenia and osteoporosis) is due to the lack of estrogen during menopause, which may eventually cause fractures in the spine or long bones (fragility fractures).
More fat building up in the abdomen.
Hair loss (thinning of the hair) is another common occurrence.
This is also common. If left untreated, these symptoms will usually taper off gradually over a period of two to five years. However, in a small minority of women, symptoms can persist for much longer.
Dr Tseng's expertise covers urinary incontinence and pelvic organ prolapse, apart from that, his particular interest lies in the holistic management of Overactive Bladder Syndrome and other functional bladder conditions. With many years of experience in this field, he is committed to providing patients
