Menopause
Menopause is the period of time that elapses after the last menstruation, in which several important and assorted physiological changes occur that can interfere with the normal life of a woman. This last menstruation is only ascertainable after the event, and one year must go by without menstruations for us to be able to say that a woman has the menopause.
The changes that appear are due to the diminishing of the ovarian function, with the reduction of the oestrogen production. As such, changes do not appear suddenly. Some years before the last menstruation –menopause - some of them can arise. Menstrual disorders are common (more frequent cycles, more abundant menstruations), and in other cases, the lack of a menstruation is produced, which causes the consequent fear of the possibility (however rare) of pregnancy. The above mentioned changes can be: hot flashes, night-time perspiration, insomnia, being moody, irritability, skin dryness, variations in the hair distribution, osteoporosis, urogenital atrophy, vaginal dryness, dispaureny (painful sexual relationships), the appearance of cardiovascular disease, etc.
All of these disorders do not have to happen to every woman, and if they appear, their intensity can be very different. In some cases medical treatment is necessary and in others, hygiene and dietetic measurements are called for.
Once this critical age is reached it is important to go to the gynaecologist because it is a good moment to undergo a complete health research, evaluating the current symtomathology, preventing the alterations that can occur and at the same time, trying to prevent most frequent cancers in these ages.
When the symtomathology indicates that it is important that treatment takes place, we try to remedy the normal ovarian function by what is called hormone replacement therapy or HRT. This is formed by two hormones: oestrogens and gestagens, using them together or separately according to the clinical circumstances.
The presentation of these medicines can be different (tablets, patches, gels) and as the guidelines of the treatment are different (continuous or cyclical), the treatment can be perfectly adjusted to the needs of each patient. First of all we carry out research to make sure that there are no circumstances which make such treatment unadvisable.
In cases where the research suggests treatment by HRT is inappropriate or where the patient is afraid to take hormones, there are alternative treatments, and although they do not have the same effects as HRT they can reduce in a certain way the symtomathology. We are speaking about phitoestrogens which are natural compounds that some foods contain, the isoflavones which are the most powerful ones and which are almost exclusively found in pulses. The soya is the pulse containing the biggest amount of isoflavones.
Osteoporosis consists of a disorder in the bones due to the loss of calcium which reduces the osseous mass and density thereby altering the microstructure of the bones. Therefore, the bones become more fragile and the risk of fracture is higher.
There are several procedures that enable us to evaluate the osseous density: radiology, ultrasound scan, osseous densitometry DXA, etc, the latter being the most reliable one. Its result shows us the osseous mass level, which will be an indicator of the fracture risk.
There are risk factors that can encourage the appearance of post-menopause osteoporosis which are not modifiable (premature menopause, thin constitution, nuliparity, short height, ethnic origin, etc.), but there are other ones which are modifiable (tobacco consumption, physical inactivity, low calcium ingestion, alcohol abuse, caffeine abuse).
When an osteopeny (decalcification) appears in the densiometry, it is time to start the treatment and also to intensify the hygiene and dietetic measurements, which should be already carried out. There are several medical treatments and the doctor will determine which one is the convenient (calcium supplement, vitamin D, biphosphonate, etc).
When menopause is achieved, it can be a good moment to palliate the common alterations of this period and to prevent other illnesses in order to improve life quality (prevention of cardiovascular disease, early diagnosis of cancer of the breast, cervical cancer and colo-rectal cancer).
The life style change is important: giving up smoking, reducing the consumption of alcohol, practising physical exercise, keeping yourself at your ideal weigh are all factors in determining the health of every woman.
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